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Respiratory Flashcards

1
Q

What do adrenergic drugs stimulate?

A

beta 2- adrenergic receptors of the sympathetic nervous system

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2
Q

What are some side effects of beta 2- adrenergic drugs?

A

tachycardia, heart palpitations, tremors, and angina with those with compromised cardiac blood vessels.

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3
Q

What disorders are inhaled anticholinergics used for?

A

those with COPD

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4
Q

What are the expected actions of anticholinergics?

A

inhibit acetylcholine, which causes vasoconstriction of the bronchioles and blocks the stimulation of parasympathetic receptors.

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5
Q

How do glucocorticoids help chronic asthma?

A

They suppress the immune system including decreasing inflammation in the airway by preventing the release of leukotrienes, prostaglandins, and histamine, which mediate inflammation.

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6
Q

What can mast cell stabilizers be used for?

A

Allergic rhinitis and chronic allergies.

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7
Q

Which generation antihistamines caused sedation?

A

First gen, the older of two types

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8
Q

What can first gen antihistamines be used for?

A

insomnia, allergic and anaphylactic reactions

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9
Q

What receptors do antihistamines bind to?

A

H1 receptors to block the release of histamine

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10
Q

What are second-gen antihistamines used for?

A

chronic and/or idiopathic urticaria

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11
Q

Why don’t second-gen antihistamines cause drowsiness?

A

they antagonize histamine effects without binding to or inactivating histamine like first-gen do

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12
Q

What are sympathomimetics for?

A

allergic rhinitis, sinusitis, and common cold.

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13
Q

What happens if a drug like sympathomimetics bind to alpha one-adrenergic receptors?

A

causes vasoconstriction
therefore nasal turbinates shrink, and relieves nasal congestion

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14
Q

What are antitussives used for?

A

Chronic nonproductive coughing related to allergies and other upper respiratory conditions

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15
Q

What is the pharmacologic action of opioid and nonopioid antitussives?

A

Suppress the cough reflex in the brain

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16
Q

What are expectorants used to treat?

A

Colds, other respiratory infections, and bronchitis to remove expectorants.

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17
Q

How does expectorants work?

A

reduces surface tension of secretions making it easy to cough out of the lungs and drain

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18
Q

Beta2 agonists and methylxanthines cause what in the airway?

A

cause bronchodilation by relaxing bronchial smooth muscle

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19
Q

A client says, “My doctor told me that I have COPD and might develop emphysema. I always thought I had chronic bronchitis.” How should the nurse respond to this statement?

A

“COPD is a combination of either asthma, chronic bronchitis, or emphysema.”

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20
Q

An 8-year-old child was just diagnosed with asthma. Which question is not pertinent for the nurse ask the child and parents during the admission assessment
1. “Have you eaten any new foods?”
2. “Were you exposed to anyone who smokes?”
3. “Have you had your carpet cleaned lately?”
4. “Have you grown taller since last year?”
5. “Has there been a change in laundry products recently?”

A

“Have you grown taller since last year?”

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21
Q

What symptoms should the nurse expect when a patient comes in with allergies?

A

Characterized by sneezing, watery eyes, and nasal congestion

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22
Q

What are some common suspects of allergic reactions?

A

Pollens from weeds, grasses, and trees
Mold spores; dust mites; certain foods
Animal dander
Genetic predisposition

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23
Q

What are some primary interventions and actions to take when someone has allergies?

A

Assess heart rate, respiratory rate, and lung sound

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24
Q

What are things that should the nurse look for if the patient has allergies?

A

Determine - patient is developing an allergic reaction

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25
Q

What are some things that you might tell the parent about adverse effects of H1 receptor agonists?

A

paradoxical CNS stimulation (opposite effect) and excitability/agitation in some children

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26
Q

What are some alternatives to H1 receptor antagonists?

A

You might need to give a second generation

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27
Q

What is the prototype drugs of H1 Receptor Antagonists?

A

diphenhydramine (Benadryl)

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28
Q

What are some adverse effects that people might face with diphenhydramine?

A

Significant drowsiness
Urinary retention/hesitancy?

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29
Q

What would you tell a patient who need to take Diphenhydramine long-term about their sleepiness?

A

Usually diminishes with long-term use and lessens within a few doses

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30
Q

What are four things you can’t do from anticholinergic effects?

A

No Seeing (blurred vision/ dizziness)
No Spitting (dry mouth)
No Peeing
No Pooping

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31
Q

What are some ADR from Diphenhydramine that you should report to the provider?

A

May experience anuria or oliguria

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32
Q

What is a physical assessment you would do for a patient on diphenhydramine?

A

Evaluate the bladder to check for distension for anuria

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33
Q

What are some things you would tell a patient on diphenhydramine to lessen their most urgent symptom?

