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FNP: Systems Review > Respiratory > Flashcards

Respiratory Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

A medication that has a side effect of “a cough”

A

ACE-I

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2
Q

Two respiratory pathogens that are known to cause “Atypical Pneumonia” are:

A
  • Mycoplasma Pneumonia

* Streptococcus Pneumonia

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3
Q

What does a “peak flow meter” measure

A
  • EXPIRATORY flow (peak expiratory flow) - The air that flows out the patient’s lungs.
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4
Q

Chest X-ray of an asthma patient will show

A
  • HyperInflation
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5
Q

The “GOLD STANDARD” to diagnose COPD and Asthma

A
  • Spirometry/Pulmonary Function Test (FEV1 and FVC)
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6
Q
  • A dry cough for the 1st 5 days, then…
  • Progressing to a productive, rough cough.
  • Sputum maybe clear, white, yellow, or green or bloody.
  • Is usually preceded by a viral infection
A
  • Acute Bronchitis
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7
Q

The most common forms of COPD include:

A
  • Chronic Bronchitis, and…

* Emphysema

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8
Q
  • An FEV1/FVC ratio of 80%

The above mentioned is indicative of:

A

Mild COPD

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9
Q

Treatment for Mild COPD includes

A
  • Reduction of risk factors (smoking cessation)
  • Flu and Pneumonia vaccines
  • Short-Acting anticholinergics (Ipratroprium/Atrovent) PRN or
  • Short-Acting beta-agonists (Albuterol/Proventil) PRN
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10
Q

The cornerstone pharmacological therapy for ASTHMA is:

A
  • Inhaled corticosteroids (ICS)
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11
Q
  • CHRONIC, recurrent cough, wheeze, shortness of breath and/or chest tightness
  • Symptoms occurs or are “worse at night”, or with exercise, viral infections, or irritants (smoking)
  • An increase in FEV1 greater than 12% from baseline, post short-acting beta2-agonist
  • **The above is a diagnosis of: ***
A
  • Asthma
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12
Q

Populations that are at increased risk for Tuberculosis and would have a PPD or Mantoux result “Greater than or equal to 10mm” ( >10mm)

A
  • Foreign born people/ Recent Immigrants
  • Prisoners
  • Nursing home residents
  • Indigents/Homeless
  • Minorities
  • Healthcare providers/Migrant Farmers
  • People with blood disorders or prolonged steroid therapy use
  • OVERCROWDED POPULATIONS
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13
Q

The goal of COPD is to:

A
  • Reduce the disease progression
  • Reduce symptoms and exacerbations
  • Improve exercise tolerance and quality of life.
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14
Q

Common sign on a chest Xray of a patient with Croup:

A
  • Steeple Sign (Soft tissues of the neck and chest show subglottic narrowing)
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15
Q

Coughing with excessive mucus production for at least 3 or more months for 2 consecutive years or more.

A
  • Chronic Bronchitis
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16
Q

Permanent alveolar damage and loss of elastic recoil, which result in chronic “hyperinflation” of the lungs

A
  • Emphysema
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17
Q

Rust colored sputum is often seen with

A
  • Steptococcus Pneumonia
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18
Q

The “GOLD STANDARD” for diagnosing Community Acquired Pneumonia is:

A
  • Chest Xray
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19
Q

In a healthy person, with a onset of severe cough of 2 weeks (14 days), you should suspect:

A
  • Pertussis
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20
Q

Difference between “Bacterial” pneumonia and “Atypical” pneumonia is:

A
  • Bacterial PNA (S. Pneumoniae) = Acute Onset, “high fever and chills”, and lobar infiltrates on C-Xray
  • Atypical PNA (M. Pneumonia = Gradual Onset, “low-grade fever”, interstitial or patchy (diffuse) infiltrates on C-Xray.
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21
Q

The cornerstone treatment for COPD includes:

A
  • Inhaled Anticholinergics (Atrovent), and/or ..

* Long-Acting Beta Agonists (Salmeterol)

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22
Q

All asthma patients need a _____ PRN

A
  • Short-Acting Beta2 agonist (Albuterol)
23
Q

Peak Expiratory Flow Rate (PEFR or PEF) is based on: (mnemonic HAG)

A
  • Height
  • Age
  • Gender
24
Q

Risk factors of Pulmonary Embolisms include:

A
  • Atrial Fibrillation (A-Fib)
  • Pregnancy
  • Estrogen therapy
  • Surgery
  • Long bone fractures
  • Prolonged Inactivity
25
Q
  • With tactile fremitus, an abnormal finding would be considered, when _____
A
  • Vibrations are felt stronger during palpation, in the lower lobes than the upper lobes, when the patients says “99” or “1,2,3”
26
Q

Reduction in airflow rates is considered as

A
  • Obstructive dysfunction (Asthma, COPD, bronchiectasis)
27
Q

1st line treatment for community acquired pneumonia in patient with no co-morbidities

A
  • *** MACROLIDES ****
  • Clarythromycin B.I.D x 10 days
  • Azythromycin Daily x 5 days
  • Erythromycin Q.I.D x 10 days
28
Q

2nd line treatment for CAP

A
  • Tetracyclines (Doxycycline 100mg B.I.D x 10 days)
29
Q

Anticholingergic medications should be avoided in patients with:

A
  • Narrow-angled Glaucoma
  • BPH
  • Bladder neck obstruction
30
Q

During percussion of the lung fields, “Tympany” or “Hyperresonance” is associated with * _______, and “Dull-tone” is associated with * _____.

