Respiratory

Question 1

Define COPD

Answer 1

COPD is a chronic inflammatory disease resulting from exposure to noxious particles that causes obstruction of airflow, characterised by emphysema and chronic bronchitis

Question 2

Pathophysiology of COPD

Answer 2

Long term exposure to irritants or noxious particles leads to progressive destruction of alveoli and their elastic fibres, and capillary beds, which reduces the surface area available for gas exchange and expiratory volume (emphysema), a chronic inflammatory response in the bronchial wall causing obstructive oedema, and the gradual increase in number and size of mucous secreting cells in the bronchial walls, causing tenacious mucous production (chronic bronchitis)

Question 3

Identify causes and risk factors of COPD

Answer 3

Causes:
tobacco smoke
dust, fumes, chemicals
pollution

Risk factors:
Childhood asthma
early life events eg. prematurity, FGR
Alpha I angiotripsin disorder

Question 4

Describe the clinical manifestation of COPD

Answer 4

Clinical manifestation is INSIDIOUS = slow progressing and no symptoms immediately present

S+S:
wheezing
coughing
tenacious mucous production
SOB/dyspnoea
low O2 sats
reduced exercise tolerance
lower resp infection
fatigue

Diagnosed by an FEV <70%

Question 5

What is the role of the nurse/goal of care when caring for a patient with COPD

Answer 5

Early intervention and management to best slow the progression of symptoms and reduce the risk of exacerbation

COPD damage is irreversible

Question 6

What medications are involved in pharmacologic COPD management

Answer 6

Short acting beta antagonists
Long acting beta antagonists
Inhaled corticosteroids
combination medications

Question 7

SABA

Answer 7

Indication: short acting relief of acute symptoms of breathlessness
MoA:
Eg.
Side effects:

Act on B2 receptors in bronchial smooth muscle to relax muscles in lungs and widened airways
Beta 2 Agonists. A= Asthma
Can be short acting or long acting
Short Acting Beta Agonists (SABA): salbutamol, tirbutaline
Long Acting Beta Agonists (LABA): salmeterol, formeterol
SABA onset of action: 2-5 minutes. Duration of action: 4-6 hours
LABA duration of action: 12-24

Question 8

LABA

Answer 8

Indication:
MoA: relaxes smooth muscle
Eg.
Side effects:

Question 9

Inhaled corticosteroids

Answer 9

Enters the cell
Enters nucleus of cell
Increases or decreases synthesis of specific proteins including enzymes involved in regulating cell inflammation
Prevent epithelial cells of the lining of the bronchi from being hypersensitive

Question 10

Combination medication

Question 11

List 5 non-pharmacological nursing interventions for COPD and their rationale

Question 12

Categorise mild, moderate and severe COPD and the difference in their management

Question 13

Identify the indication and role of the nurse in a COPD patient with a tracheostomy

Question 14

Identify the indication and goals of NIV treatment

Question 15

Describe the role of the nurse in administering NIV

Question 16

Define asthma

Question 16

Compare CPAP and BIPAP

Question 17

Pathophysiology of asthma

Question 18

Identify causes and triggers for asthma

Question 19

Describe the clinical manifestation of asthma

Question 20

What is the role of the nurse/goal of care when caring for a patient with asthma

Question 21

What medications are involved in pharmacologic asthma management

Question 22

Anticholinergics/antimuscarinics

Question 23

Identify 2 non pharmacologic nursing interventions for asthma and their rationale

Question 24

Outline the nurses emergency response to an asthma attack

Question 25

What assessments can be completed to evaluate nursing interventions