Respiratory 2 Lecture Flashcards
Define asthma
-Chronic inflammatory disorder of the airways
-Episodic reversible airway obstruction.
-Increased bronchial activity, airway inflammation
When attempting to diagnose asthma, what are some things to consider during the history and physical exam?
-attacks, triggers, allergies, family history
-expiratory wheezing
How will the pulmonary function test show up for asthma?
-It will only show up abnormal during the asthma attack.
-typically decrease in vital capacity and expiratory volumes.
-if poor function, reversible with bronchodilators can be confirmatory
What is albuterol?
short-acting B2-adrenergic agonist that produces bronchodilation within minutes.
What are the adverse effects of albuterol?
- Tachycardia
- Palpitations
- Shakes.
- Tremors
- Anxiety
- Restlessness
- Nausea
What is atrovent?
-An anticholinergic drug that decreases sputum (not a bronchodilator); opens airways so its easier to breathe.
-More effective when given in combination with B2 agonists.
Albuterol + Atrovent = ?
Combivent
What are corticosteroids?
-anti-inflammatory drug that suppresses the inflammatory response and reduce mucus production.
What are some inhaled corticosteroids used for asthma?
Beclovent, flovent, azmacort,pulmicort; long-term control of persistent asthma.
What is the PO medication given for asthma?
Prednisone
What is the IV medication given for asthma?
methylprednisolone (solumedrol)
Are corticosteroids rapid-acting?
No, they decrease inflammation and effects on onset at 4-6 hours post IVP; not the direct meds given for acute exacerbations or emergencies.
What are treatment options for acute asthma attacks?
-Oxygen (NC, FM, NRB)
-Vital signs, pulse ox, auscultate breath sounds, work of breathing
-ABG
-bronchodilating meds via nebulizer STAT (albuterol)
-systemic corticosteroids IV as ordered after bronchodilator
-sputum collection for possible bacterial diagnosis
-help patient control anxiety, stay with patient until attack subsides.
What is the only asthma reliever?
Albuterol
When a patient with asthma is admitted to the emergency department with severe respiratory distress, the nurse anticipates that initial drug treatment will most likely include administration of
Inhaled albuterol
What is the best way to prevent COPD?
Never smoke or to quit smoking
True or False: Patients who have chronic cough and sputum production with a history of exposure to risk factors should be tested for airflow limitation via pulmonary function tests, even if they do not have dyspnea.
True. This is to prevent progression.
What is the gold standard for diagnosis and assessment of COPD?
Pulmonary Function Test. PFT is the way to diagnose COPD.
COPD - Education: what are some thing people with COPD should avoid?
people with URIs, children, and crowds
Permissive Hypoxemia
Describes a concept in which a lower level of arterial oxygenation than usual is accepted to avoid detrimental effects of fractional-inspired oxygen and invasive mechanical ventilation.
What is the O2 therapy goal for patients with CO2 narcosis?
SPO2 saturation at 88-92%. Giving COPD patients too much O2 can kill them.
How does pursed lip breathing help patients with COPD?
- prolongs exhalation
- prevents bronchiolar collapse and air trapping.
- breathe in slowly through nose and exhale slowly through pursed lips (I:E = 1:3)
What is a pulmonary embolism?
Obstruction of the pulmonary arteries or one of its branches.
Due to thrombus, air, or fat. Produces widespread vasoconstriction, impaired ventilation and perfusion, life threatening hypoxemia.
What is the difference between a thrombus and emboli?
An emboli is a moving clot and a thrombus is a stationary clot.
What assessment data supports the client experienced a pulmonary embolism?
Sudden onset of chest pain, dyspnea, and elevated D-dimer blood test.
What are treatment options for emboli?
-Heparin x 5 days until Warfarin (Coumadin) reaches therapeutic level; (LMWH; unfractioned Heparin)
-Bedrest if DVT present and not anticoagulated.
What are the common obstructive pulmonary diseases?
-Asthma
-COPD (chronic bronchitis and emphysema)
-Cystic fibrosis
