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Nur 336 > Respiratory - Unit 3 - Lower Airway Disorders (Part 1) > Flashcards

Respiratory - Unit 3 - Lower Airway Disorders (Part 1) Flashcards

1
Q

What does nicotine cause? (Think vessels/vitals)

A

Constriction of blood vessels, increases HR and BP, curbs appetite and slows digestion, reduces body temp

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2
Q

Within 20 minutes of your last cigarette, your HR ___.

A

Drops

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3
Q

12 hours after quitting, the carbon monoxide level in your blood drops to ___

A

normal.

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4
Q

2 weeks –> 3 months after quitting, your heart attack risk begins to ____ & lung function begins to ___

A

Drop & improve.

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5
Q

1 to 9 months after quitting, coughing and shortness of breath ___.

A

decrease.

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6
Q

1 year after quitting, added risk of coronary heart disease is 1/2 that of a smoker’s. T/F?

A

True!

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7
Q

5 years after quitting, stroke risk is reduced to that of a ____.

A

Non-smoker’s.

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8
Q

10 years after quitting, lung cancer death rate is ___ that of a smoker’s.

A

Half!

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9
Q

15 years after quitting, risk of coronary heart disease is back to that of a normal nonsmoker T/F?

A

True!

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10
Q

What are some parts of smoking cessation?

A

Individual or group programs, coping strategies, avoid smokeless tobacco, medication therapies - also, relapses are common and NOT a failure.

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11
Q

What are the 5 A’s of smoking cessation?

A

ASK (About use)
ADVISE (inform of benefits of quitting, meds, etc.)
ASSESS (when ready/willing to begin)
ASSIST (Create a cessation plan, how to stay off)
ARRANGE (follow up, etc)

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12
Q

What are some side effects of nicotine replacement therapy (meds)?

A

Dry mouth, cough, scratchy throat and feeling on edge

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13
Q

What are some meds that reduce withdrawal symptoms?

A

Bubroprion/Wellbutrin, Varenciline/Chantix/Champix

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14
Q

How long is someone on buproprion? S/E?

A

7-12 weeks to 6 months, RX

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15
Q

How long is someone on varenicline/Chanix/champix? Is it long term? S/E?

A

3 mon-6 month, RX, S/E = Insomnia, GI upset, vivid dreams

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16
Q

What is the definition of COPD?

A

Airflow limitation disease - progressive and associated with abnormal inflammatory response of the lung. It is treatable and preventable

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17
Q

What are the two diseases that make up COPD?

A

Chronic bronchitis and pulmonary emphysema

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18
Q

COPD - ___th leading cause of death.

A

4th leading cause of death.

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19
Q

Women don’t get COPD more than men and then die from it. T/F?

A

False - more women die from it.

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20
Q

85-90% of deaths from COPD are DIRECTLY linked to _____.

A

Smoking

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21
Q

What are some COPD risk factors?

A

Smoking is #1, then 2nd hand smoke, occupational exposure (chemicals, smoke, etc), air pollution, deficiency of alpha 1 anitrypsin, history of childhood lung disease, etc.

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22
Q

What is chronic bronchitis?

A

Inflammation of the bronchi and bronchioles.

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23
Q

When is chronic bronchitis diagnosed?

A

Presence of cough and sputum production for at least 3 months in two consecutive years

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24
Q

Exposure to irritants triggers inflammatory response in chronic bronchitis, causing:

A

Vasodilation, congestion, mucosal edema, bronchospasm.

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25
Q

Chronic inflammation of the airways in chronic bronchitis causes:

A

thickened bronchial walls, increase in number and size of mucosal glands.

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26
Q

What are some classic assessment findings for chronic bronchitis?

A

Persistent cough, foul copious sputum, dusky color (blue bloater), dyspnea, tachypnea, overweight, early right sided heart failure

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27
Q

What is emphysema?

A

Abnormal permanent enlargement of airways/destruction of alveoli walls.

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28
Q

emphysema = loss of elasticity & hyperinflation of lung, along with trapped air. T/F?

