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MedSurg > T1-Ch 27: Noninfectious LR Problems > Flashcards

T1-Ch 27: Noninfectious LR Problems Flashcards

1
Q

chronic lower respiratory disorder that causes inflammation that obstructs the airway via bronchoconstriction

A

asthma

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2
Q

Asthma triggers (4)

A

-specific allergens
-general irritants
(cold air, dry air, fine airborne particles, microorganisms)
-aspirin & other NSAIDs
-WBCs (eosinophils and neutrophils activated by IL-5 or IL-7)

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3
Q

Symptoms for asthma control scale: (4)

A

-Daytime: wheezing, dyspnea, coughing, present more than twice weekly
-Waking from night sleep with symptoms go wheezing, dyspnea, coughing
-Reliever drug needed more than twice weekly
-Activity limited or stopped by symptoms

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4
Q

Asthma control level:
no symptoms present

A

controlled

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5
Q

Asthma control level:
1-2 symptoms

A

Partly controlled

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6
Q

Asthma control level:
3-4 symptoms

A

uncontrolled

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7
Q

General asthma s/s (4)

A

-audible wheeze
-longer breathing cycle w/ prolonged and more effortful exhalation
-decreased ability to speak
-hypoxia

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8
Q

Asthma patients ABG will show:

A

decreased CO2

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9
Q

Asthma patients End-vital carbon dioxide levels _____ in later stages

A

rise

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10
Q

Asthma patients have _____ eosinophil count and IgE due to ________

A

elevated
allergen triggers

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11
Q

Most accurate test to diagnose asthma

A

pulmonary function test

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12
Q

How many steps are therein asthma step therapy?

A

5 steps

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13
Q

Asthma Therapy: Step 1

A

Albuterol PRN

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14
Q

Asthma Therapy: Step 2

A

Albuterol PRN
Daily dose ICS or Leukotriene modifier

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15
Q

Asthma Therapy: Step 3

A

Albuterol PRN
Daily low dose:
1) ICS + Laba
2) medium to high dose ICS
3) low dose ICS + Leukotriene modifier
OR
4) Low dose ICS + SR theophylline

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16
Q

Asthma Therapy: Step 4

A

Albuterol PRN
Daily Step 3 Treatment
Daily:
1) medium/high dose ICS + Laba
OR
2) Leukotriene modifier + SR theophylline

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17
Q

Asthma Therapy: Step 5

A

Albuterol PRN
Daily treatment with Step-4 options
Additional:
1) Oral glucocorticoid
OR
2) IgE antagonist (IL-5 or IL-7)

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18
Q

Emergency services are requires for asthma patients when: (5)

A

-Fingertips or lips are gray/blue
-Difficulty breathing, walking, or talking
-Retractions of the neck, chest, or ribs
-Nasal flaring
-Failure of drugs to control worsening symptoms

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19
Q

A destruction of lung’s elastic tissue that reduces its ability to recoil after stretching, leading to hyperinflation of the lungs

A

Emphysema

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20
Q

Hyper-inflated lungs ______ the diaphragm, weakening it

A

flatten

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21
Q

Patients with emphysema use accessory muscles of the ___, ___, and _____ to inhale and exhale

A

neck, chest wall, and abdomen

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22
Q

increased work to breath = increase in oxygen needed = _____

A

air hunger

23
Q

ABGs of emphysema patients may show chronic ______ _______

A

respiratory acidosis

24
Q

Emphysema causes include: (3)

A

-tobacco smoking
-marijuana use
-chronic inhaled particular matter exposure (wood smoke & biomass fuels)

25
Q

Greatest risk factor for COPD

A

smoking

26
Q

Other risk factors for COPD

A

-genetic
-environmental

27
Q

complications of COPD (5)

A

-hypoxemia
-acidosis
-respiratory infection
-cardiac failure
-cardiac dysrhtymias

28
Q

COPD is classified from mild to very severe on the basis of: (2)

A

-symptoms
-pulmonary function test changes

29
Q

Decreased gas exchanges with COPD is due to: (8)

