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NURS 1355 > Non-Infectious Upper & Lower Respitory Disorders > Flashcards

Non-Infectious Upper & Lower Respitory Disorders Flashcards

1
Q

Epistaxis …

A

Nosebleed

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2
Q

Nasal fractures

3 key assessments

A

Breathing
Pain
Leaking CFS

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3
Q

Medical management of Epitaxis…

(2)

A

Apply pressure

Nasal packing

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4
Q

Management of Nasal Polyps…

(2)

A

Inhaled steroids

Polypectomy

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5
Q

Assessments

Airway
Edema
Pain
CSF leaking
6 fields of vision
Extra Occular motions
Convergence, PERRLA

A

Facial trauma

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6
Q

Risk factors

Neck 17” or bigger
Being over weight

HTN
Stroke
MI
MOTOR VEHICLE ACCIDENTS

A

Sleep apnea

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7
Q

The CPAP provides positive air pressure to keep your airway open and breathes for you

T or F

A

F

It doesn’t breath for you

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8
Q

Type of cancer that affects head and neck

A

Squamous cell

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9
Q

Head and neck cancer usually begins with…

A

Chronically irritated mucous

Becomes thicker & tougher

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10
Q

Pre-op with laryngeal cancer.
According to ED this is the most important

A

Arrange for communication

They won’t be able to talk post op

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11
Q

MVA ….

A

Motor vehicle accident

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12
Q

Most important nursing intervention for post rhinoplasty

A

Patient remains in Semi-Fowlers posistion for 48 hrs to prevent increase in edema

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13
Q

Admitting patient with R/O laryngeal cancer.

Which info do they teach

A. Demonstrate proper gargling with normal saline

B. Perform voice exercises 30 min daily

C. Explain that a lighted instrument will be used to biopsy

D. Teach monthly self-exam tech

A

C. Explain that a lighted instrument will be used to biopsy

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14
Q

Preparing a patient for total laryngectomy which intervention has priority

Take them on tour of ICU

Explain they will need to ask for pain meds

Demonstrate proper use of TED hose

Determine if they can read or write

A

Determine if they can read or write

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15
Q

Is asthma reversible?

A

Generally, yes

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16
Q

Mucosal edema
Mucus secretion
Bronchial construction

Antigen-Antibody reaction

Describes….

A

Asthma

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17
Q

Peak flow zones

Green zone
Yellow zone
Red zone

A

Green zone: >80% personal best
Yellow zone 50 - 80% - increase meds / treatments
Red zone <50% - Urgent care needed

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18
Q

Inhaled corticosteroids
Fluticasone
Budesonide
Mometasone
Beclomethasone
Ciclesonide

Leukotriene modifiers

Montelukast (Singulair®).
Zafirlukast (Accolate®).
Zileuton (Zyflo®).

LABS- long acting beta agonist
Salmeterol
Formoterol

Theophylline (Bronchodilator)

Combination inhalers both corticosteroids & LABA

Used for what purpose

A

Long term asthma control

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19
Q

Short-Acting beta agonist
Albuterol

Ipratropium
(Atrovent)

Oral & IV corticosteroids
(For serious asthma attacks

Used for…

A

Quick relief/ Rescue medications

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20
Q

Omalizumab ( Xolair) is used for…

A

Allergy induced asthma

Long-term

monoclonal anti-immunoglobulin E (IgE) antibody

Anti-inflammatory

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21
Q

Brand names: Proventil, Ventolin, ProAir

Bronchodilator relives Wheezing & chest tightness caused by COPD & Asthma

Works by relaxing airways

Inhaler or Nebulizer

Contradictions:

Heart rhythm disorder, seizures, diabetes

Drug interactions:

Beta blockers, antidepressants, Bronchodilators

SE: Sleep problemas, muscle pain, dry mouth, dizzy

A

Albuterol

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22
Q

Combines 2 medications
Budesonide & formoterol fumarate

Prevents bronchospasms in COPD & Asthma

Aerosol Inhalation

Budesonide = corticosteroids (reduces inflammation)

Formoterol long acting beta 2 adrenergic agonist (relaxes muscles)

Only use in patients whose asthma is not well controlled by other meds

A

Symbicort - Maintenance Inhaler

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23
Q

Formoterol:
long acting beta 2 adrenergic agonist

Function

A

relaxes muscles

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24
Q

Formoterol
Long-acting beta 2 adrenergic

This serious risk

A

Increased risk of asthma related death

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25
Q

Combines fluticasone (steroid Reduces Inflammation) & salmeterol (long-acting beta 2 adrenergic) Relaxes airway muscles