A

True!

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29
Q

What are some classic assessment findings for emphysema?

A

Progressive, constant dyspnea, pink puffer skin color, increased AP diameter (barrel chest), tachypnea with difficulty exhaling, no cough, small amount of sputum, thin/wasted appearing

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30
Q

What are the three primary symptoms for COPD?

A

chronic cough, sputum production, dyspnea

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31
Q

What are some other parts of the COPD diagnosis?

A

ABG’s, sputum culture, HgB, HcT

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32
Q

What are some imaging tests done for COPD diagnosis?

A

Chest X-Ray, CT scan, lab tests, etc.

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33
Q

What is pulmonary function testing?

A

Comparison of FEV and FCV to classify mild to severe COPD.

34
Q

Post bronchodilator FEV = best predictor of survival. T/F?

A

True

35
Q

What are parts of the medical management for COPD?

A

Risk reduction, monitoring for the disease, prevent and treat exacerbations, pharmacologic therapy, etc.

36
Q

What’s the goal of treatment for COPD?

A

Reduce mortality and improve quality of life

37
Q

What are different bronchodilators?

A

Beta-adrenergic agonists (albuterol), cholinergic antagonists (atrovent), methylxanthines (theophylline), combination drugs

38
Q

What are some other meds for COPD?

A

corticosteroids (prednisone, short term & oral), pulmicort (inhaled).

Mast Cell Stabilizers (inhibit release of histamines),

leukotriene antagonists (decrease inflammation and edema) - singulair

mucolytic agents (for chronic bronchitis, thins secretions, give and encourage water!!!!!), mycomist, guafenisin)

39
Q

Hypoxemia and Acidosis - two major complications of COPD. T/F?

A

True!

40
Q

Why are we hesitant to put a COPD patient on too much 02?

A

Because if they have too much, they might stop breathing - a COPD patient’s drive to breathe comes from hypoxia

41
Q

Hypoxia =

Hypoxemia =

A

Hypoxia = low O2 in body.

Hypoxemia = low O2 in blood.

42
Q

Should a COPD patient wear a mask in cold weather, have a humidifier at home, and stop smoking?

A

YES

43
Q

Are COPD patients at a high risk for infection?

A

Yes, due to increased mucous production and poor oxygenation.

44
Q

Should COPD patients be around a lot of people and not get the flu shot?

A

NO FUCKING WAY! haha

45
Q

Do COPD patients have a risk for cardiac failure?

A

Yes, it’s called cor pulmonale - air trapping/collapsed airways cause alveolar wall increase, which makes the right side of the heart work harder. The right heart then enlarges…..which causes systemic edema.

46
Q

What are some nursing interventions for COPD?

A

position patient to maximize ventilation, instruct on breathing patterns (diaphragmatic/pursed lip), monitor respirations ever 2 hours, monitor effectiveness of O2 therapy, low-flow oxygen 1-3 liters, rest between activities, drink 2-3 liters daily, pulmonary rehab, etc.

47
Q

What is one of the big assessment findings on a X-Ray of someone with emphysema?

A

A flattened diaphragm

48
Q

What is acute bronchitis?

A

Diffuse inflammation of the mucosal lining of the bronchial tree and excess mucous production (after infection, typically).

49
Q

Acute Bronchitis is usually bacterial based. T/F?

A

FALSE - it’s 90% viral.

50
Q

What are some symptoms of acute bronchitis?

A

Cough that begins dry/non-productive that progresses to productive with clear or purulent sputum, low grade fever, substernal chest burning, wheezing or crackles, malaise, head ache.

51
Q

What is a good way to diagnose acute bronchitis?

A

Chest X-Ray

52
Q

What are some treatments for acute bronchitis?

A

Bed rest, nutrition, humidification, antipyretic, expectorant, antitussive (robitussin, tessalon, codiene), antibiotics IF BACTERIAL, STOP SMOKING

53
Q

Flu - often leads to pneumonia or death in:

A

elderly, debilitated, chronic respiratory disease patients, immunocompromised patients

54
Q

How do we prevent influenza?