A

Encourage patient to drink more fluids or ask if you can put in an IV for fluids

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34
Q

What are some ADR’s you should look for for with Sudafed P E Sinus and Allergy tablets?

A

Dysrhythmias- Normal rate with an irregular pattern 90 and irregular

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35
Q

How long should you give nasal decongestants to see results?

A

3-5 days

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36
Q

What may happen if a patient takes a nasal decongestant for too long?

A

Rebound nasal congestion if use is prolonged

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37
Q

Why should a patient stop using a nasal decongestant after a while?

A

congestion will clear up after stopping the spray.

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38
Q

What are some ADR’s that might happen if you take Oral Preparation Decongestants?

A

Can cause hypertension

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39
Q

What are the differences in the effects of taking an oral prep vs an intranasal decongestant?

A

The oral prep has more systemic effects

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40
Q

What is the prototype drug for intranasal corticosteroids?

A

fluticasone (Flonase)

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41
Q

What are some things that you should ask before someone takes Veramyst?

A

Are you pregnant?

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42
Q

What are some MOA of Benzonatate HCl ?

A

Suppresses the cough center in the medulla
Does not depress respiration.
Does not cause sedation, physical dependence, nor tolerance.

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43
Q

How does guaifenesin (Mucinex) work?

A

Loosen thick bronchial secretions - bronchial passages
Less thick and sticky and easier to cough up phlegm from the lungs

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44
Q

If a patient is taking Mucinex for a cold, what other teaching should you give?

A

Drink 8 glasses of water minimum a day
Drowsiness, dizziness, irritability and nausea can occur

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45
Q

What are some ADR of expectorants or mucolytics?

A

Drowsiness, dizziness, irritability and nausea can occur

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46
Q

What should you ask a patient before they take Dextromethorphan?

A

Ask them if they smoke or drink

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47
Q

How can you tell a patient is taking dextromethorphan and alcohol?

A

They report hallucinations and have slurred speech.

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48
Q

What are some patient teachings for Dextromethorphan?

A

Do not drink grapefruit juice while taking this medication, smoke, or drink

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48
Q

What kind of behavior should you report when someone is taking Dextromethorphan?

A

Slurred speech

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49
Q

What are some questions to figure out the triggers to asthma?

A

Have you eaten any new foods?
Are you exposed to anyone who smokes?
Have you had your carpet cleaned lately?
Has there been a change in laundry products recently?

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50
Q

What are the three goals of asthma drug therapy?

A

To terminate acute bronchospasms in progress (quick-relief/rescue medications)
To reduce the frequency of asthma attacks (long-acting medications)
Prevent asthmatic attacks

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51
Q

What are some lab assessment to monitor when a patient has albuterol?

A

serum electrolyte (Potassium)
serum glucose level

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52
Q

What are some types of albuterol?

A

ProAir H F A, Proventil, H F A, Ventolin H F A, VoSpire E R

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53
Q

What are some ADRs from overuse of albuterol?

A

Overdose results in an exaggerated sympathetic activation, causing dysrhythmias, hypokalemia, and hyperglycemia.

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54
Q

What must you inform the patient to get rid of bitter taste after ipratropium (Atrovent) use?

A

Rinse the mouth

55
Q

What four drugs are used consistently and long term for asthma?

A

Corticosteroids
Mast cell stabilizers- Cromolyn (Intal)
Leukotriene modfiers
Anticholinergics

56
Q

What is the most effective long-term anti-inflammatory medications for asthma?

A

Inhaled corticosteroids

57
Q

What are some benefits of Inhaled corticosteroids over oral corticosteroids to deal with asthma?

A

fewer side effects than oral corticosteroids and most potent and consistently effective

58
Q

What are inhaled corticosteroids used for?

A

Used for management of persistent asthma at all levels of severity to improve symptoms and pulmonary function.

59
Q

What is a type of Mast Cell Stabilizers?

A

Cromolyn (Intal)

60
Q

What type of Leukotriene modifier should you use for infants?

A

montelukast (Singulair)

61
Q

What type of Leukotriene modifier should you use for those older than 7 y.o.?

A

zafirlukast (Accolate)

62
Q

What is a type of anticholinergic for long-term management of asthma?

A

Spiriva® Respimat (tiotropium bromide)

63
Q

What is the MOA for Spiriva® Respimat (tiotropium bromide)?

A

relaxes and dilates the bronchioles.

64
Q

What would you assess for fungal infection of Beclomethasone?

A

Sore on tongue
White spots on tongue and oral mucous membranes

65
Q

What are some signs of Candida albicans oropharyngeal) ?

A

Sore on tongue
White spots on tongue and oral mucous membranes

66
Q

What are some questions to ask a patient on Beclomethasone for asthma?

