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Adult Health 1 - (Josh) > T2 - Asthma, Sarcoidosis, Lung Cancer (Josh) > Flashcards

T2 - Asthma, Sarcoidosis, Lung Cancer (Josh) Flashcards

1
Q

What happens to bronchioles during asthma?

A

obstructed on expiration due to muscle spasm, edema of mucosa, and thick secretions

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2
Q

Statistics of Asthma:

What is the impact of Asthma on healthcare?

A

5000 ED visits daily ; 217,000 ED visits annually

1000 hospital admissions daily ; 500,000 annually

10.5 million PCP visits each year

***Increases odds of needing medical treatment by 33% for obese clients

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3
Q

Statistics of Asthma:

What is the prevalence of Asthma in U.S.?

A

20 million americans

300 million worldwide

more common in adult women than men

more common in AA than Whites

***Number continues to increase

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4
Q

Statistics of Asthma:

What is the cost of Asthma in U.S.?

A

$ 19.7 billion annually

$3,300 per person annually

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5
Q

Asthma:

What are the two steps of Asthma?

A

Inflammation

Airway hyperresponsiveness leading to bronchoconstriction

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6
Q

Asthma:

Pathophysiology

A

Intermittent and resversible airflow obstruction affecting airways only, not alveoli

***AIRWAYS ONLY, NOT ALVEOLI

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7
Q

Asthma:

How could ASA and other NSAIDS trigger asthma?

A

increased production of leukotriene while suppressing other inflammatory pathways

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8
Q

Asthma:

What are some triggers of the Inflammation process?

A

Cold air

Dry air

Specific Allergens

General Irritants

Microorganisms

ASA

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9
Q

Asthma:

What are some triggers of the Hyper-Responsiveness process?

A

Exercise

URI

GERD

unknown reasons

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10
Q

Asthma:

What are some clinical manifestations?

A

Audible wheeze

Increased RR and cough

Use of accessory muscles

Barrel chest

Long breathing cycle

Cyanosis

Hypoxemia

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11
Q

Asthma:

What may happen to CO2 during asthma attack?

A

arterial CO2 may decrease (alkalosis) early in attack and increase (acidosis) later

***indicating poor gas exchange

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12
Q

Asthma:

What would serum eosinophil levels and Immunoglobulin E levels look like?

A

elevated

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13
Q

Asthma:

What is most accurate way to assess Pulmonary Function?

A

Spirometry

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14
Q

What is Forced Vital Capacity (FVC)?

A

volume of exhaled air from full inhalation to full exhalation

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15
Q

What is Forced Expiratory Volume in First Second (FEV1)?

A

volume of air blown out as hard and fast as possible during the first second after a full inhalation

***decreases by 15-20% of expected value is common in asthma

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16
Q

What is Peak Expiratory Flow Rate (PEFR)?

A

fastest airflow rate reached during exhalation

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17
Q

Asthma Severity:

What is Mild Intermittent?

A

symptoms less than twice a week

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18
Q

Asthma Severity:

What is Mild Persistent?

A

symptoms more than twice a week, but not daily

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19
Q

Asthma Severity:

What is Moderate Persistent?

A

daily symptoms, with exacerbations twice a week

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20
Q

Asthma Severity:

What is Severe Persistent?

A

symptoms occur continually with frequent exacerbations

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21
Q

Asthma Meds:

Which bronchodilator would not be first choice due to narrow therapeutic range?

A

Theophyline

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22
Q

Asthma Meds:

What anti-cholinergic is often used as a bronchodilator?

A

ipratroprium

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23
Q

Asthma Meds:

What are the anti-inflammatory agents?

A

Corticosteroids

Cromones (cromolyn)

Leukotrien Modifiers (reduce inflammation)

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24
Q

Status Asthmaticus:

What is it?

A

severe, life-threatenine, acute episode of airway obstruction

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25
Q

Status Asthmaticus:

Does patient respond to normal asthma meds?

A

no

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26
Q

Status Asthmaticus:

What are some complications?

A

Pneumothorax

Cardiac / Respiratory arrest

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27
Q

Status Asthmaticus:

What is treatment regimen?

A

IV fluids

Potent Systemic bronchodilator

Steroids

Epi

O2

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28
Q

Emphysema and Chronic Bronchitis are examples of —

A

COPD (Chronic Obstructive Pulmonary Disease)

29
Q

COPD:

What is it characterized by?

A

bronchospasm and dyspnea

***tissue damage is NOT reversible

***only can treat the symptoms

30
Q

COPD:

Chronic Bronchitis is an — problem

Pulmonary Emphysema is an — problem

A

Airway

Alveolar

*** both are examples of COPD

31
Q

COPD:

— is a loss of lung elasticity leading to hyperinflation of lungs.

32
Q

COPD:

— is air trapping caused by loss of elastic recoil in alveolar walls, overstretching and enlargement of alveoli into bullae, collapse of small airways (bronchioles).

33
Q

COPD:

In Emphysema, the hyperinflated lung (due to loss of elasticity) does what to the diaphragm?

A

flattens it

34
Q

COPD:

— is inflammation of bronchi and bronchioles caused by chronic exposure to irritants, especially CIGARETTE SMOKE

A

Chronic Bronchitis

35
Q

In Chronic Bronchities, what is the pathophysioligy?

