Unit 5 - Asthma Flashcards
T/F: most asthma attacks require treatment
T
Asthma in early life may lead to…
airway remodeling
asthma can turn into…
chronic inflammatory disease
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
- causes activation of inflammatory cells
- bronchoconstriction, airway edema, impaired clearance of secretion
- increases
- trapped air mixes with inhaled air
- impairs gas exchange
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 _____
- 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
Pediatric differences:
- _____ airway
- _____ and _____
- ribs _____
- oxygen consumption _____
- _____ _____ muscle fatigue
- narrower airway
- edema and swelling
- ribs flexible
- oxygen consumption higher
- more rapid muscle fatigue
5 common causes of asthma
- air pollutants
- allergens
- chemicals, food
- stress
- respiratory infections
Preventions of Asthma:
- avoiding _____ and _____ _____
- _____ dust
- _____ carpets
- covering _____ and _____
- _____ removal
- avoiding allergies and environemental triggers
- controlling dust
- removing carpets
- covering mattresses and pillows
- pet removal
Traffic signals for asthma:
green
- green: 80 - 100% of personal best, asthma is under control
Traffic signals for asthma:
yellow
- yellow: 50 - 80% caution, need treatment
Traffic signals for asthma:
red
- red: < 50% immediate need for bronchodilator/further medical treatment
_____ is the most common respiratory disease in pregnancy
asthma
asthma in pregnancy can lead to a _____ baby and _____ _____ _____
premature and low birth weight
Asthma and Pregnancy:
- improves in _____, maintains in _____, worsens in _____
improves in 1/3, maintains in 1/3, and worsens in 1/3
3 specific diagnostic tests for asthma
- PEFR
- Allergic asthma: scratch or patch testing, IgE testing
What do bronchodilators do
relax smooth muscles of airway
Bronchodilator:
- _____ stimulant
- _____ agents
- _____
- adrenergic stimulant (beta 2 agonist)
- anticholinergic agents (ipratropium/atrovent) usually used with another med
- methylxanthines (theophylline and aminophylline)
Corticosteroids and NSAIDS
cromolyn sodium, nedocromil
Leukotrine modifiers
- _____ medications
oral medications
- montelukast (singulait)
- zafirlukast
- zileuton
The client admitted with an acute exacerbation of asthma will require a _____ medication, such as an _____ _____-_____ _____-_____, oral _____, inhaled _____-_____ _____ _____
rescue
inhaled short-acting beta agonist
oral corticosteroids
inhaled long-acting beta agonists
oral _____ are _____ medications used to treat asthma
oral anticholinergics are maintenance medications
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
ipratropium bromide (atrovent) (anticholinergic bronchodilator)
_____ _____ acts to stimulate the fight-or-flight response, _____-_____ receptors of the sympathetic nervous system are _____, the bronchiolar smooth muscle _____, and _____ occurs
bronchodilator therapy beta2-adrenergic stimulated relaxes bronchodilators
_____ 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)
rinse
_____ 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.
Leukotriene (singulair)
1
before
If sing _____, it will require therapeutic blood levels to be drawn, severe side effects of too much
theophylline
inaudible breath sounds, reduced wheezing, and ineffective cough are some indicators that…
little or no air movement into and out of the lungs is taking place and immediate intervention is needed
affects on vitals during asthma attack
- P
- BPM
- expiration
- tachycardia
- tachypnea
- prolonged expirations
an increased respiratory rate indicates respiratory _____, but not _____
compromise, exhaustion
_____ 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
diffuse, accessory, do not
T/F: respiratory status can changes rapidly during an acute asthma attack
T
Slowed, shallow respiratory with significantly diminished breath sounds and (increased, decreased) wheezing may indicate…Therefore, _____ intervention is necessary
decreased
exhaustion and impending respiratory failure
immediate
One of the indicators for ineffective breathing pattern is _____
wheezing
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
exacerbations
fewer
reduce
improved
To help promote airway clearance place the client in _____ position to facilitate breathing and lung expansion
Fowler
Providing adequate rest periods prevents _____ and _____ oxygen demands
fatigue and reduces
Reducing excessive _____ promotes rest
stimuli
Assisting with activities of daily living _____ energy and _____ oxygen demands
conserves and reduces
Effective treatment of asthma include _____-_____ treatment to prevent attacks and _____ inflammation, as well as short-term treatment when an attack occurs.
long-term
decrease
Long-term treatment continues _____, not just for a year
indefinitely
Age-appropriate, evidence-based interventions for a young adolescent client diagnosed with asthma includes referral to…
- peer-lead support group
- assessing peer-support for the client
- collaborating with teachers to ensure the client has the necessary support in school
While it is appropriate to include the parents in the education process, the client should be taught…
how to administer medications prior to teaching the parents