Prevent breathing difficulties & tight chest associated with COPD & Asthma

Inhalation: Powder discus

Increases risk of Asthma related deat

SE: Sinus pain, sore throat, sneezes, stomach pain

A

Advair - Long-term

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26
Q

Brand name: Xopenex

Short acting

Similar to albuterol in chemistry & action

A

Levalbuterol

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27
Q

Similar to Albuterol & levalbuterol

Sold under brand name Maxair

Not for use by children

A

Pirbuterol

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28
Q

Brand name: Serevent (Salmeterol)

Increases risk for: Heart rate, tremor, nervous, headache

Long / Rescue inhaler

A

Long-term

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29
Q

Foradil/ Perforomist (Formoterol)

Dry powder inhaler

SE Tachycardia, insomnia, lightheaded, headaches

Long / Rescue inhaler

A

Long

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30
Q

Long acting bronchodilator

Oral pill or tab

Many drug interactions

A

Theophylline

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31
Q

Aformoterol aka Brovana

Longterm bronchodilator

Is taken how

A

Nebulizer

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32
Q

Ipratropium

Short term bronchodilator

Nebulizer or inhaler

SE: Cough, Dry mouth, blurr3d vision

Commonly taken with this medication

A

Albuterol

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33
Q

Tiotropium is sold under brand name____

Comes in capsules for use in a Handihaler device

SE: Dry mouth, cough amd slowing of heart

NOT FOR USE IN CHILDREN

A

Spiriva - long term

anticholinergic

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34
Q

Short & Long acting beta² agonist

Methylxanthines

Cholinergic Antagonist

This type of medication

A

Bronchodilators

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35
Q

(-terol) Suffix

Which medication

A

Rapid acting Beta² agonist

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36
Q

Monitor patient for what after bronchodilator

A

Tachycardia

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37
Q

Use bronchodilator (after/before) other medications

Exp of bronchodilators

A

short-acting bronchodilators: Albuterol, Proventil HFA, ProAir, Ventolin HFA (albuterol), and Xopenex HFA.

Anticholinergics: Like ipratropium, tiotropium, aclidinium, and glycopyrronium

Theophylline

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38
Q

(Long / Short-acting beta-2 agonists): Albuterol, levalbuterol.

(Long / Short-acting beta-2 agonists): Formoterol, salmeterol, indacaterol

A

Short-acting beta-2 agonists:Albuterol, levalbuterol.

Long-acting beta-2 agonists: Formoterol, salmeterol, indacaterol

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39
Q

Steroids cause

Hypoglycemia/Hyperglycemia

A

Hyperglycemia

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40
Q

Flovent (fluticasone)
Pulmicort (Budesonide)
Vanceril: (Beclomethasone)
Advair (fluticasone propionate and salmeterol)

All which type of medication?

Monitor for…

How to discontinue?

A

Inhaled steroids

Monitor for oral candidiasis

Gradual tapering off of medication

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41
Q

Teaching for using an inhaled steroid

A

Swish and spit

Water or mouth wash

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42
Q

Why give mast cell stabilizers to asthma patients?

A

Prevents mast cells from opening

Mast cells are associated with allergies and inflammation

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43
Q

Leukotriene Antagonist

Treats persistent asthma

Prevent bronchconstriction

Example…

A

Singular (Oral Medication)

44
Q

Status Asthmaticus

Describe

A

Life threatening

Tachycardia/ Tachypnea

Wheezing

Possible intubation

45
Q

COPD is an umbrella term that covers

A

Emphysema, Chronic Bronchitis, ect

46
Q

The alveoli get damaged and trap air inside of them instead of sending it throughout the body

Describes this disease

A

COPD

47
Q

Rupture of air sacs and the creation of one large air pocket instead of many smaller ones.

