respiratory

Question 1

asthma

Answer 1

chronic disease, airflow obstruction, inflammation, hyper-responsiveness

chronic airflow limitation (CAL)

Question 2

asthma incidence, etiology, risks

Answer 2

5 million under age 18
allergy, esophageal reflux, male, genetics, elderly, urban areas, ethnicity

Question 3

asthma clinical manifestations

Answer 3

wheezing, chest tightness, dyspnea, SOB, no wheezing if blocked, cough, tachycardia, diaphoresis, anxiety, panic, mood changes, hyperventilation

Question 4

bronchodilators

Answer 4

short acting= albuterol
long acting= salmeterol
increases smooth muscle relaxation, no effect on inflammation, increase fluid intake, take 5 minutes before other inhaled drugs
monitor HR

Question 5

methylxanthines

Answer 5

long acting
theophylline= most common med
dilates bronchi, used when other drugs are ineffective, can build up and cause toxicity

Question 6

cholinergic antagonists

Answer 6

intermediate acting
ipratropium= most common
adverse reactions= increased HR

Question 7

anti inflammatory drugs

Answer 7

corticosteroids
long acting, local or systemic
pulmicort/flovent/azmacort= most common
significant S/E= delayed wound healing, personality changes, fluid retention
taper doses, rinse mouth

Question 8

asthma complications

Answer 8

pneumonia, atelectasis, hypoxemia, respiratory acidosis, respiratory failure, emphysema, chronic hypoxia, chronic bronchitis, asthmaticus

Question 9

COPD

Answer 9

emphysema and chronic bronchitis
Symptoms: worsening breathlessness upon exertion, leads to breathlessness at rest

Question 10

COPD etiology/ risk factors

Answer 10

smoking, alpha 1-antitrypsin deficiency, air pollution, occupational exposure, infection
3 million deaths each year

Question 11

clinical manifestations of COPD

Answer 11

distended neck veins, right ventricular enlargement, lower sternal pulsations, GI disturbance, weight loss, dependent edema, metabolic and resp acidosis, pulmonary hypertension, hypoxia, fatigue, weak, enlarged/tender liver, bounding pulse, warm cyanotic extremities, cough

Question 12

oxygen therapy for COPD

Answer 12

heated, humidified system
clear secretions
monitor liter flow and effectiveness with pulse ox., oxygen toxicity and oxygen induced hypoventilation, skin breakdown, anxiety
teach at home use

Question 13

COPD complications

Answer 13

pulmonary hypertension, cardiac dysrhythmias, pneumonia, atelectasis, pneumothorax, bronchospasm, RF

Question 14

emphysema

Answer 14

increased ventilatory “dead space”, hyperinflation of the lung, loss of elasticity, increased mucus, destruction of alveolar walls, alveoli collapse, spontaneous pneumothorax, chest tube for re-expansion of lung
caused by smoking, genetics, pollution

Question 15

emphysema clinical manifestations

Answer 15

severe SOB at rest
O2 level below 40mmHg
chronic productive cough
barrel chest
wheezing, crackles, rhonchi
diminished breath sounds
tachypnea
hypoxia
hypoxemia
hypercapnia
fatigue
anorexia

Question 16

emphysema complications

Answer 16

hypoxemia, acidosis, cardiac dysrhythmias, pneumonia, atelectasis, pneumothorax, cardiac failure, respiratory failure