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Nursing Semester 2 > Monica - Week 10 - Exam 3 > Flashcards

Monica - Week 10 - Exam 3 Flashcards

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1
Q

what is asthma?

A

chronic disorder of airway; bronchi/bronchioles become narrowed

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2
Q

what are the characteristics of asthma?

A

inflammation, swelling, and mucus production; bronchospasm (acute narrowing)

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3
Q

what are the 5 asthma triggers?

A

o allergens (dust, grass)
o air pollutants (perfume, smoke, exhaust)
o respiratory infections (exacerbate asthma → airway narrowing)
o GERD (exacerbate → weak lower esophageal sphincter → aspirate into bronchioles)
o exercise (loss of heat/H2O, cold/dry air)

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4
Q

characteristics of an asthmatic airway.

A

relaxed smooth muscles; wall inflamed and thickened

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5
Q

characteristics of an asthmatic airway during attack

A

tightened smooth muscles, air trapped in alveoli, and wall inflamed and thickened

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6
Q

where are beta-1 receptors located?

A

the heart

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7
Q

what occurs when beta-1 receptors are activated?

A

↑ contractility, ↑ HR, ↑ conduction

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8
Q

where are beta-2 receptors located?

A

kidneys, vascular and non-vascular smooth muscle

***beta-2 blockers affect the lungs

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9
Q

what occurs when beta-2 are activated?

A

vasodilation

***beta-2 blockers affect the lungs

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10
Q

T/F beta-1 blockers may affect beta-2 receptors

A

TRUE

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11
Q

what do selective beta-2 adrenergics do?

A
  • stimulates beta-2 receptors → bronchodilation
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12
Q

what are the two selective beta-2 adrenergic drugs?

A

albuterol and salmeterol diskus

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13
Q

what are two characteristics of albuterol?

A
  • short acting drug

- “rescue medication”

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14
Q

how does albuterol work?

A
  • facilitates mucus drainage

- inhibits release of inflammatory chemicals

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15
Q

how long does albuterol work?

A

2 - 6 hrs

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16
Q

what are the AEs of albuterol?

A

nervousness, palpitations, and tremors

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17
Q

T/F: albuterol is the drug of choice in acute bronchospasm

A

TRUE

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18
Q

salmeterol is a ____ acting drug

A

long - not used for acute episodes

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19
Q

how long does salmeterol work?

A

up to 12 hrs

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20
Q

what is the indication for salmeterol diskus?

A

asthma prophylaxis and long-term therapy for COPD

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21
Q

what do leukotriene receptor antagonists do?

A
  • leukotrienes released w/ exposure to allergens

- brochoconstriction, airway edema

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22
Q

what are leukotrienes?

A

inflammatory chemicals that cause the airway to tighten

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23
Q

what is the leukotriene receptor antagonist drug?

A

montelukast

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24
Q

how does montelukast work?

A
  • bind to leukotriene receptors
  • vasodilate airway muscles
  • ↓ airway edema
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25
Q

what are the indications for montelukast?

A
  • prevention and tx of chronic asthma

- prevention of exercise-induced bronchoconstriction

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26
Q

what ware 5 ways to reduce or avoid triggers that can cause symptoms of attacks?

A
  • Keep windows closed during pollen season
  • Clean home environment
  • Reduce pet dander
  • Cover nose and mouth in cold environments
  • Control heartburn and GERD w/ meds
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27
Q

what are the two different types of medications used to manage attacks and when are they used?

A
  • short term: acute attacks

- long term: management

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28
Q

how is chronic obstructive pulmonary disease (COPD) described?

A
  • persistent airflow limitation - chronic bronchitis and emphysema
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29
Q

what are the 2 characteristics of chronic bronchitis?

A
  • cough and sputum production

- occurs for at least 3 mo. in a 2 year period

30
Q

what are 3 characteristics of emphysema?

A
  • chronic inflammation
  • loss of elasticity of bronchioles and damage to alveoli
  • air trapping, ↓ perfusion, ↓gas exchange
31
Q

what are the risk factors for COPD, emphysema, and chronic bronchitis?

A
  • exposure to cigarette smoke, fumes, dust, chemicals, air pollutants
32
Q

what are all the clinical manifestations of COPD? (10)

A
  • chronic cough
  • sputum production
  • dyspnea
  • barrel-chest
  • wheezing
  • clubbed fingers
  • fatigue and weakness
  • activity intolerance
  • gas exchange abnormalities
  • ↑ susceptibility to infections
  • exacerbations
33
Q

health promotions and lifestyle modification to prevent tx of complications and maintain lung capacity

A
  • Smoking cessation and avoidance of 2nd hand smoke
  • Breathing exercises (pursed lip breath)
  • Nutrition (takes energy, smaller, frequent meals, high caloric high protein intake; ↑ mucus ↓ taste)
  • Increase fluid intake (dehyrdation, liquid secretion)
  • Exercise (last in day before meals)
  • Prevention (flu /pneumonia shots)
  • Low level oxygen therapy (85 - 90% O2 sat)
34
Q

T/F: COPD pts are accustomed to CO2 drive so too much O2 may stop drive

A

TRUE

35
Q

what do anticholinergics target and what do they do?