Reduction in lung surface area traps air in the damaged tissue, making breathing difficult

Describes which COPD disease

A

Emphysema

48
Q

Smokers cough

Mucus cough for 3 or more months for 2 or more years

This COPD disease

A

Chronic Bronchitis

49
Q

Primary symptom

Dyspnea on exertion

A

Emphysema

50
Q

Emphysema causes alveoli to become smaller & less effective

T or F

A

F

They become enlarged and Trap Air inside

51
Q

Levels of CO2 & Oxygen with Emphysema

A

Increased CO2 > 45
Decreased Ox < 80

52
Q

Chronic bronchitis is caused by Smoking

Primary symptom is (Productive/ Non-Productuve) cough

A

Productive

53
Q

Interventions FOR COPD

A

Airway Maintenane

Breathing techniques

Positioning

Conservative energy

Cough Enhancement

54
Q

COPD

Keep sPO² between these levels

A

90 - 92 %

55
Q

What is the mechanism by which chemoreceptors trigger breathing in COPD patients

A

Oxygen levels

NOT

CO² Levels like regular peeps

56
Q

Complications of COPD

(4)

A

Hypoxemia, Acidosis

Infections

Cor pulmonale (Right sided heart failure)

Dysrhthmias

57
Q

Cor Pulmonale (Right-Sided Heart Failure)

Describe

A

Cor pulmonale is an enlarged right ventricle in your heart.

Pushing against high pressure in your pulmonary artery can cause your right ventricle to fail

58
Q

Dependent edema (lower extremities)
Dyspnea
Fatigue
Neck vein distention

Polycythaemia (increased RBC)

Happen in this disease related to COPD

A

Cor pulmonale

Right sided heart failure

59
Q

Clinical features

Thin
Dyspnea
Clubbing
Absent cough
Increased AP diameter
Prolonged expiration
Hyperresonant upon percussion (Snap, Crackle, Pop)

Which disease

A

Emphysema

60
Q

Clinical features

Recurrent respiratory infections
Persistent cough
Copious sputum
Edematus, bloated
JVD
Peripheral edema
Rhonchi & Wheezing
Clubbing
Normal percussion

A

Chronic bronchitis

61
Q

Blue bloated = (emphysema/ chronic bronchitis)

Pink puffer = (emphysema/ chronic bronchitis)

A

Blue bloated = Chronic bronchitis

Pink puffer = Emphysema

62
Q

Chronic bronchitis/ Emphysema

Increased Hgb & RR
SMOKER
Cardiac enlarge
JVD
Sputum Increase
Dusky / Cyanotic color
Airway flow Problem

A

Chronic Bronchitis

63
Q

Chronic bronchitis/ Emphysema

Pursed lip
Thin
Barrel chest3d
Speaks short choppy sentences
Anxoius

A

Emphysema

64
Q

Drugs for COPD (3)

A

Antitussives (Robotussin) anticough
Expectorant (Guaifenesin) makes cough produce mucus
Mucolytics (Acetylcyseine) breaks up mucus in lungs

65
Q

Enlarged right ventricle & narrowing of Pulmonary Artery leads to…

A

Pulmonary HTN

66
Q

Sarcoidosis

Pulmonary/ Cystic fibrosis

Are this type of Pulmonary disease

A

Restrictive Disease

Sarcoidosis

immune system to overreact, forming small, red, swollen lumps called granulomas in one or more organs

67
Q

Most cancers can’t be detected until they are this size…

Where do cancers develop in the airway

A

1cm

Occur in segmental bronchi and upper lobes

68
Q

Classify lung cancer PERCENTAGES

Small cell lung cancer ____ %

Non-small cell lung cancer ____ %

NSCLC
squamous
Adenocarcinoma
Large cell

A

SCLC = 20%
NSCLC = 80%

69
Q

Non-small cell lung cancer

Squamous

Location

A

Towards middleish

70
Q

Non-small cell lung cancer

Small cell (oat cell)

Location

A

Large mass nearest the trachea

71
Q

Non-small cell lung cancer

Adenocarcinoma

Location

A

Outer edges

72
Q

Non-small cell lung cancer

Large cell

Location

A

Top and bottom of lungs

73
Q

This system is used to stage lung cancer

A

T: Tumor size, location, invasion
N: Node, Lymph involvement
M: Metastasis

74
Q

Why is TNM not used to stage Small Cell Lung Cancer?

A

Cancer has Metastasis before diagnosis is made

75
Q

Cancer Staging

1,2,3 A = (Operable/ Inoperable)

3B and above (Operable/ Inoperable)

A

1,2,3 A Operable

3B and above Inoperable

76
Q

Which stages for small cell lung cancer are Operable

A

None. By time it’s diagnosed it’s Metastasis

77
Q

Chest tube management

A

See other flashcards

78
Q

Small cell lung cancer is associated with Asbestos or Smoking

A

Smoking

79
Q

COPD patient

Which requires immediate intervention by the nurse

A. Pulse Ox 92%
B. ABG pO² 74%
C. SOB when walking to the bathroom
D. Sputum is rusty colored

A

C. SOB when walking

80
Q

Which medication should the nurse discuss with patients who have mild persistent asthma