A

Assess if the client has blown his nose prior to administration of nasal spray.
Assess if the client has had a change in taste.
Assess the client for any hoarseness or change in voice.
Tachycardia

67
Q

What type of patient should you avoid giving Beclomethasone to? Why?

A

Do not give clients with an infection because corticosteroids can mask s/s of infection and are contraindicated if an active infection is present

68
Q

What is a contraindication of Beclomethasone? Why?

A

Don’t give clients with an infection because corticosteroids can mask s/s of infection

69
Q

What are some lab assessment for Montelukast?

A

CBC, liver levels, ALT

70
Q

How would you teach the patient to take Montelukast?

A

Do not use ibuprofen or aspirin
Take in the evening preferably

71
Q

What vitals should be monitored for Montelukast?

A

Respiratory and pulse rates, respiratory effort, lung sounds, Skin color and oxygen saturation level

72
Q

What should you give for pain if a patient is taking Montelukast?

A

Tylenol because NSAIDS can be toxic

73
Q

What is a reason you would tell an alcoholic not to drink when on Montelukast?

A

Chronic users of alcohol may not tolerate the medication because it is metabolized by the liver

74
Q

What are two types of patients who should not take Leukotriene Therapy for Asthma?

A

Alcoholics and those with hepatic dysfunction

75
Q

When should Montelukast be used?

A

Consistently, but not for acute attacks

76
Q

Why should a person taking Methylxanthine Therapy for Asthma get decaf?

A

The medication is a a xanthine derivative, which can cause increased risk of toxicity and severe adverse effects

77
Q

What are somethings a person should avoid when taking Methylxanthine Therapy for Asthma?

A

Avoid caffeine and smoking

78
Q

Why should a person taking Methylxanthine Therapy for Asthma not smoke?

A

It increases the metabolism of theophylline so they Require a higher dose for therapeutic effects.

79
Q

What is a side effect of increasing the dose of Methylxanthine Therapy for Asthma?

A

Headache and nausea

80
Q

What should you inform the patient about the dose of taking Methylxanthine Therapy for Asthma?

A

It has a narrow therapeutic range - must be dosed carefully by the provider

81
Q

What are some administration reminders to tell the patient taking Methylxanthine Therapy for Asthma?

A

GI symptoms are common side effects.
Take on empty stomach because food slows absorption

82
Q

What are contraindicated with Methylxanthine Therapy for Asthma?

A

Stimulants – caffeine–causes toxicity and severe ADRs
Ephedra – potentiates theophylline–may increase SEs

83
Q

What is some possible prescription for chronic bronchitis?

A

ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled glucocorticoid medication (steroid)

84
Q

What is the order in which meds for chronic bronchitis are administered?

A

1st Beta agonist first
2nd ipratropium bromide
3rd Glucocorticoid steroi

85
Q

Why is the order important when administering meds for chronic bronchitis

A

1st Beta agonist first- helps bronchioles dialate
2nd ipratropium bromide - Subsequent medications can be deposited in the bronchioles for improved effect.
3rd Glucocorticoid steroid

86
Q

What are some types of Beta agonist?

A

Albuterol (Proventil, Ventolin)

87
Q

What are some types of Glucocorticoid Steroids?

A

beclomethasone (Q V A R)

88
Q

What are some types of Bronchodilators?

A

ipratropium bromide (Atrovent)

89
Q

How do we know a COPD combo therapy is making the COPD better?

A

combined increase the forced expiratory volume in 1 second (FEV1)

90
Q

What are two types of COPD drugs for the phlegm?

A

Mucolytics and expectorants

91
Q

What is the combo therapy for COPD?

A

ipratropium bromide/albuterol sulfate (Combivent)

92
Q

What is the prototype drug for anti-inflammatory drug for asthma and allergic rhinitis?

A

Beclomethasone (Q V A R)

93
Q

What are some treatments for coughing and how would you teach them to the patient?

A

Antitussives (suppressant) inhibit cough by suppressing the cough center in the medulla

Opioids used to inhibit severe cough with sedation

Expectorants inhibit mucus production

94
Q

If a patient has thick secretions in her cough, what should they take?

A

Expecorants or mucolytics

95
Q

What are some opioids to give to a Severely coughing patient?

A

Codeine – causes sedation
hydrocodone combined with homatropine (Hycodan, others)Codeine – causes sedation
hydrocodone combined with homatropine (Hycodan, others)

96
Q

What are some types of methylxanthine therapy for asmatics?

A

Theo 24, Theochron, Elixophyllin, aminophylline, and Uniphyl

97
Q

What are some vital signs to monitor with methylxanthine?

A

HR, BP, RR, O2

98
Q

What is the role of bronchodilators?

A

ipratropium bromide (Atrovent) gives epinephrine to dilate the bronchioles

99
Q

What is the prototype drug for diphenhydramine?

A

Benadryl

100
Q

What do antihistamines do?

