Unit 5 - Asthma

Question 1

T/F: most asthma attacks require treatment

Answer 1

T

Question 2

Asthma in early life may lead to…

Answer 2

airway remodeling

Question 3

asthma can turn into…

Answer 3

chronic inflammatory disease

Question 4

Acute inflammatory response triggered:

Inflammatory mediators released:

• causes activation of…
• broncho…, airway ___, impaired clearance of _____
• (increases/decreases) work of breathing
• trapped air mixes with _____ air
• _____ gas exchange

Answer 4

• causes activation of inflammatory cells
• bronchoconstriction, airway edema, impaired clearance of secretion
• increases
• trapped air mixes with inhaled air
• impairs gas exchange

Question 5

Pathophysiology and Etiology:

Attack prolonged by late-phase response:

• _____ hours after exposure to trigger
• inflammatory cells _____ airway epithelium, _____ mucosal edema, and _____ bronchoconstriction
• airway resistance _____
• if untreated, _____ develops
• _____ can lead to respiratory _____

Answer 5

• 4-12 hours after exposure to trigger
• inflammatory cells damage airway epithelium, produce mucosal edema, and prolong bronchoconstriction
• increases
  if untreated, hypoxemia develops
• hyperventilation can lead to respiratory alkalosis

Question 6

Pediatric differences:

• _____ airway
• _____ and _____
• ribs _____
• oxygen consumption _____
• _____ _____ muscle fatigue

Answer 6

• narrower airway
• edema and swelling
• ribs flexible
• oxygen consumption higher
• more rapid muscle fatigue

Question 7

5 common causes of asthma

Answer 7

• air pollutants
• allergens
• chemicals, food
• stress
• respiratory infections

Question 8

Preventions of Asthma:

• avoiding _____ and _____ _____
• _____ dust
• _____ carpets
• covering _____ and _____
• _____ removal

Answer 8

• avoiding allergies and environemental triggers
• controlling dust
• removing carpets
• covering mattresses and pillows
• pet removal

Question 9

Traffic signals for asthma:

green

Answer 9

• green: 80 - 100% of personal best, asthma is under control

Question 10

Traffic signals for asthma:

yellow

Answer 10

• yellow: 50 - 80% caution, need treatment

Question 11

Traffic signals for asthma:

red

Answer 11

• red: < 50% immediate need for bronchodilator/further medical treatment

Question 12

_____ is the most common respiratory disease in pregnancy

Answer 12

asthma

Question 13

asthma in pregnancy can lead to a _____ baby and _____ _____ _____

Answer 13

premature and low birth weight

Question 14

Asthma and Pregnancy:

- improves in _____, maintains in _____, worsens in _____

Answer 14

improves in 1/3, maintains in 1/3, and worsens in 1/3

Question 15

3 specific diagnostic tests for asthma

Answer 15

• PEFR

- Allergic asthma: scratch or patch testing, IgE testing

Question 16

What do bronchodilators do

Answer 16

relax smooth muscles of airway

Question 17

Bronchodilator:

• _____ stimulant
• _____ agents
• _____

Answer 17

• adrenergic stimulant (beta 2 agonist)
• anticholinergic agents (ipratropium/atrovent) usually used with another med
• methylxanthines (theophylline and aminophylline)

Question 18

Corticosteroids and NSAIDS

Answer 18

cromolyn sodium, nedocromil

Question 19

Leukotrine modifiers

- _____ medications

Answer 19

oral medications

• montelukast (singulait)
• zafirlukast
• zileuton

Question 20

The client admitted with an acute exacerbation of asthma will require a _____ medication, such as an _____ _____-_____ _____-_____, oral _____, inhaled _____-_____ _____ _____

Answer 20

rescue
inhaled short-acting beta agonist
oral corticosteroids
inhaled long-acting beta agonists

Question 21

oral _____ are _____ medications used to treat asthma

Answer 21

oral anticholinergics are maintenance medications

Question 22

Appropriate teaching a for a client prescribed _____ _____ (_____) (_____ _____) includes only taking the prescribed number of doses each day to prevent a drug overdose and the use of hard candy or extra fluids to decrease dry mouth

Answer 22

ipratropium bromide (atrovent) (anticholinergic bronchodilator)

Question 23

_____ _____ acts to stimulate the fight-or-flight response, _____-_____ receptors of the sympathetic nervous system are _____, the bronchiolar smooth muscle _____, and _____ occurs

Answer 23

bronchodilator therapy
beta2-adrenergic
stimulated
relaxes
bronchodilators

Question 24

_____ mouth after using inhalers/leaving steroids in the mouth can cause thrush and also to reduce the amount of drug swallowed that may contribute to systemic side effects of steroids (not so much with newer inhalers)

Answer 24

rinse

Question 25

_____ modifiers works by blocking substances in your lungs called leukotrienes that cause narrowing and swelling of airways. Blocking leukotrienes improves asthma symptoms and helps prevent asthma attacks. Leukotrienes also cause allergic rhinitis symptoms. By blocking leukotrienes, singulair improves seasonal allergic rhinitis symptoms. Take singulair at least _____ hour _____ eating.

Answer 25

Leukotriene (singulair) 1 before

Question 26

If sing _____, it will require therapeutic blood levels to be drawn, severe side effects of too much

Answer 26

theophylline

Question 27

inaudible breath sounds, reduced wheezing, and ineffective cough are some indicators that...

Answer 27

little or no air movement into and out of the lungs is taking place and immediate intervention is needed

Question 28

affects on vitals during asthma attack - P - BPM - expiration

Answer 28

- tachycardia - tachypnea - prolonged expirations

Question 29

an increased respiratory rate indicates respiratory _____, but not _____

Answer 29

compromise, exhaustion

Question 30

_____ wheezing and the use of _____ muscles when inhaling indicate a progression of the severity of the symptoms, but airflow is still occurring; therefore, they (do, do not) require the most urgent action

Answer 30

diffuse, accessory, do not

Question 31

T/F: respiratory status can changes rapidly during an acute asthma attack

Answer 31

T

Question 32

Slowed, shallow respiratory with significantly diminished breath sounds and (increased, decreased) wheezing may indicate...Therefore, _____ intervention is necessary

Answer 32

decreased exhaustion and impending respiratory failure immediate

Question 33

One of the indicators for ineffective breathing pattern is _____

Answer 33

wheezing

Question 34

Goals may include: client will... - experience decreased number and severity of _____ - require _____ unscheduled visits to primary care provider or emergency department _____ exposure to irritants that aggravate asthma control - experience _____ quality of life

Answer 34

exacerbations fewer reduce improved

Question 35

To help promote airway clearance place the client in _____ position to facilitate breathing and lung expansion

Answer 35

Fowler

Question 36

Providing adequate rest periods prevents _____ and _____ oxygen demands

Answer 36

fatigue and reduces

Question 37

Reducing excessive _____ promotes rest

Answer 37

stimuli

Question 38

Assisting with activities of daily living _____ energy and _____ oxygen demands

Answer 38

conserves and reduces

Question 39

Effective treatment of asthma include _____-_____ treatment to prevent attacks and _____ inflammation, as well as short-term treatment when an attack occurs.

Answer 39

long-term | decrease

Question 40

Long-term treatment continues _____, not just for a year

Answer 40

indefinitely

Question 41

Age-appropriate, evidence-based interventions for a young adolescent client diagnosed with asthma includes referral to...

Answer 41

- peer-lead support group - assessing peer-support for the client - collaborating with teachers to ensure the client has the necessary support in school

Question 42

While it is appropriate to include the parents in the education process, the client should be taught...

Answer 42

how to administer medications prior to teaching the parents