Respiratory Illness of Lower Airway - Asthma

Question 1

what is the most common chronic respiratory illness

Answer 1

asthma

Question 2

T/F - asthma is the leading cause of school absenteeism

Answer 2

true

Question 3

which demographic of children are more likely to have asthma

Answer 3

black children

Question 4

what is asthma

Answer 4

-chronic inflammatory disorder of the airways
-recurrent episodes
-limited air flow or obstruction that reverses spontaneously or with treatment
-bronchi hyperresponsiveness

Question 5

what are symptoms seen during an asthma episode

Answer 5

-Wheezing, especially on expiration
-Breathlessness
-Chest tightness
-Cough (especially at night): Chronic and nonproductive

Question 6

what are examples that impact the social determinants of health

Answer 6

Housing, Food, Education, Employment, Health care services, Recreation, Transportation, Public safety, Social support, Race/Ethnicity, Exposure to crime, violence, Poverty, Residential segregation, Language/ Literacy, Culture

Question 7

is zip code a better predictor of health status than genetic code

Answer 7

yes

Question 8

what triggers an asthma attack

Answer 8

-Tobacco Smoke
-Dust Mites
-Outdoor Air Pollution
-Pests (e.g., cockroaches, mice)
-Pets
-Mold
-Cleaning and Disinfection

Question 9

what are the goals of asthma management

Answer 9

-Follow an Asthma Action Plan
-Self-management: Avoid allergens, triggers, Inhalers with child, Monitor function with a peak flow meter
-Preventative medications
-Relieve asthmatic episodes promptly
-Seek medical help when medications are ineffective and respiratory symptoms worsen
-Support child, adolescent, and family

Question 10

what is the thing most people have a challenge with regarding asthma medication

Answer 10

when to take a bronchi dialator or steroid inhaler

Question 11

what is a short acting bronchodilator (albuterol)

Answer 11

-Beta agonist (SABA)
-Rescue – quick relief - PRN
-MDI (metered dose inhaler)

Question 12

what is a long acting bronchodilator (Formoterol)

Answer 12

Maintenance, daily

Question 13

what is a low to high dose corticosteroid (Fluticasone)

Answer 13

Start with inhaled (Flovent), may need to move to systemic (Prednisone)

Question 14

what should a child do after using a steroid inhaler

Answer 14

rinse their mouth to prevent mouth lesions

Question 15

is a nebulizer superior to an inhaler with a space?

Answer 15

nope

Question 16

t/f - respiratory distress continues despite vigorous therapeutic measures

Answer 16

true - ED and PICU continue to do nebs (albuterol) every 2 hours

Question 17

what are the medications for acute asthma

Answer 17

-nebulized bronchodilators: b-adrenergic agonists –albuterol methylxanthines – aminophylline, theophylline
-steroids IV or oral: Methylprednisolone (IV Solu-medrol, po Orapred)
-magnesium sulfate: inhibits smooth muscle contraction, decreases histamine release from mast cells, and inhibits acetylcholine release
-heliox

Question 18

A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following should the client be instructed to take as needed before exercise?

a. Fluticasone/salmeterol (Advair)
b. Montelukast (Singulair)
c. Prednisone (Deltasone)
d. Albuterol (Proventil)

Answer 18

d. Albuterol (Proventil)

Question 19

A nurse is planning care for a child who has asthma. Which of the following interventions should be included in the plan of care? Select all that apply.

a. Perform chest percussion
b. Place the child in an upright position
c. Monitor oxygen saturation
d. Administer bronchodilators
e. Administer dornase alfa (Pulmozyme) daily

Answer 19

b. Place the child in an upright position
c. Monitor oxygen saturation
d. Administer bronchodilators

Question 20

A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy. Which of the following are appropriate actions for the nurse to take? (Select all that apply.)

A. Instruct the child that the treatment will last 30 minutes
B. Obtain vital signs prior to the procedure
C. Tell the child to take slow deep breaths
D. Determine if the child should use a mask
E. Attach the device to an air source

Answer 20

B. Obtain vital signs prior to the procedure
C. Tell the child to take slow deep breaths
D. Determine if the child should use a mask

Question 21

A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child’s respiratory status? (Select all that apply.)

a. Oxygen saturation 95%
b. Wheezing
c. Retraction of sternal muscles
d. Warm extremities
e. Nasal flaring

Answer 21

b. Wheezing
c. Retraction of sternal muscles
e. Nasal flaring