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MS: NCM 112 > P1.3: RESPIRATORY: BRONCHIAL ASTHMA > Flashcards

P1.3: RESPIRATORY: BRONCHIAL ASTHMA Flashcards

1
Q

A condition characterized by increased responsiveness of the tracheobronchial tree to various stimuli with resulting bronchospasm and inflammation of the bronchial mucosa

A

BRONCHIAL ASTHMA

AIRFLOW LIMITATIONS

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2
Q

Risk Factors of Bronchial Asthma

A
  • Cigarette smoking
  • Respiratory infection
  • Extreme emotions
  • Seasonal changes
  • Allergic reactions
  • Family history
  • Occupational exposure to dust or chemical irritant
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3
Q

What are the 3 causes of airflow limitations in bronchial asthma

A
  1. Bronchospasm
  2. Increased Mucous Secretions
  3. Mucosal Edema
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4
Q

What does HAPE stands for?

A

High Altitude Pulmonary Edema

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5
Q

2 types of Bronchial Asthma

A
  1. Intrinsic Asthma
  2. Extrinsic Asthma
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6
Q

Type of Bronchial Asthma:

  • Occurs as a response to an allergen or trigger to which the patient is hyperresponsive
  • Mediated by IgE and appears more often in children and may disappear during adolescence
A

Extrinsic Asthma

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7
Q

Type of Bronchial Asthma:

  • Considered a non-allergic type of asthma
  • Triggered by intrinsic factors which includes emotional stress, changes in humidity and temperature, exposure to noxious fumes and coughing
A

Intrinsic Asthma

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8
Q

Signs and Symptoms of LACK OF OXYGEN

A
  1. Decreased 02 Sat
  2. Increased RR
  3. Cyanosis
  4. Decreased Capillary Refill Time
  5. Confusion (late sign)
  6. Nasal Flaring
  7. Intercostal Retreaction
  8. Shortness of Breath
  9. Tachycardia
  10. Restlessness (early sign)
  11. Use of Accessory Muscles
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9
Q

ACC TO LM:

Stages of Asthma:

A
  1. Mild (episodic)
  2. Moderate (one to two times a week)
  3. Severe
  4. Status Asthmaticus
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10
Q

ACC TO PPT:

Stages of Asthma:

A
  • STAGE 1: Intermittent
  • STAGE 2: Mild Persisten
  • STAGE 3: Moderate Persistent
  • STAGE 4: Severe Persistent
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11
Q

COMPLETE THE FF:

STAGE 1: Intermittent

STAGES OF ATHMA ACC TO PPT:

What are the Symptoms and Noctural Symptoms

A

S: <1 time a week
NS:<2 times a month

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12
Q

COMPLETE THE FF:

STAGE 2: Mild Persistent

STAGES OF ATHMA ACC TO PPT:

What are the Symptoms and Noctural Symptoms

A

S: >1 time a week but <1 time a day
NS: >2 times a month

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13
Q

COMPLETE THE FF:

STAGE 3: Moderate Persistent

STAGES OF ATHMA ACC TO PPT:

What are the Symptoms and Noctural Symptoms

A

**S: **Daily
**NS: **>1 time a week

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14
Q

COMPLETE THE FF:

STAGE 4: Severe Persistent

STAGES OF ATHMA ACC TO PPT:

What are the Symptoms and Noctural Symptoms

A

S: Continous
NS: Frequent

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15
Q

Common Triggers of Asthma Attacks:

A
  • Air pollutants
  • Perfumes
  • Cold, dry air or abrupt weather changes
  • Allergens (feathers, animal dander, dust mites, pollen)
  • Foods, especially those with sulphites (wine, beer, salad, dried fruits, eggs)
  • Viral infections
  • Gastroesophageal reflux disease
  • Stress
  • Anxiety
  • Exercise
  • Wood and vegetable (flour) dust
  • Medications
  • Food additives (monosodium glutamate
  • Endocrine factors (menses, pregnancy, thyroid disease)
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16
Q

