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from flashcardlet > (3) Exam 2-😗💨 (10/1/15) Lecture - Asthma, Environmental Factors, PE & Lung Cancer > Flashcards

(3) Exam 2-😗💨 (10/1/15) Lecture - Asthma, Environmental Factors, PE & Lung Cancer Flashcards

0
Q 
Respiratory Dysfunctions (Objective#21)
People that work with stone, concrete, glass, rock, sand, and granite are at risk for getting what environmental lung disease?
A

Silicosis

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1
Q 
Respiratory Dysfunctions (Objective#21)
What is Pneumoconiosis
A

Acquired lung disease based on exposure in a work environment

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2
Q 
Respiratory Dysfunctions (Objective#21)
What chronic and environmental lung disease is characterized by prolonged exposure to small fibers that can cause lung tissue scarring and shortness of breath?
A

Asbestosis

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3
Q 
Respiratory Dysfunctions (Objective#21)
What individuals are at risk for getting "Black Lung"
A

Coal Workers

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4
Q 
Respiratory Dysfunctions (Objective#21)
What environmental lung disease gradually results in a hardening of the lungs making them difficult to inflate, requires a lung transplant to save the patients life, and many times results from an unknown cause?
A

Pulmonary Fibrosis

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5
Q 
Respiratory Dysfunctions (Objective#21)
💥To decrease environmental toxins and occupational exposure, what does a work environment need?
A

▪️Good Ventilation
▪️Good Protective Equipment
▪️Occupational Nurses need to be aware of exposure and know the signs
▪️💥FITTED RESPIRATORS💥

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6
Q 
Respiratory Dysfunctions (Objective#21)
😰In the work environment the occupational nurse needs to be aware of exposure and know to look for what s/s?
A

▪️Shortness of Breath

▪️Cough

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7
Q 
Respiratory Dysfunctions (Objective#21)
What environmental lung disease is due to exposure of chemicals that are "floating around"?
A

Chemical Pneumonitis

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8
Q 
Respiratory Dysfunctions (Objective#22)
What blockage of the pulmonary artery by thrombus can be stationary or an emboli?
A

Pulmonary Embolism

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9
Q 
Respiratory Dysfunctions (Objective#22)
What is an emboli?
A

Something that travels from a different location

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10
Q 
Respiratory Dysfunctions (Objective#22)
A Pulmonary Embolism is usually found in what part of the lungs?
A

Smaller vessels in the lower lobes

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11
Q 
Respiratory Dysfunctions (Objective#22)
What percentage of patients with a Pulmonary Embolism die within the first hour?
A

10%

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12
Q 
Respiratory Dysfunctions (Objective#22)
Describe the process of a Pulmonary Embolism.
A

Material gets access to the Venus system → Pulmonary Circulation → Travels with blood flow until it gets to smaller and smaller vessels → Obstructs alveolar perfusion → Stops

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13
Q 
Respiratory Dysfunctions (Objective#22)
What blocks the pulmonary arteries to cause a Pulmonary Embolism?
A

Thrombus, Fat or Air Embolus, or Tumor Tissue

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14
Q 
Respiratory Dysfunctions (Objective#22)
What type of obstruction can be caused by a IV or Syringe that hasn't been primed?
A

Air Embolism

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15
Q 
Respiratory Dysfunctions (Objective#22)
What injury causes a Fat Embolism?
A

Fractured Long Bone

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16
Q 
Respiratory Dysfunctions (Objective#22)
What are Pulmonary Embolisms caused by 90% of the time?
A

Deep Vein Thrombosis (DVT)

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17
Q 
Respiratory Dysfunctions (Objective#22)
😰What is the most common symptom of a Pulmonary Embolism and is present in 85% of cases?
A

Dyspnea (Shortness of Breath)

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18
Q 
Respiratory Dysfunctions (Objective#22)
😰Clinical Manifestations of a Pulmonary Embolism
A 
▪️Dyspnea
▪️Tachypnea
▪️Cough
▪️Chest Pain
▪️Hemoptysis
▪️Fever
▪️Tachycardia
▪️Syncope
▪️Change in LOC
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19
Q 
Respiratory Dysfunctions (Objective#22)
😰What sounds may be heard in the lungs with a Pulmonary Embolism?
A

▪️Crackles

▪️Wheezing

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20
Q 
Respiratory Dysfunctions (Objective#22)
😰What symptoms are expected with a Massive Emboli?
A

Abrupt Hypotension and Shock

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21
Q 
Respiratory Dysfunctions (Objective#22)
📈What is the best diagnostic study to use with a Pulmonary Embolism?
A

