Respiratory 2 Lecture

Question 1

Define asthma

Answer 1

-Chronic inflammatory disorder of the airways
-Episodic reversible airway obstruction.
-Increased bronchial activity, airway inflammation

Question 2

When attempting to diagnose asthma, what are some things to consider during the history and physical exam?

Answer 2

-attacks, triggers, allergies, family history
-expiratory wheezing

Question 3

How will the pulmonary function test show up for asthma?

Answer 3

-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

Question 4

What is albuterol?

Answer 4

short-acting B2-adrenergic agonist that produces bronchodilation within minutes.

Question 5

What are the adverse effects of albuterol?

Answer 5

1. Tachycardia
2. Palpitations
3. Shakes.
4. Tremors
5. Anxiety
6. Restlessness
7. Nausea

Question 6

What is atrovent?

Answer 6

-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.

Question 7

Albuterol + Atrovent = ?

Answer 7

Combivent

Question 8

What are corticosteroids?

Answer 8

-anti-inflammatory drug that suppresses the inflammatory response and reduce mucus production.

Question 9

What are some inhaled corticosteroids used for asthma?

Answer 9

Beclovent, flovent, azmacort,pulmicort; long-term control of persistent asthma.

Question 10

What is the PO medication given for asthma?

Answer 10

Prednisone

Question 11

What is the IV medication given for asthma?

Answer 11

methylprednisolone (solumedrol)

Question 12

Are corticosteroids rapid-acting?

Answer 12

No, they decrease inflammation and effects on onset at 4-6 hours post IVP; not the direct meds given for acute exacerbations or emergencies.

Question 13

What are treatment options for acute asthma attacks?

Answer 13

-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.

Question 14

What is the only asthma reliever?

Answer 14

Albuterol

Question 15

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

Answer 15

Inhaled albuterol

Question 16

What is the best way to prevent COPD?

Answer 16

Never smoke or to quit smoking

Question 17

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.

Answer 17

True. This is to prevent progression.

Question 18

What is the gold standard for diagnosis and assessment of COPD?

Answer 18

Pulmonary Function Test. PFT is the way to diagnose COPD.

Question 19

COPD - Education: what are some thing people with COPD should avoid?

Answer 19

people with URIs, children, and crowds

Question 20

Permissive Hypoxemia

Answer 20

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.

Question 21

What is the O2 therapy goal for patients with CO2 narcosis?

Answer 21

SPO2 saturation at 88-92%. Giving COPD patients too much O2 can kill them.

Question 22

How does pursed lip breathing help patients with COPD?

Answer 22

1. prolongs exhalation
2. prevents bronchiolar collapse and air trapping.
3. breathe in slowly through nose and exhale slowly through pursed lips (I:E = 1:3)

Question 23

What is a pulmonary embolism?

Answer 23

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.

Question 24

What is the difference between a thrombus and emboli?

Answer 24

An emboli is a moving clot and a thrombus is a stationary clot.

Question 25

What assessment data supports the client experienced a pulmonary embolism?

Answer 25

Sudden onset of chest pain, dyspnea, and elevated D-dimer blood test.

Question 26

What are treatment options for emboli?

Answer 26

-Heparin x 5 days until Warfarin (Coumadin) reaches therapeutic level; (LMWH; unfractioned Heparin)
-Bedrest if DVT present and not anticoagulated.

Question 27

What are the common obstructive pulmonary diseases?

Answer 27

-Asthma
-COPD (chronic bronchitis and emphysema)
-Cystic fibrosis