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kol- Med Surg 320 Spring > Asthma > Flashcards

Asthma Flashcards

1
Q

what is oxygenation?

A

Delivery of oxygen to body’s tissue and cells. Oxygenation is required to sustain life

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2
Q

If patient not oxygenating what are 1st 2 priorities?

A
  1. Elevate HOB

2. Provide oxygen

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3
Q

What is asthma?

A

-Chronic condition characterized by intermittent and reversible obstruction of the airway due to (1) inflammation and (2) sensitivity of the airway tissue

  • –>Inflammation causes obstruction of lumen of airway
  • –>Hypersensitivity causes constriction of bronchial smooth muscle and results in narrowing of the outside of the airway (Bronchospasms)
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4
Q

What happens with frequent and repeated asthma attacks?

A
  • Over time, repeated, frequent asthma attacks will cause permanent damage to airway, resulting in enlargement of epithelial cells and changes in bronchial smooth muscle
    - > permanent airway inhibition
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5
Q

Asthma assessment (signs/sxs, history of)

A
  • Dyspnea Episodes “SHOB”
  • Chest tightness
  • Coughing
  • Wheezing
  • ↑ Mucous Production
  • Timing? - when do episodes of SHOB occur?
  • Associated with anything?
  • Allergies?
  • Family History
  • Smoker?
  • NSAID’s & Aspirin - cause release of leukotrienes leading to inflammatory response
  • Gastroesophageal Reflux Disease (GERD) - acid in airway can trigger asthma attack
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6
Q

How do -NSAID’s & Aspirin lead to asthma attacks?

A

cause release of leukotrienes leading to inflammatory response

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7
Q

How does gerd lead to asthma attack?

A

-Gastroesophageal Reflux Disease (GERD) - acid in airway can trigger asthma attac

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8
Q

what do you see with acute asthma attack?

A

Acute Asthma attack

- Audible wheeze
- Increased respiratory rate
- Coughing
- Use of accessory muscles with breathing
- Increased work of breathing
- Prolonged exhalation: air trapping, takes a lot fo work to blow air out
- Hypoxemia -> Hypoxia 
	- Cyanosis
	- Confusion/ Change in LOC (+ anxiety)
	- Tachycardia
- Barrel chest: From severe long-term asthma
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9
Q

What is ABG like for person with acute asthma attack?

A

-PaO2- low (80-100) during acute unless long term damage (60-100)
-PaCO2-
Early- respiratory alkalosis
Late- respiratory acidosis due to air trapping as unable to blow off CO2

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10
Q

What are FEV and PEF/PEFR ?

A

pulmonary function test

FEV-(Forced Expiratory Volume) inhale and push air out, VOLUME that comes out in 1st second
PEF- (peek expiratory flow rate) RATE of air coming out in 1st second

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11
Q

how do they determine ranges for FEV/PEF

A

-Expected “normal” values based on age, sex and size/ NHANES

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12
Q

How do FEV/PEF diagnose asthma?

A

-Diagnosis of asthma= 12% increase in FEV and PEFR after bronchodilator

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13
Q

What is a methacholine test?

A

Induces bronchospasms/tighten of smooth muscle in
bronchioles

-diagnose asthma

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14
Q

What are goals for treating asthma?

A

-To Prevent and Control Acute Episodes
->Reduces permanent damage/ worsening of
disease
-Improve Airflow
-Optimize Gas Exchange
-Symptom Relief

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15
Q

Interventions for asthma?

A
  • Personal Asthma Action Plan
  • Education
  • Drug Therapy: need control and rescue medication*
  • Lifestyle Modifications
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16
Q

what is a personal action plan?

A
  • Empowerment
  • Goals
    • Increase symptom-free periods
    • Reduce severity of attacks
    • Self-assessment
    • Tracking attacks/ triggers
    • Peak Flow Meter
    • Medication adjustments
    • When to call the provider
    • Directions for emergency
17
Q

What do we use peak flow meter for?

A

Establish a personal best (Baseline) PEF over 2-3 weeks/Measure BID with well controlled sxs

18
Q

how often do we do peak flow meter assessments?

A

-Assess asthma severity twice daily (minimum) with the peak flow meter and compare to baseline

19
Q

What is the goal range for peak flow meter?

A

80-100% is good/ no increase in medication

20
Q

What if peak flow meter score is only 50-80% of baseline?

A

requires use of reliever (rescue) medication (and follow-up PEF)
–>Frequent readings in this range may require an increase in control medication(s)

21
Q

What is peak flow meter reading is less than 50%?

A

-50% or less of personal best requires reliever medication and seek emergency help

22
Q

What are some common triggers for asthma?

A 
Cold Air
Dry Air
NSAIDS & Aspirin
Beta Blockers
Small Air Particles
Exercise
Upper Respiratory Illness
“MSG”
Stress
23
Q

Interventions for asthma?

A

Exercise
Oxygen & Positioning
Rest
Relaxation techniques

24
Q

Signs of an Emergency for someone with asthma

A
  • When someone is at 50% or less of personal best
  • If peak expiratory rate flow is declining with therapy
  • Medication is not working
  • -Cyanosis
  • Nasal Flaring
  • Retractions
  • Increased work of breathing that effects ability to walk or talk
25
Q

what is status asthmaticus?

A

-Acute episode of asthma that does not respond to medications

26
Q

signs and sxs of status asthmaticus?

A
  • Severe labored breathing with use of accessory muscles
  • Wheezing
  • Distention of neck veins
27
Q

Status Asthmaticus

can lead to what untreated?

A

-Can lead to pneumothorax, respiratory arrest and cardiac arrest

28
Q

treatment for status asthmaticus includes?

A 
High Fowlers
Bronchodilators Neb 
Steroids IV
Epinephrine
Oxygen
Fluids
May require intubation and mechanical ventilation
29
Q

4 hallmark signs of asthma?

A
  • Dyspnea Episodes “SHOB”
  • Chest tightness
  • Coughing
  • Wheezing
30
Q

lil dude comes in with status asthmaticus- they have O2 and HOB is Elevated. What are the next 2 things ya gonna do?

A

Nebulize and start an IV

kol- Med Surg 320 Spring (43 decks)

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