Manifestations of Asthma Attacks:

A
  • Respiratory distress
  • Dyspnea/ “air hunger”
  • Tachypnea
  • Prolonged expiratory phase
  • Tachycardia
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17
Q

Physical Signs of Asthma Attacks:

A

▪ Retraction of intercostals and sterna muscles
▪ Percussion- hyperresonant
▪ Distant breath sounds
▪ Ronchi, wheezes, rales

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18
Q

Diagnosis of Asthma:

A
  • History and physical examination
  • Arterial Blood Gas (ABG) analysis
  • Serum IgE levels
  • Complete Blood Count (CBC) with Differential Count
  • Chest X-rays
  • Pulmonary Function Studies
  • Skin Testing
  • Bronchial Challenge Testing
  • Pulse Oximetry
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19
Q

Diagnosis of Asthma:

It reveals hypoxemia

A

Arterial Blood Gas (ABG) analysis

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20
Q

Diagnosis of Asthma:

increase from allergic reaction

A

Serum IgE levels

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21
Q

Diagnosis of Asthma:

it shows increase eosinohil count

A

Complete Blood Count (CBC) with Differential Count

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22
Q

Diagnosis of Asthma:

May show hyperinflation with areas of local atelectasis

A

Chest X-rays

23
Q

Diagnosis of Asthma:

It may show decreased peak flows and forced expiratory volume in 1 second, low-normal or decreased vital capacity, and increased total lung and residual capacities

A

Pulmonary Function Studies

24
Q

Diagnosis of Asthma:

It may identify specific allergens

A

Skin Testing

25
Q

Diagnosis of Asthma:

It shows the clinical significance of allergens identified by skin testing

A

Bronchial Challenge Testing

26
Q

Diagnosis of Asthma:

It may show decreased oxygen saturation

A

Pulse Oximetry

27
Q

These methods are aimed at preventing attacks and intervening early during an attack:

A

Non-pharmacologic methods

28
Q

2 types of Pharmacologic Management:

A
  1. Quick-relief
  2. Long Term control medications
29
Q

Pharmacologic Management:

  • Bronchodilators which act primarily to relax bronchial smooth muscle and dilate the airways
  • Anticholinergics such as ipratropium are used to increase the effects of bronchodilators
A

Quick-relief

30
Q

Pharmacologic Management:

  • Corticosteroids, leukotriene modifiers
  • Sympathomimetic aerosol sprays
A

Long Term Control Medications

31
Q

Examples of Long-Acting Control Medications

A
  • Corticosteroids
  • Mast Cell Stabilizer
  • Long-Acting beta-Adrenergic Agents
  • Xanthine Derivatives
  • Leukotriene Modifiers (inhibitors)
  • Combination Products
32
Q

Examples of Quick-Relief Medications

A
  • Short-Acting Beta-Adrenergic Agents
  • Anticholinergics
33
Q

Nursing Management Requires extensive education of the patient and family regarding:

A
  • pursed –lip and diaphragmatic breathing
  • use of peak flow meter
  • effective coughing techniques
  • maintaining adequate hydration
  • when to notify the physician
34
Q

WHAT ARE THE INFLAMMATORY DISORDERS

A
  1. Sinusitis
  2. Laryngitis
  3. Pharygitis
35
Q

INFLAMMATORY DISORDER:

  • A condition characterized by the inflammation of the mucus membrane lining the sinuses
  • May either be a bacterial infection or secondary to a viral exposure
A

SINUSITIS

1. ACUTE SINUSITIS
2. CHRONIC SINUSITIS

36
Q

TYPE OF SINUSITIS:

  • Most common causes are allergy and bacterial infection
  • Damage to the mucusa of the sinuses are reversible
A

Acute Sinusitis

37
Q

TYPE OF SINUSITIS:

  • May result from untreated acute sinusitis
  • Damage to the mucosa of the sinuses are irreversible
A