A

Handwashing, cover mouth/nose when sneezing/coughing, avoid ill persons, avoid contact with others when sick.

55
Q

Influenza Vaccine =

IM (what ages) and intranasal (what ages?)

A

IM = 6 months and above…but intranasal = 2-8 years.

56
Q

Who should get the flu vaccine?

A

Patients with COPD, asthma, COPD, are in long-term care, those at risk or those who work with sick patients.

57
Q

What are the common symptoms of a cold?

A

Sneezing more, sore throat, minor aches and pains, , hacking, develops over a period of a few days, clogged nose

58
Q

What are the common symptoms of the flu?

A

Headaches, fever, chills, aches, develops quickly, tired feeling, cough, severe chest discomfort

59
Q

What are some treatment options for antiviral agents?

A

Flumadine, Relenza, Tamiflu (administer 24-48 hours of symptoms

Rest, drink fluids, saline gargles, antihistamines, watch for complications, avoid infecting others, etc.

60
Q

What is atelectasis?

A

Collapsed lung.

61
Q

Who is at risk for atelectasis?

A

Elderly, immobile patients, etc.

62
Q

How do we prevent atelectasis?

A

Avoid oversedating, encourage fluids, prevent abdominal overextension, etc.

63
Q

Pulmonary Tuberculosis - caused by mycobacterium tuberculosis bacillus. T/F? What happens?

A

True! It leads to necrosis and calcification.

64
Q

Is TB highly communicable?

A

YES

65
Q

How is TB transmitted?

A

Airborne

66
Q

What are some risk factors for TB?

A

Excess alcohol use #1, homelessness #2, non-injecting drug use #3, then injecting drug use, long term care resident, correctional facility

67
Q

In TB, they have a cough usually in the ___.

A

Morning (non-productive).

68
Q

TB patients can have a purulent, blood tinged sputum. T/F?

A

True

69
Q

What’s the difference between TB latent infection and TV active disease?

A

Latent = exposed to TB, may get ill in future but not now, CANNOT spread TB to others, positive mantoux but x-ray and sputum negative. Needs drug treatment to prevent active TB

ACTIVE = has symptoms (fever, weight loss, etc), CAN spread to others, positive mantoux (unless HIV+), or positive blood test, positive chest x-ray, sputum culture positive, etc.

70
Q

What’s the BCG vaccine?

A

Vaccine for TB, does NOT always protect people, not used in USA - usually used for young children in other countries, needs chest x-ray to assess

71
Q

Once positive, mantoux test is always positive. T/F?

A

True

72
Q

Positive mantoux indicates what?

A

exposure to TB or dormant disease.

73
Q

sputum culture = 2=8 weeks (or bactec 1-3 weeks) - T/F?

A

True

74
Q

3 positive cultures = TB.

3 Neg = non contagious.

T/F?

A

True

75
Q

For TB, drug therapy is easy and you don’t have to adhere to it. T/F?

A

FALSE - you MUST adhere.

76
Q

What are the four meds used for Active TB?

A

Isoniazid (INH), Rifampin (RIF), Pyraxinamide (PZA), Ethambutol (EMB) or Streptomycin

77
Q

What is the schedule for the four meds with active TB?

A

Isoniazid - kills active cells (start immediately)
Rifampin - kills slower growing cells (start immediately)
Pyraxinamide (added after 2nd month)
Ethambutol (added 4th month)

78
Q

Isoniazid - take on full stomach. T/F?

A

FALSE - you take on empty stomach, Vit B 12 can help with the hepato/neuro toxicity this can cause.

79
Q

Rifampin - what color does it turn your secretions/ee?

A

ORANGE

80
Q

PZA - should we take it with lots of water?

A

YES - DO NOT DRINK BOOZE

81
Q

What are some other S/E’s of the 4 TB meds?

A

Anorexia, N/V, abd pain, fever, rash, bleeding/bruising, aching joints, dizziness, blurred vision, females (oral birth control NOT effective!!!)

Nur 336 (26 decks)

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