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Med Surg - Exam 2 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

First line TB Agents

A

Isoniazid (INH)
Rifampin
Pyrazinamide
Ethambutol
Streptomycin

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2
Q

Isoniazid (INH)
S/E & Considerations

A

Abx for TB
Hepatotoxicity/Hepatitis, flulike syndrome, neuropathy, hypersensitivity

Considerations: Pyridoxine (Vit B) to prevent/decrease neuropathy
Monitor liver enzymes

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3
Q

Rifampin

A
  • Orange discoloration of urine & other secretions
  • Hepatitis
  • febrile reaction
  • increases metabolism of oral contraceptives, corticosteroids, Coumadin, digoxin & oral hypoglycemic
  • monitor liver enzymes
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4
Q

Pyrazinamide

A

Abx

hepatotoxic

Hyperuricemia

arthralgia

skin rash

GI irritation

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5
Q

Ethambutol

A

Abx
* optic neuritis
- decreased visual acuity
- impaired red/green color distinguishing
- blindness
- skin rash

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6
Q

Streptomycin

A

Abx
- Ototoxicity
- Nephrotoxicity
- Hypokalemia

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7
Q

Mucolytics

A
  1. acetylcysteine (Mucomyst)
  2. Dornase Alfa (pulmozyme) : used for thick bronchial secretions e.g. Cystic Fibrosis

Considerations : can trigger bronchospasm or sulfur odor

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8
Q

Expectorants

A

Guaifenesin

liquifies resp secretions
S/E : headaches, drowsiness, GI upset

Nursing Implications : instruct to cough effectively & avoid driving after ingesting

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9
Q

Antitussives

A

Suppresses cough reflex. Opioid doses are about 1/10 than those used for analgesia

Two groups :
1. Opioid
- Hydrocodone + homatropine (Hycodan)
- Codeine

  1. Non opioid
    - Dextromethorphan (Benylin)
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10
Q

Decongestants

A
  1. Pseudoephedrine (Sudafed)
  2. Phenylephrine (Afrin)
  3. Neosynephrine (oxymetazolline)
  4. Ephedrine (pretz-d)

Sympathomimetics — Relieves stuffiness

S/E :
- vasoconstriction (tachy, difficulty voiding)
- CNS agitation (restlessness)
- rebound congestion due to chronic use

Implications :
CI for arrhythmias, HTN, CAD
Highly monitored for abuse

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11
Q

Immunomodulators

A

Omalizumab (Xolair)

  • Decreases Immune response by interfering with cytokines & immune cells
  • long term control & prevention for allergic asthma

S/E : allergic reactions & infection

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12
Q

Antihistamines

A

Antagonizes action of histamine (H1RA)

  1. Benadryl (diphenhydramine)
  2. Zyrtec (cetirizine)
  3. Allegra (fexofenadine)
  4. Claritin (loratidine)

Implications:
- CI with acute asthma episode, impaired GI motility or obstruction, UT obstruction & heart disease
- may cause excitation of the CNS

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13
Q

Benadryl

A

diphenhydramine

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14
Q

Eupnea

A

Normal breathing at 14-20 breaths per min

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15
Q

Bradypnea

A

Slower than normal <10 breaths per min
With regular rhythm & normal depth
Can be due to increased ICP, a brain injury or drug overdose

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16
Q

Tachypnea

A

Rapid, shallow breathing
>24 breaths per min
Assc with pneumonia, pulmonary edema, metabolic acidosis, septicemia, severe pain or a rib fracture

17
Q

Hypoventilation

A

Irregular, shallow breathing

18
Q

Hyperpnea

A

Increased depth of respirations

19
Q

Hyperventilation

A

Increased rate & depth that result in decreased PaCO2 level
Assc with exertion, anxiety & metabolic acidosis or DKA/renal disease (the hyperventilating would be called Kussmaul’s)

20
Q

Apnea

A

Period of cessation of breathing

21
Q

Cheyne-Stokes

A

Regular cycle where the rate & depth of breathing increase then decrease until apnea for abt 20s

The duration of apnea varies, therefore, it is timed & recorded
Assc with heart failure & damage to the resp system (drug induced, tumor, trauma)

22
Q

Biot’s Respirations

A

Periods of normal breathing (3-4 breaths) followed by a varying prd of apnea (10-60s) aka ataxic breathing

Resp depression assc with drug overdose & brain injury

23
Q

Obstructive

A

Airway narrowing as seen in asthma, COPD & bronchitis
Prolonged phase of expiratory resp

24
Q

Albuterol Sulfate brand names

A

AccuNeb
Proventil HFA
Ventolin HFA
ProAir RespiClick

25
Q

Albuterol Sulfate

A

Go-to for acute symptoms

May cause transient hypokalemia with nebulization (check potassium levels)

Advise pt to use before using other inhalation medication

26
Q

Racepinephrine

A

SABA

Given via nebulizer

Onset: one minute

Affects both beta 1 and beta 2 adrenergic receptor sites

Can result in peripheral vasoconstriction

Mostly used in children

27
Q

Levalbuterol Tartrate brand name

A

Xopenex HFA

28
Q

Levalbuterol Tartrate

A

SABA

Selected for beta (pulmonary) receptors

Causes less cardiac effects

Onset: 10-17 mins

29
Q

What do mast cell stabilizers do?

A

Act as an inflammation anti-inflammatory

Stabilizes mast cell membranes & inhibits the activation & release of histamine from cells

Preventive tx before exposure to allergen or to exercise

Blocks reaction to allergen

30
Q

Therapeutic timing for Mast cell stabilizers

A

Several weeks

Used as ppx & maintenance

31
Q

Therapeutic timing for Mast cell stabilizers

A

Several weeks

Used as ppx & maintenance

32
Q

What do methylxanathines do?

A

Bronchodilator

33
Q

What do methylxanathines do?

A

Bronchodilator

34
Q

Nursing Considerations for Methylxanathines

A

Narrow therapeutic safety margin

Must swallow enteric coated pill as whole

Caffeine will intensify its affects, avoid

CI for pts with untreated seizure disorders or PUD

35
Q

What do anticholinergics do?

A

Blocks parasympathetic nervous system, causing bronchial smooth muscle relaxation, however, does not block exercise induced bronchospasm

Therapy for maintenance of reversible airway obstruction due to COPD

36
Q

Nursing considerations for Anticholinergics

A

Onset of action is longer than albuterol not a rescue medication

Combining with beta 2 agonists is more efficient than by itself

CI in pts with glaucoma, prostatic hypertrophy, bladder obstructions, allergies in peanut & soy

Avoid getting it in eyes

37
Q

What do Leukotriene Modifiers do?

A

Blocks the inflammatory process in the airways by antagonizing the effects of leukotriene, a potent bronchoconstrictor

38
Q

Nursing Considerations for Leukotriene modifiers

A

Long-term therapy for asthma, maintenance

Med Surg - Exam 2 (2 decks)

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