Chronic Sinusitis

38
Q

MANIFESTATIONS OF SINUSITIS

A
  • Facial pain and headache
  • Toothaches
  • Headache for frontal and ethmoid sinuses
  • Mucoid nasal discharge
  • Nasal congestion
  • Orbital edema
  • Cough and sore throat
  • Inability to smell
  • Lack of appetite
  • Fever
39
Q

DIAGNOSIS OF SINUSITIS

A
  • History and Physical Examination
  • Sinus X-Rays
  • Computed Tomography Scanning
40
Q

DIAGNOSIS OF SINUSITIS:

  • For instance, to know if there was trauma
A

History and Physical Examination

41
Q

DIAGNOSIS OF SINUSITIS:

Detect sinus opacity, mucosal thickening, bone destruction, and air-fluid levels

A

Sinus X-ray

42
Q

DIAGNOSIS OF SINUSITIS:

Most effective diagnostic tool. It is also used to rule out other local or systemic isorders, such as tumor, fistula, and allergy

A

Computed Tomography Scanning

43
Q

If the sinusitis does not respond to antibiotics, surgical intervention may be required:

A
  1. Functional Endoscopic Sinus Surgery (FESS)
  2. Anthral Irrigation
  3. Caldwell-Luc Surgery
44
Q

Surgical intervention If the sinusitis dont respond to antibiotics:

Use of fiberoptic endoscope is used to disect nasal tissue

Complications:
* Nasal bleeding
* Orbital hematoma
* Injury to the optic nerve which may lead to blindness

A

Functional Endoscopic Sinus Surgery (FESS)

45
Q

Surgical intervention If the sinusitis dont respond to antibiotics:

A sharp metal instrument (known as trocar) is inserted through anthrum into the lateral wall of the nose into the sinus

A

Anthral Irrigation

46
Q

Surgical intervention If the sinusitis dont respond to antibiotics:

An incision is made under the upper lip, above the lateral incisor teeth and part of the bony anthrum is removed, producing a permanent window allowing drainage and removal of the deceased mucosa and periosteum

Usually done when antibiotic treatment is no longer effective

A

Caldwell-Luc Surgery

  • Also known as radical anthrum surgery
  • Indicated for chronic maxillary sinusitis
47
Q

INFLAMMATORY DISORDER:

Commonly known as sore throat — is an inflammation of the pharynx, resulting in a sore throat. Thus, it is a symptom, rather than a condition.

A

PHARYNGITIS

48
Q

RISK FACTORS OF PHARYNGITIS

A
  • Viral and/or bacterial infections
  • Allergies
  • Dry indoor air
  • Muscle strain
  • Gastroesophageal reflux disease (GERD)
49
Q

MANIFESTATIONS OF PHARYNGITIS

A
  • Sore throat
  • Dry, scratchy throat
  • Pain when swallowing
  • Pain when speaking
50
Q

Diagnosis of Pharyngitis requires a ________ exam and ________ to assess for all the possible causes of pharyngitis.

A

physical; laryngoscopy (scope exam in a clinic)

51
Q

INFLAMMATORY DISORDER:

Inflammation of the vocal cords can alter the way the vocal cords come together and vibrate, causing voice changes.

A

LARYNGITIS

ACUTE AND CHRONIC LARYNGITIS

  • Can be acute (short-term), lasting less than three weeks.
  • Or it can be chronic (longterm), lasting more than three weeks
52
Q

DIAGNOSIS OF LARYNGITIS

A
  • History and physical examination
  • Formal voice analysis and fiberoptic laryngoscopy
  • Stroboscopy
53
Q

TREATMENT/MANAGEMENT OF LARYNGITIS

A
  • Voice rest
  • Steam Inhalation
  • Avoidance of irritants
  • Dietary modification
54
Q

MEDICATIONS FOR LARYNGITIS

A
  • Oral antifungal agents such as
    fluconazole
  • Mucolytics like guaifenesin
  • Anti-reflux medications

MS: NCM 112 (14 decks)

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