respiratory medications

Question 1

rhonchi/coarse

Answer 1

excess mucous in the airways; inspiration or expiration; CF, pneumonias, bronchitis, chronic smokers, {cough, antibiotics}

Question 2

rales/crackles

Answer 2

fluid in and around the alveoli; inspiration only; CHF {Diuretic ie Lasix}

Question 3

wheezes

Answer 3

obstruction or narrowing of the airways; inspiration and/or expiration {bronchodilators}

Question 4

diminished/decreased breath sounds

Answer 4

cant hear anything during deep breath; atelectasis {cough and deep breath, incentive spirometer}

Question 5

histamine receptors

Answer 5

when stimulated by histamine cause rhinorrhea, itching, and sneezing.

Question 6

antihistamine competes with ______ preventing ______

Answer 6

competes with histamine for receptor sites thus preventing a histamine response.

Question 7

anticholinergic side effects

Answer 7

drowsiness, blurred vision, dry mouth, urinary retention, constipation

Question 8

antihistamine SE

Answer 8

anticholinergic effects- drowsiness, blurred vision, dry mouth, urinary retention, constipation
increase in blood sugar and intraocular pressure

Question 9

caution antihistamine use with

Answer 9

HTN, diabetes, glaucoma, renal disease, prostate disease

Question 10

other uses of 1st generation of antihistamines

Answer 10

hypersensitivity reactions, motion sickness, sleep aid

Question 11

2nd generation antihistamines

Answer 11

non-sedating antihistamines cause less drowsiness and sedation.

Question 12

use for 2nd generation antihistamines

Answer 12

Primarily used for seasonal allergies

Question 13

cautions decongestant use with

Answer 13

HTN, hyperthyroidism, CV disease, glaucoma, BPH.

Question 14

overuse of decongestants results in

Answer 14

rebound nasal congestion

Question 15

do not use nasal sprays longer than

Answer 15

5 days

can cause rebound nasal congestion

Question 16

intranasal steroid agents

Answer 16

Local corticosteroid used in conjunction with antihistamines and decongestants to help with congestion associated with allergies.

Question 17

response for intranasal steroid agents takes

Answer 17

2-3 weeks
given by inhalation
discontinue if symptoms dont subside

Question 18

are intranasal steroid agents associated with rebound congestion?

Answer 18

no

Question 19

SE of intranasal steroid agents (fluticasone propionate (flonase))

Answer 19

epistaxis, nasal burning, irritation to nasal mucous membranes

Question 20

antitussives should not be used in patients

Answer 20

with excessive secretions who need to be able to cough up the secretions i.e. asthma, emphysema.

Question 21

SE of codeine

Answer 21

drowsiness, nausea, constipation, respiratory depression

Question 22

expectorants are used in combination with

Answer 22

analgesics, antihistamines, decongestants and antitussives.

Question 23

side effects of guaifenesin (robitussin)- expectorant

Answer 23

N&V, dizziness, headache

Question 24

mucolytics

Answer 24

break up secretions
for COPD, pneumonias
mucomyst antidote for tylenol

Question 25

asthma

Answer 25

a chronic inflammatory disorder of the airways
mucus in airways
bronchoconstriction

Question 26

COPD

Answer 26

emphysema
bronchitis
Barrel chest
Smoking decreases appetite and taste => Thin extremities

Question 27

bronchitis

Answer 27

Inflammation of mucus

Not as much bronchoconstriction as asthma

Question 28

emphysema

Answer 28

Destruction of the alveoli => decrease in surface area, air trapping
Diminished breath sounds

Question 29

beta 2 adrenergic agonists

Answer 29

mimic the sympathetic nervous system, cause bronchodilation, increase HR
Rescue inhalers (rapid acting)
indications: asthma and COPD
Two categories: Bronchodilators (BD) , inhaled corticosteroids (decrease inflammation in airways)

Question 30

side effects of beta 2 adrenergic agonists

Answer 30

TACHYCARDIA, heart palpitations, shakiness, restlessness, agitated, increase in BP

don’t take before bed as it will keep you awake

Question 31

Xanthine bronchodilators

Answer 31

cause BRONCHODILATION at cellular chemical level
includes caffeine, theophylline, theobromine.
Tachycardia palpitations
CNS complications restlessness, agitation, seizures

Question 32

nursing precautions Theophylline (theolair; theodur, Slo-phylline)

Answer 32

May cause GI distress.

Give with milk or meals to reduce GI upset

Question 33

inhaled corticosteroids

Answer 33

Prophylaxis for asthma attacks
Long term slower acting to decrease inflammation and edema
Local absorption

Question 34

combination agents- advair

Answer 34

contains:
salmeterol (albuterol long acting bronchodilator)
fluticasone (steroid)
At risk for fungal infection due to steroid; MUST rinse their mouth after each use

Question 35

inhaler instructions

Answer 35

Take bronchodilator before steroid (wait 5 min)
Shake prior to use.
Have patient exhale first-place mouthpiece into mouth-lips with a good seal.
Push cylinder down once and inhale slowly until the lungs feel full.
Remove mouthpiece while holding breath for several seconds to allow medication to reach alveoli then exhale slowly.
Repeat as ordered for number of puffs.
Patient may rinse mouth afterward to remove taste of medication.

Question 36

Avoid exposure to conditions that precipitate bronchospasm

Answer 36

allergens, smoking, stress, air pollutants

Question 37

If a beta-agonist bronchodilator and corticosteroid inhaler are both ordered,

Answer 37

the bronchodilator should be used several minutes before the corticosteroid to provide bronchodilation before administration of the corticosteroid

Question 38

intranasal steroid agent MOA

Answer 38

decrease edema in the nasal membranes and sinuses through steroid (anti-inflammatory action). Blocks histamine and allergic response