A: Daily inhaled steroids
B. Rescue inhaler
C. Systemic steroids
D. Leukotriene agonist

A

Systemic steroids

81
Q

Signs and symptoms associated with asthma

A

Dyspnea & Wheezing

82
Q

2 long lasting Maintenance inhalers that combine steroids & beta-2 agonists for daily maintenance

A

Symbicort & advair

83
Q

a class of drugs that relax smooth muscles

A

Beta 2 agonists

84
Q

Symbicort

Spiriva

Singulair

A

Symbicort: 2 meds in 1 inhaler Asthma/ COPD. Budesonide / Formoterol

Spiriva: Tiotropium bromide
Bronchodilator COPD.

Singulair: (Pill) Montelukast Anti-inflammatory
It can treat allergies and prevent asthma attacks.

85
Q

Asthma, chronic bronchitis, Emphysema

Lung protease collapse the walls of the bronchioles ams alveolar sacks. Transforming from numerous small elastic air-exchanging surface area to 1 large less efficient air-exchange area

Airway overreacts to common stimuli with bronchospams, edematous swelling, & production of thick mucus

Infection or bronchial irritants cause increased secretion, edema, bronchospasm & impaired mucus clearance.

A

Emphysema:
Lung protease collapse the walls of the bronchioles and alveolar sacks. Transforming from numerous small elastic air-exchanging surface area to 1 large less efficient air-exchange area

Asthma
Airway overreacts to common stimuli with bronchospams, edematous swelling, & production of thick mucus

Chronic bronchitis
Infection or bronchial irritants cause increased secretion, edema, bronchospasm & impaired mucus clearance.

86
Q

With inhaler use

Do you put the inhaler directly to your lips ?

How long do you hold your breath after breathing in

A

No. 1 to 2 inches away

10 secs

87
Q

Do you wrap your lips tightly around the inhaler?

How long do you hold the breath in for

A

No. 1 to 2 inches away

10 seconds

88
Q

Ipratropium is this type of medication

Use…

A

Anticholinergic

Short term must be taken several times a day.

Most anticholinergic are like this

89
Q

Tiotropium is this type of medication

A

Spiriva

Long term anticholinergic

1x daily

90
Q

This type of medicine is only given when other treatments are ineffective.

The therapeutic dosage is close to the toxic dosage

A

Theophylline (Xanthine) bronchodilators long lasting

91
Q

Oxygen delivery for asthma

A

Heliox

50-50 mixture of helium & oxygen

92
Q

What is given to help in condition of Status Asthmaticus (5)

A

IV Fluids
Systemic bronchodilator
Steroids
Epinephrine
Oxygen

93
Q

Status Asthmaticus

Labored breathing & Wheezing
Accessory muscles use &…..

A

JVD

94
Q

Sudden absence of Wheezing in Status Asthmaticus….

Treatment….

A

Complete obstruction

Tracheostomy

95
Q

Protease in higher than normal amounts breakdown alveoli and sacs lose elasticity, small airways collapse, alveoli become large and rigid.

Alveoli trap air inside and air filled spaces call bullae.

This flattens the diaphragm and hence use of accessory muscles to breathe.

This breathing problem

A

Emphysema

96
Q

Singulair a once a day oral medication is in this class of drugs.

A

Leukotriene receptor Antagonist

97
Q

Spiriva an anticholinergic has this precaution

A

Not for use in children

98
Q

Numbness of face, lips, mouth

Burning sensation when drinking citrus or hot liquids

A

Head and neck cancer

Squamous cell (Slow)

99
Q

Lung cancer causes change in _____ (this area,this type of cell)

A

Bronchial epithelium

100
Q

How long for a tumor in the bronchus epithelium to reach 1cm

A

8 - 10 years

101
Q

Uses:

Strep & Staph pneumonia

Syphilis & meningoccous

A

Penicillin

102
Q

SE of bronchodilators

A

Esp. Albuterol

Shakes/ Tremors
Tachycardia
Nervous
Muscle cramps

103
Q

What to teach about Singulair (Montelukast) - A Leukotriene receptor Antagonist

Type of administration?
Rescue medicine?
Prescribed for?

A

Oral: Pill
No, long-term
Asthma, allergic rhinitis

104
Q

Exam findings with pneumonia

Percussion sound?

Fremitus?

A

Dull sound

Fremitus increase

105
Q

____ work by Suppressing the body’s immune response and reducing inflammation

A

Steroids (-one)

NURS 1355 (12 decks)

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