Ventilation / Perfusion Scan

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22
Q 
Respiratory Dysfunctions (Objective#22)
📈 What Diagnostic Test is done first with a Pulmonary Embolism?
A

X-Ray

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23
Q 
Respiratory Dysfunctions (Objective#22)
What type of Emboli can be taken care of by out circulatory system?
A

Small Emboli

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24
Q 
Respiratory Dysfunctions (Objective#22)
📈What Diagnostic study involves inection and inhalation of a radioactive substance?
A

VQ Scan (Ventilation Perfusion Scan)

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25
Q 
Respiratory Dysfunctions (Objective#22)
♿️ What complication of a Pulmonary Embolism is most likely due to an occlusion in a large vessel, insufficient circulation in the bronchial system, or preexisting lung disease?
A

Pulmonary Infarction

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26
Q 
Respiratory Dysfunctions (Objective#22)
♿️ What complication can manifest from unrelieved Pulmonary Hypertension?
A

Right Ventricular Hypertrophy

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27
Q 
Respiratory Dysfunctions (Objective#22)
 ♿️Complications of a Pulmonary Embolism
A

▪️Pulmonary Infarction

▪️Pulmonary Hypertension

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28
Q 
Respiratory Dysfunctions (Objective#22)
What results from hypoxia associated with a massive or recurrent emboli?
A

Pulmonary Hypertension

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29
Q 
Respiratory Dysfunctions (Objective#22)
📈 What is the most frequently used Diagnostic Test for a Pulmonary Embolism, requires IV Contrast and allows for 3D visualization of all regions of the lungs?
A

Spiral (Helical) CT Scan

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30
Q 
Respiratory Dysfunctions (Objective#22)
📈 What does an X-Ray reveal with a Pulmonary Embolism?
A

Flattening diaphragm, and respiratory distress or atelectasis (alveolar collapsing).

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31
Q 
Respiratory Dysfunctions (Objective#22)
📈 Although it is NOT diagnostic of a Pulmonary Embolism, what might a Electrocardiogram reveal?
A

ST segment or T-Wave Changes

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32
Q 
Respiratory Dysfunctions (Objective#22)
💉 What protein identifies that a blood clot was present, is elevated with any clot degradation and can give false negatives with small a small pulmonary embolism?
A

D-Dimer

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33
Q 
Respiratory Dysfunctions (Objective#22)
💉 Due to inadequate oxygenation to an occluded vessel, what results may appear with ABG's?
A

↓PaO2

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34
Q 
Respiratory Dysfunctions (Objective#22)
😷How do you prevent DVT and Pulmonary Embolism?
A 
▪️Early ambulation of post-op patients 
▪️Avoid immobility
▪️Leg exercises for bedridden patients
▪️Prophylactic Anticoagulants
▪️Pneumatic device for lower extremities
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35
Q 
Respiratory Dysfunctions (Objective#22)
💉 What is a normal PTT?
A

25-35 seconds

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36
Q 
Respiratory Dysfunctions (Objective#22)
💉 What is the PTT therapeutic range for patient receiving Heparin?
A

1.5 - 2 times the normal value.

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37
Q 
Respiratory Dysfunctions (Objective#22)
💊What medication is given to patients that have a predisposition for an emboli?
A

Heparin

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38
Q 
Respiratory Dysfunctions (Objective#22)
💊To wean patients off of Heparin, what is given before Heparin is stopped / discontinued?
A

Coumadin

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39
Q 
Respiratory Dysfunctions (Objective#22)
💊 How long will a patient be on Coumadin when given to wean off Heparin?
A

3-6 months

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40
Q 
Respiratory Dysfunctions (Objective#22)
😷 In addition to turn, cough and deep breathing, how often should a patient use an inventive spirometer after surgery?
A

Every couple hours for the first 24 hours

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41
Q 
Respiratory Dysfunctions (Objective#22)
💊 What pain medication is given r/t coronary blood flow?
A

Morphine

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42
Q 
Respiratory Dysfunctions (Objective#22)
What tissue plasminogen activator in our body causes blood clots to dissolve?
A

Alteplase

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43
Q 
Respiratory Dysfunctions (Objective#22)
💊 What is a low weight Heparin that is given SubQ and considered safer?
A

Lovenox

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44
Q 
Respiratory Dysfunctions (Objective#22)
In severe cases, what surgery can be performed for a massive pulmonary embolism that has a high mortality rate?
A