A

Inflammation leads to

Vasodilation, which leads to

Congestions, which leads to

Mucosal Edema, which leads to

Bronchospasm

36
Q

COPD:

Chronic Bronchitis affects the —, not the —

A

airways

alveoli

***produces a large amount of thick mucous

37
Q

COPD:

Etiology

A

Cig smoke

Advanced Age

Alpha 1 - antitrypsan (AAT) Deficiency

Exposure to Air Pollution

38
Q

COPD:

Complications

A

Hypoxemia / Tissue Anoxia

Acidosis

Resp. Infections

Cardiac failure, especially cor pulmonale

Cardiac dysrthymia (PVCs)

39
Q

COPD:

What is Cor Pulmonale?

A

right sided HR caused by pulmonary problems

40
Q

COPD:

In lab assessment, what would we see in CBC?

A

Increase in HCT and Hgb

Polycythemia

WBC increase (due to mucous increase)

41
Q

COPD:

What are nursing interventions?

A

Improve oxygenation and reduce CO2 retention

Prevent weight loss

Minimize anxiety

Improve activity intolerance

Prevent resp. infection

42
Q

COPD:

How do we manage dyspnea while providing nutrition?

A

rest before meals

4-6 small meals a day (high calorie / high nutrient)

43
Q

COPD:

What breathing techniques should we teach?

A

Pursed lip breathing

Diaphragmatic breathing

44
Q

– – is a genetic disease that is an error of chloride transport, producing thick mucus with low water content.

A

Cystic Fibrosis

***life expectancy is 37 yrs

**sweat chloride test (normal is 5-45) (positive is 60-100 mEq/L)

45
Q

CF:

Clinical Manifestations

A

Smaller, thinner adults due to malnutrition

Abdominal distention

GERD, Rectal Prolapse, Fouls Smelling Stools, Steatorrhea

Vit deficiences

DM

Osteoporosis

46
Q

CF:

Pulmonary Manifestations

A

Resp infections

Chest congestion

Limited exercise tolerance

Cough and Sputum production

Use of accessory moscles

Decreased pulmonary function

Changes in CXR

Barrel Chest

47
Q

CF:

What can we do NUTRITIONALLY to manage CF?

A

Weight mgmt

Vit supplementation

Diabetes mgmt

Pancreatic enzyme replacement

48
Q

CF:

What can we do for PREVENTIVE therapy?

A

Chest physiotherapy

Positive EXPIRATORY pressure

Active cycle breathing technique

Exercise

49
Q

CF:

What can we do to manage EXCASERBATIONS?

A

Avoid mechanical ventilation

Supplemental O2

Heliox (50% O2 / 50% helium)

Airway clearance techniques

Drug therapy

Prevention

50
Q

CF:

What types of drugs can we use?

A

Pancrealipase

Bronchodilators

Antiinflammatories

Mucolytics

51
Q

CF:

What can we do surgically to manage CF?

A

Lung and/or Pancreatic transplant

  • **doesn’t cure
  • **adds 10-20 yrs to life
  • **continued risk for lethal pulmonary infections
52
Q

Interstitial Pulmonary Diseases:

Which area of lungs do these diseases affect?

A

alveoli,

blood vessels,

surrounding support lung tissue

53
Q

Interstitial Pulmonary Diseases:

Slow of Fast onset?

A

Slow (not acute)

54
Q

Interstitial Pulmonary Diseases:

What is the most common manifestation?

A

SOB (Dyspnea)

55
Q

Interstitial Pulmonary Diseases:

What type of disease is this?

A

restrictive disease resulting in thickened lung tissue, reduced gas exchange, and STIFF LUNGS

56
Q

Sarcoidosis:

What is it?

A

GRANULOMATOUS disorder of unknown cause

Scar Tissue

57
Q

Which disease?

Autoimmune response where normally protective T-lymphocytes increase and damage lung tissue.

A

Sarcoidosis

***treat with corticosteroids

58
Q

Sarcoidosis:

What drug class is used to treat?

A

Corticosteroids

59
Q

Idiopathic Pulmonary Fibrosis:

Restrictive or Obstructive Disease?

A

Restrictive

60
Q

Idiopathic Pulmonary Fibrosis:

What is the etiology?

A

Cigarette smoking

Chronic exposure to inhalant irritants

AMIODARONE (long term high doses)

61
Q

Idiopathic Pulmonary Fibrosis:

Leads to extensive – and treated with –

A

scarring

corticosteroids

62
Q

What is the leading cause of cancer deaths worldwide?

A

Lung Cancer

***poor long-term survival due to late-stage dx

63
Q

Lung Cancer:

What do the letters stand for in the TNM Classification System?

A

T = size of tumor

N = number of nodes involved

M = number of areas of metastatic involvement

64
Q

Lung Cancer:

What is Stage 1?

A

T1 with or without metastasis to the lymph nodes

T2 with no nodal or metastatic involvement

65
Q

Lung Cancer:

What is Stage 2?

A

T2 with metastasis to the ipsilateral hilar lymph nodes

66
Q

Lung Cancer:

What is Stage 3?

A

all tumors more extensive than T2

Any tumor with metastasis to the lymph nodes in the mediastynum or with distant metastasis

67
Q

Lung Cancer:

After a pneumectomy, what are two major nursing responsibilities?

A

Airway

Pain Control

68
Q

What are the Chest Tube Chambers used for?

A

Chamber 1: collects fluid draining from patient

Chamber 2: water seal prevents air from re-entering patient’s pleural space

Chamber 3: suction control of system

Adult Health 1 - (Josh) (26 decks)

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