A

-alveolar-capillary membrane changes
-reduced airway size
-ventilatory muscle fatigue
-excessive mucus production
-airway obstruction
-diaphragm flattening
-fatigue
-decreased energy

30
Q

Weight loss in COPD patients is due to: (4)

A

-dyspnea
-excessive secretions
-anorexia
-fatigue

31
Q

Anxiety in COPD patients is often due to: (2)

A

-changes in health status
-situational crisis

32
Q

Decreased endurance in COPD patients is due to: (3)

A

-fatigue
-dyspnea
-imbalance between oxygen supply and demand

33
Q

COPD cues (5)

A

-decreased gas exchange
-weight loss
-anxiety
-decreased endurance
-pneumonia/respiratory infection

34
Q

Before a nurse conducts an intervention on COPD patient they should assess (4)

A

-breathing rate
-rhythm
-depth
-use of accessory muscles

35
Q

Nursing care for COPD patients

A

-assess breathing before interventions
-conduct interventions
-teach effective coughing & exercise conditioning
-Use oxygen therapy, suctioning, and ensure hydration

36
Q

Nursing interventions for COPD patients

A

-ensure consistency prescribed drug therapy use for airway maintenance
-monitor for improvements
-use breathing techniques
-reposition patients

37
Q

COPD severity classification:
FEV > 80% predicted

A

Gold 1: Mild

38
Q

COPD severity classification:
FEV 50-79% predicted

A

Gold 2: Moderate

39
Q

COPD severity classification:
FEV 30-49% predicted

A

Gold 3: Severe

40
Q

COPD severity classification:
FEV < 30% predicted

A

Gold 4: very severe

41
Q

Breathing techniques: (2)

A

-pursed-lip breathing
-diaphragmatic or abdominal breathing

42
Q

Steps for diaphragmatic/abdominal breathing

A

-lie on you back with knees bent (or sitting in chair if unable to lie down)
-Place your hands or a book on your abdomen to create resistance
-begin breathing from your abdomen while keeping your chest still (look for rise/fall of book or hand)

43
Q

Steps for Pursed-Lip Breathing (3)

A

-Close your mouth and breath in through your nose
-Purse your lips as you would to whistle; breath out slowly through your mouth, without puffing your cheeks; spend twice the amount of time it took you to breath in
-Use your abdominal muscles to squeeze out every bit of air possible

44
Q

an autosomal recessive genetic disease that affects many organs with most impairment occurring to pancreatic and/or lung function

A

Cystic Fibrosis

45
Q

Organs most commonly impaired in Cystic Fibrosis patients (5)

A

-pancreas
-lungs
-liver
-salivary glands
-testes

46
Q

How are babies screened for Cystic Fibrosis?

A

Sweat test

47
Q

In pts with Cystic Fibrosis, poor ______ transport causes the formation of mucus that has little water content and is _______

A

-chloride transport
-thick

48
Q

Non-pulmonary problems of COPD patients include: (6)

A

-pancreatic insufficiency
-malnutrition
-intestinal obstruction
-poor growth
-male sterility
-cirrhosis of the liver

49
Q

_____ & ______ are concerns of cystic fibrosis pts due to nutritional issues

A

-osteoporosis
-diabetes mellitus

50
Q

Main cause of death for Cystic Fibrosis pts

A

Respiratory Failure

51
Q

Cystic Fibrosis ABG
ABG shows _____ :
_____ arterial oxygen levels
_____ arterial carbon dioxide
_____ bicarb

A

acidosis
-greatly reduced arterial oxygen level
-increased arterial carbon dioxide levels
-increased bicarbonate

52
Q

Cystic fibrosis management includes: (8)

A

-drug therapy
-infection prevention
-pulmonary hygiene
-nutrition & vitamin supplements
-Oxygen therapy
-treatment for respiratory infections
-gene therapy
-sometime surgery

53
Q

Major issues of lung transplants in cystic fibrosis patients (3)

A

-bleeding
-infection
-transplant rejection

MedSurg (14 decks)

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