Pulmonary Embolectomy

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45
Q 
Respiratory Dysfunctions (Objective#22)
What is put in the inferior vena cava through the femoral artery to prevent migration of clots in the pulmonary system?
A

Inferior Vena Cava Filters

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46
Q 
Respiratory Dysfunctions (Objective#22)
😷 What is the first thing you want to do if a pulmonary embolism is suspected?
A

Sit the patient up in the semi-fowlers position

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47
Q 
Respiratory Dysfunctions (Objective#22)
💉When monitoring laboratory results for pulmonary embolism, what do you want the the Warfarin / Coumadin therapeutic range to be?
A

2.0 - 3.0

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48
Q 
Respiratory Dysfunctions (Objective#22)
😷 What type of support should not be overlooked in patient with a Pulmonary Embolism and why?
A

Emotional support and reassurance because the patient is scared.

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49
Q 
Respiratory Dysfunctions (Objective#22)
😷 What complications do you want to asses for when a patient is on Anticoagulant Therapy?
A

Petechia
Bruising
Bleeding

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50
Q 
Respiratory Dysfunctions (Objective#22)
😷 How do you assess for bleeding in patients taking Anticoagulant Therapy?
A

Turn them over because bleeding tends to pool

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51
Q 
Respiratory Dysfunctions (Objective#23)
What contains 60 carcinogens that interfere with cell development and causes a change in bronchial epithelium?
A

Smoking

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52
Q 
Respiratory Dysfunctions (Objective#23)
What is the Smoking Calculator used for?
A

Determines the risk for developing lung cancer

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53
Q 
Respiratory Dysfunctions (Objective#23)
How do you determine the number of packs per year using the Smoking Calculator when the patient smokes >1 pack/day?
A

Packs/day ✖️ Years smoked = Packs per Year

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54
Q 
Respiratory Dysfunctions (Objective#23)
How do you determine the number of packs per year using the Smoking Calculator when the patient smokes <1 pack per day?
A

Number of Cigs ➗ 20 = ?

? ✖️ Number of years smoked = Packs per Year

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55
Q 
Respiratory Dysfunctions (Objective#23)
A patient smokes 15 cigarettes per day for 40 years. Determine packs per year using the Smoking Calculator
A

15 ➗ 20 = 0.75

0.75 ✖️ 40 = 30 Pack Year

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56
Q 
Respiratory Dysfunctions (Objective#23)
🚬What is the risk for lung cancer related to?
A

Total exposure to tobacco smoke

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57
Q 
Respiratory Dysfunctions (Objective#23)
🚬 Why are woman smokers at greater risk for lung cancer than male smokers?
A

Smaller surface

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58
Q 
Respiratory Dysfunctions (Objective#23)
How long does it take a tumor to reach 1cm?
A

8-10 years

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59
Q 
Respiratory Dysfunctions (Objective#23)
🚬 What is the most important risk factor in 80-90% of all lung cancers?
A

Smoking

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60
Q 
Respiratory Dysfunctions (Objective#23)
In what area does lung cancer primarily occur?
A

In segmental bronchi and upper lobes

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61
Q 
Respiratory Dysfunctions (Objective#23)
Primary lung cancer is categorized into what two subtypes?
A

Non-Small-Cell Lung Cancer (NSCLC)

Small-Cell Lung Cancer (SCLC)

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62
Q 
Respiratory Dysfunctions (Objective#23)
Which primary lung cancer grows at different rates and accounts for 80% of primary lung cancers?
A

Non-Small-Cell Lung Cancer

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63
Q 
Respiratory Dysfunctions (Objective#23)
What primary lung cancer accounts for 20% of all primary lung cancers and grows rapidly?
A

Small-Cell Lung Cancer

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64
Q 
Respiratory Dysfunctions (Objective#23)
What is the average survival rate for patients with Small-Cell Lung cancer who are receiving treatment?
A

12 Months

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65
Q 
Respiratory Dysfunctions (Objective#23)
What is the average survival rate for a patient with Small-Cell Lung Cancer
A

6 Weeks

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66
Q 
Respiratory Dysfunctions (Objective#23)
Squamous Cell Carcinoma, Adenocarcinoma, and Large-Cell Carcinoma are what type of lung cancer?
A

Non-Small Cell Lung Cancer (NSCLC)

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67
Q 
Respiratory Dysfunctions (Objective#23)
😰 What are the early symptoms of Squamous Cell Carcinoma?
A

Non-Productive Cough and Hemoptysis (Coughing up blood)

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68
Q 
Respiratory Dysfunctions (Objective#23)
What is the most rapid growing NSCLC?
A