A

Prevent the onset of allergies by blocking the H1 histamine receptor blocker

101
Q

What are some nursing assessment on people taking diphenhydramine?

A

Evaluate the bladder to check for dissension for Anura

102
Q

What are som ADR’s for diphenhydramine?

A

Anticholinergic: dry mouth, tachycardia, mild hypotension, drowsiness occasionally

103
Q

What are some ADR’s in children for diphenhydramine?

A

Paradoxical CNS stimulation and excitability/agitation in some children

104
Q

What might happen if someone takes Benadryl for too long?

A

The sleepiness symptoms go away or diminishes

105
Q

How do intranasal corticosteroid medications work?

A

Decreases local inflammation in the nasal passages, thus, reducing nasal stuffiness

106
Q

What is a question to answer before someone takes intranasal corticosteroids?

A

Ask if they are pregnant

107
Q

What are some ADR’s of Fluticasone?

A

Nasal irritation and epistaxis

108
Q

What is the prototype drug of Benzonatate HCI?

A

Thessalon Perles

109
Q

What is an advantage of Thessalon Perles?

A

It does not depress respiration and only suppresses the cough center in the medulla. Also does not cause sedation, physical dependence, nor tolerance

110
Q

What are two ways that guaifenesin works to help someone with a cold?

A

Inhibits mucus production so it is less thick and sticky and easier to cough up phlegm

Loosens thick bronchial secretions

111
Q

What are some ADR’s of Mucinex?

A

Drowsiness, dizziness, irritability, and nausea

112
Q

What are some type of nonopioid cough meds?

A

Delysm
Robitussin, Vicks, DayQuil
Buckly’s

113
Q

What should patients not drink with Dextromethorphan?

A

Alcohol and grapefruit juice

114
Q

How do you know if someone is drinking while on Mucinex?

A

Visual hallucinations and slurred speech

115
Q

How do Beta 2 adrenergic agonists work?

A

The medication binds to beta two adrenergic receptors in the bronchial smooth muscles to cause bronchodilation

116
Q

What medication stimulates the fight or flight response of the nervous system?

A

Beta 2 adrenergic agonist aka Albuterol

117
Q

The patient is says that the nurse measures serum potassium and glucose levels. What medication are they most likely taking for their asthma?

A

albuterol or ProAir HFA or VoSpire ER

118
Q

If a patient asks why they shouldn’t drink caffeine while on Albuterol, what is the reason the nurse should give?

A

Caffeine can cause nervousness, tremors, or palpitations

119
Q

What happens if a patient takes too many puffs of their Albuterol?

A

Palpations and airway narrowing and bronchospasm
Also, exaggerated sympathetic activation such as Dysrhythmias, hypokalemia, and hyperglycemia

120
Q

How do anticholinergic bronchodilators work?

A

They relax the bronchioles

121
Q

Which bronchodilator can cause a reaction to soy?

A

Anticholinergics such as ipratroprium and Spiriva

122
Q

Why should people rinse out their mouths after using anticholinergic inhalants?

A

To prevent or reduce the bitter taste and hoarseness

123
Q

What symptoms should people using Atrovent and Tiotropium bromide report to the doctor?

A

Dyspnea, odd urinary pattern, and consistent something

124
Q

What is the prototype drug for beclomethasone?

A

QVAR

125
Q

What is the prototype drug for cromolyn aka?

A

Intal

126
Q

What should you tell people to do while taking mast cell stabilizers?

A

Drink lots of water

127
Q

What type of leukotriene modifier should an infant take?

A

Montelukast (Singulair)

128
Q

What type of leukotriene modifier should a patient older than seven take?

A

Zafirlukast (Accolate)

129
Q

What thinks should you assess for if someone is taking leukotriene modifiers?

A

Vitals: RR, effort, lung sounds, CBC, and ALT

130
Q

If someone is on ibuprofen and/or aspirin, what should they not take?

A

Leukotriene modifiers

131
Q

If a patient is unresponsive to beta agonists or corticosteroids, what might be recommended to them?

A

Methylxanthine Therapy for Asthma

132
Q

What are some things a patient should do to take Methylxanthine: theyophylline (Theo 24, theochron, Elixophyllin

A

Without caffeine on empty stomach

133
Q

What should a patient on ephedra and stimulants not be given? (prototypes)

A

Elixophyllin, aminophylline, and Uniphyl

134
Q

Why must a person on Methylxanthine: theyophylline (Theo 24, theochron, Elixophyllin) not self administer any dose?

A

It has a narrow therapeutic range and must be dosed carefully

135
Q

What are some ADR’s of Methylxanthine: theyophylline (Theo 24, theochron, Elixophyllin)?

A

GI symptoms, nausea, vomiting, CNS simulation, palpitations and jitteriness

Pharm (10 decks)

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