A
  • Tympany = COPD

* Dull-tone = Bacterial PNA with lobar consolidation, Pleural effusion.

31
Q

Reduction of lung volume due to decreased lung compliance

A
  • Restrictive Dysfunction (Pulmonary fibrosis, pleural disease, diaphragm obstruction)
32
Q

This testing is used on immunocompromised patients testing for TB and Candida

A
  • Anergy testing (PPD is placed in one arm and Candidas is placed in the other arm)
33
Q

If a PPD test is greater than 10mm induration, what should be ordered?

A
  • Chest X-ray
34
Q

Medications that do NOT affect the inflammatory changes seen in Asthma patients include:

A
  • Bronchodilators - bronchodilators open up air passages, but do not have anti-inflammatory components to reduce inflammatory changes seen in Asthma patients.
35
Q
  • HIV (+)
  • Recent contact with infectious TB cases
  • CXR with fibrotic changes consistent with previous TB disease.
  • Any child who had close contact or has TB symptoms (before age 5)
  • Immunocompromised patients
  • *** The above mentioned will show a PPD or mantoux result of:
A
  • Greater than or equal 5 mm (>5mm)
36
Q

1st line treatment for SEVERE asthmatic exacerbation or respiratory distress is:

A
  • Adrenaline Injection (Epinepherine)
37
Q

Treatment plan for Acute Bronchitis includes:

A
  • Fluids and Rest (1st Choice)
  • Anti-tussives (Benzonatate/Tessalon)
  • Muculytics/Expectorants (Guaifenesin)
  • Albuterol Inhalers for wheezing
  • ** NO ANTIBIOTICS***
38
Q
  • Severe sore throat
  • High Fever
  • Fine sand paper rash
  • ** The above mentioned are characteristics of ***
A
  • Scarlet Fever (A group “A” streptococcal infection)
39
Q

Streptococcus Pneumoniae is the bacterium most responsible for the highest mortality in patients with _____

A
  • Community Acquired Pneumonia
40
Q
  • A viral infection caused by RSV that is commonly seen during the winter/spring months in infants and young children.
  • Signs and Symptoms include: Fever, Inspiratory and/or Expiratory wheezing, with clear drainage
  • *** The above mentioned is indicative of **
A
  • Bronchiolitis
41
Q

This asthma classification includes:

  • Normal FEV between exacerbations
  • Symptoms are less than 2 days a week
  • Use of Short acting beta-agonist (S.A.B.A) is less than 2 days a week.
A
  • Intermittent Asthma
42
Q

Mild Persistent asthma includes:

A
  • FEV greater than 80%
  • Symptoms are greater than/equal to 2 days a week, but not daily.
  • Night time awakenings are 1 - 2 a month
  • Used of S.A.B.A is greater than/equal to 2 days a week, but not daily.
  • Minor limitation in normal activity
43
Q

This classification of asthma includes:

  • Symptoms throughout the day
  • Nighttime awakenings > 1 time a week
  • S.A.B.A usage is several times a day
  • Extremely limited in normal activity
  • FEV
A
  • Severe Persistent
44
Q

Abnormal forms of lymphocytes will occasionally show in which viral infections

A
  • Epstein Barr Virus
45
Q

A pathogenic bacteria found in older children and adults with cystic fibrosis

A
  • Pseudomonas Aeruginosa
46
Q

Medications that do NOT treat inflammation in Asthma patients include

A
  • Theophylline - this medication controls inflammation, but does not reduce inflammation.
47
Q

Auscultation of normal breath sounds would include:

A
  • Vesicular breath sounds in the lower lobes, and…

* Bronchial breath sounds in the upper lobes

48
Q

Pulsus Paradoxus is usually associated with:

A
  • Severe Airway Obstruction (i.e status asthmaticus, severe COPD exacerbation)
49
Q

Treatment for Intermittent Asthma (mild intermittent asthma) includes:

A
  • Albuterol (Ventolin) M.D.I prn
50
Q

Treatment for Severe Persistent Asthma includes:

A
  • High-dose ICS, plus…
  • Long-acting beta2 - agonists, plus…
  • Oral steroids daily
  • Albuterol M.D.I prn
51
Q
  • Risk Factors for “Drug Resistant Streptococcus Pneumonia” include:
A
  • Antimicrobial therapy within the last 3 months
  • Alcoholism, liver, or renal disease
  • Co-Morbidities
  • Immunosuppression
  • Exposure to children in daycare
52
Q

The only treatment known to prolong life in COPD patients is:

A

Supplemental Oxygen

53
Q

The treatment for TB exposure in HIV (-) patients include:

A
  • INH 300mg/day for 9 months
54
Q
  • How does the anticholinergic drug “Ipratropium (Atrovent)”,used in COPD patients, work?
A
  • It decreases parasympathetic tone/reduces cholinergic tone, which thereby produces bronchodilation

FNP: Systems Review (10 decks)

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