Large Cell Carcinoma

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69
Q 
Respiratory Dysfunctions (Objective#23)
What NSCLC is the most common type in people who don't smoke?
A

Adenocarcinoma

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70
Q 
Respiratory Dysfunctions (Objective#23)
In what NSCLC will symptoms not been seen until it has already spread?
A

Adenocarcinoma

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71
Q 
Respiratory Dysfunctions (Objective#23)
What NSCLC is slow growing and centrally located?
A

Squamous Cell Carcinoma

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72
Q 
Respiratory Dysfunctions (Objective#23)
What NSCLC does not metastasize?
A

Squamous Cell Carcinoma

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73
Q 
Respiratory Dysfunctions (Objective#23)
With what NSCLC is surgery typically not done due to the high rate of metastasis?
A

Large-Cell Carcinoma

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74
Q 
Respiratory Dysfunctions (Objective#23)
💊Due to its slow growing process, what treatment option is more likely to be used for Squamous Cell Carcinoma than in other types of NSCLC?
A

Surgery

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75
Q 
Respiratory Dysfunctions (Objective#23)
What NSCLC does not respond well to chemotherapy?
A

Adenocarcinoma

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76
Q 
Respiratory Dysfunctions (Objective#23)
💊What NSCLC arise in bronchi and get into lymphatic system in the blood?
A

Large Cell Carcinoma

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77
Q 
Respiratory Dysfunctions (Objective#23)
What NSCLC is highly metastatic, very malignant and has a poor prognosis?
A

Large-Cell Carcinoma

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78
Q 
Respiratory Dysfunctions (Objective#23)
What lung cancer metastasis by Direct Extension, Blood Circulation or Lymphatic System?
A

Small-Cell Lung Cancer (SCLC)

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79
Q 
Respiratory Dysfunctions (Objective#23)
♿️ SCLC can metastasis to what locations?
A 
Liver
Brain
Bones
Lymph Nodes
Adrenal Glands
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80
Q 
Respiratory Dysfunctions (Objective#23)
What lung cancer is associated with an endocrine disorder?
A

SCLC

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81
Q 
Respiratory Dysfunctions (Objective#23)
💊 What is the primary treatment for SCLC?
A

Chemotherapy

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82
Q 
Respiratory Dysfunctions (Objective#23)
At what rate does SCLC grow?
A

Very rapid

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83
Q 
Respiratory Dysfunctions (Objective#23)
😰 Lung Cancer usually presents as what illness that doesn't respond to treatment.
A

Lobular Pneumonia that doesn’t respond to treatment.

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84
Q 
Respiratory Dysfunctions (Objective#23)
😰 What is the most common symptom of lung cancer?
A

Persistent cough with sputum

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85
Q 
Respiratory Dysfunctions (Objective#23)
😰 In later manifestations of Lung Cancer, what can Cardiac Tamponade lead to?
A

Dysrhythmias

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86
Q 
Respiratory Dysfunctions (Objective#23)
😰 Lung Cancer symptoms appear late in disease and may be masked by what symptom?
A

Chronic Cough

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87
Q 
Respiratory Dysfunctions (Objective#23)
😰 What early manifestations may occur in lung cancer?
A 
Dyspnea 
Wheezing
Chest Pain
Hemoptysis
Pneumonitis (Inflammation of the walls of the alveoli)
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88
Q 
Respiratory Dysfunctions (Objective#23)
😰 What may be obstructed in the late manifestations of Lung Cancer?
A

Superior Vena Cava

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89
Q 
Respiratory Dysfunctions (Objective#23)
😰 What are late manifestations of Lung Cancer?
A 
Anorexia / Weight Loss
Fatigue
N & V
Hoarseness 
Unilateral Paralysis of Diaphragm
Dysphagia
Superior Vena Cava Obstruction
Palpable Lymph Nodes  
Pericardial Effusion
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90
Q 
Respiratory Dysfunctions (Objective#23)
📈 Why cant Sputum Cytology be diagnostic for Lung Cancer?
A

You cant always catch it because there will not always be lung cancer cells in each sputum sample.