A
  • acetylcholine receptors on bronchial tree

- acetylcholine binding → bronchial vasoconstriction

36
Q

what is the short acting anticholinergic?

A

ipratropium inhaler

37
Q

when is ipratropium inhaler indicated?
what is it administered with?
how many times is it administered?

A

o relieves and prevents bronchospasm of asthma/COPD
o administered w/albuterol (DuoNeb)
o up to 4 or more times per day

38
Q

what is the long acting anticholinergic?

A

tiotropium dry powder inhaler (DPI)

39
Q

when is tiotropium dry powder inhaler used? and what is the indication?

A
  • daily dosing

- maintenance/prophylaxis of bronchospasm w/COPD

40
Q

what are the 3 different inhaler corticosteroids?

A

fluticasone dry powder inhaler (DPI) + fluticasone/salmeterol (Advair) + fluticasone/vilanterol (Breo)

41
Q

what are the four characteristics of fluticasone dry powder inhaler (DPI) ?

A

o anti-inflammatory o ↓ edema and mucus secretion o long-term management of asthma or COPD
o ↓ frequency and severity of asthma attacks

42
Q

what kind of combo are both fluticasone/salmeterol (Advair) + fluticasone/vilanterol (Breo)?

A

combo corticosteroid and bronchodilator

43
Q

what are the AEs of corticosteroid inhalers?

A

HA, hoarseness, hyperglycemia,

oral/esophageal candidiasis

44
Q

T/F it’s important to rinse mouth after use of corticosteroid inhalers?

A

TRUE

45
Q

what are the names of the systemic corticosteroid drugs?

A

methylprednisolone (IV → ST)

perdnisone (ST/LT)

46
Q

what is the indication for systemic corticosteroid?

A
  • anti-inflammatory
  • short term tx for acute asthma and COPD
    exacerbations
47
Q

what does systemic corticosteroid do?

A

↓ mucus production and edema (swelling/↓ airway constriction)

48
Q

for how long are systemic corticosteroids prescribed?

A
  • prescribed for 5 to 7 days -tapering dose ↓ to prevent adrenal insufficiency
49
Q

what are the AE of systemic corticosteroids?

A

hyperglycemia, euphoria, depression, HTN, ↓ wound

healing, ecchymoses, peptic ulceration

50
Q

what is the purpose for pulmonary function tests? (PFT)

A
  • differentiate b/t obstructive diseases
  • disease progression, assess bronchodilator response
  • measure lung volumes and airflow
  • depends on age, weight, height, gender
51
Q

what do PFTs measure?

A
  • total lung capacity
  • residual volume (air left after expiration)
  • forced vital capacity (amt air that can be quickly and forcefully exhaled before taking another breath)
52
Q

what are the 3 characteristics of acid-base balance?

A
  • metabolic and respiratory processes maintain H+ levels
  • pH is a measure of acidity or alkalinity
  • imbalances are a sx of an underlying health problem
53
Q

what are the 3 mechanisms to regulate the acid-base balance?

A
  • buffer system
  • respiratory system
  • renal system (metabolic system)
54
Q

how does the buffer system work?

A
  • neutralizing strong acids to weaker

- primary buffers HCO3- and phosphate

55
Q

how does the respiratory response work?

A
  • CO2 removed during exhalation
  • hypoventilation → retain CO2 → acidosis
  • hyperventilation → expel CO2 → alkalosis
56
Q

how does the renal (metabolic) response?

A
  • acidosis → kidneys reabsorb HCO3- and secrete more H+

- alkalosis → kidneys excrete HCO3 and reduce H+ secretion

57
Q

what are the acidic pH levels?

A

< 7.35

58
Q

what are normal pH levels

A

7.35 - 7.45; NORMAL: 7.4

59
Q

what are the alkaline pH levels?

A

> 7.45

60
Q

what are the acidic CO2 levels?

A

> 45

61
Q

what are the normal CO2 levels?

A

35 - 45

62
Q

what are the alkalotic CO2 levels?

A

< 35

63
Q

what are the acidic HCO3 levels?

A

< 22

64
Q

what are the normal HCO3 levels?

A

22 - 26

65
Q

what are the alkalotic HCO3 levels?

A

> 26

66
Q

T/F : ABGs will also show fully compensated, partially compensated or
uncompensated

A

TRUE

67
Q

what are the possible causes of metabolic acidosis?

A

DKA, Shock, Diarrhea, Salicylate OD, Renal failure , Sepsis

68
Q

what are the possible causes of metabolic alkalosis?

A

Loss of gastric secretions
Overuse of antacids
K+-wasting diuretics

69
Q

what are the possible causes of respiratory acidosis?

A

Hypoventilation r/t:
COPD Chest trauma Drug OD Airway obstruction
Neuromuscular disorder

70
Q

what are the possible causes of respiratory alkalosis?

A

Hyperventilation r/t:
Anxiety
High altitude
Fever

Nursing Semester 2 (21 decks)

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