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91
Q 
Respiratory Dysfunctions (Objective#23)
📈 How do you get a definitive diagnosis for Lung Cancer?
A

Lung Biopsy

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92
Q 
Respiratory Dysfunctions (Objective#23)
😷 If you're assisting with a Thoracentesis, when would you want to save fluid and have it analyzed?
A

If the patient has had a productive or nonproductive cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q 
Respiratory Dysfunctions (Objective#23)
What system is used to stage NSCLC?
A

TNM System

94
Q 
Respiratory Dysfunctions (Objective#23)
Why isn't TNM System always useful in SCLC?
A

Because its so aggressive

95
Q 
Respiratory Dysfunctions (Objective#23)
💥 What does the "T" stand for in the TNM System?
A

Denotes- Tumor Size, Location, & Degree of invasion

96
Q 
Respiratory Dysfunctions (Objective#23)
💥 What does the "N" stand for in the TNM System?
A

Indicates Region - Lymph Node Invasion / Involvement

97
Q 
Respiratory Dysfunctions (Objective#23)
💥 What does the "M" stand for in the TNM System?
A

The presence or absence of distant Metastases

98
Q 
Respiratory Dysfunctions (Objective#23)
Who are surgical candidates related to TNM criteria?
A

1A, 2A, 2A

99
Q 
Respiratory Dysfunctions (Objective#23)
😷 What care is given to patients that are stage 3B or 4 on the TNM System?
A

Chemo & Radiation

100
Q 
Respiratory Dysfunctions (Objective#23)
How do you determine if a Lung Cancer is staged as Limited and Extensive?
A

Limited - Tumor Finds one side of the chest and regional lymph nodes around it

Extensive- Beyond Limited stage

101
Q 
Respiratory Dysfunctions (Objective#23)
💊 What is the treatment choice for early stage NSCLC?
A

Surgery

102
Q 
Respiratory Dysfunctions (Objective#23)
💊 What therapy is not indicated for SCLC?
A

Surgical Therapy

103
Q 
Respiratory Dysfunctions (Objective#23)
What is Pneumonectomy?
A

Taking out one lung

104
Q 
Respiratory Dysfunctions (Objective#23)
What is Lobectomy?
A

Taking out one lobe

105
Q 
Respiratory Dysfunctions (Objective#23)
💊💥 What type of surgical therapy is the smallest sample and removes a sample of lung containing cancer cells along with cells that surround it?
A

Wedge Resections

106
Q 
Respiratory Dysfunctions (Objective#23)
💊💥 What lung sample is bigger than the Wedge sample?
A

Segmental

107
Q 
Respiratory Dysfunctions (Objective#23)
What is VATS used for?
A

Tumors near the outside of the lung

108
Q 
Respiratory Dysfunctions (Objective#23)
💊What is the primary therapy used for those that are unable to tolerate surgery?
A

Radiation Therapy

109
Q 
Respiratory Dysfunctions (Objective#23)
💊Radiation used as pallative therapy is used to relieve what symptoms?
A

Dyspnea and Pain

110
Q 
Respiratory Dysfunctions (Objective#23)
♿️ What complications do you want to monitor for with radiation therapy?
A

Esophagitis
Skin Irritation
N & V
Anorexia

111
Q 
Respiratory Dysfunctions (Objective#23)
💊 Chemotherapy is typically combined with two or more drugs that do what action?
A

Targeted Therapies that target the growth of the molecules and the other targets the cancer cells

112
Q 
Respiratory Dysfunctions (Objective#23)
💊 What is the action of the chemotherapy drug Erlotinib (Tarceva)?
A

Looks for signals for growth of cancer cells and blocks that signal

113
Q 
Respiratory Dysfunctions (Objective#23)
💊 Even in progressive disease, what can be done to remove tumors to help the patient breathe better?
A

Bronchoscopy

114
Q 
Respiratory Dysfunctions (Objective#23)
What is Airway Stinting used for?
A

Obstruction

115
Q 
Respiratory Dysfunctions (Objective#23)
What is Radio-frequency Ablation used for?
A

SCLC and NSCLC tumors that are on the outer edge of the lungs

116
Q 
Respiratory Dysfunctions (Objective#23)
😷 When do you recommend getting into hospice once diagnosed with Lung Cancer?
A

Get into hospice right away

117
Q

Respiratory Dysfunctions
(Objective #22)
What percentage die from a reoccurring Pulmonary Embolism?

A

30%

118
Q

Respiratory Dysfunctions
(Objective #22)
🚬 What are the risk factors for a Pulmonary Embolism?

**FYI- I listed the 3 she talked about the most in other sides but here is the entire list incase you want to know all of them

A 
▪️DVT
▪️IV or Syringe that hasn't been primed 
▪️Fracture of long bone 
▪️Immobility or Reduced Mobility
▪️Surgery
▪️History of DVT
▪️Malignancy
▪️Obesity
▪️Smoking
▪️Heart Failure
▪️Pregnancy / Delivery
▪️Clotting Disorders
▪️Atrial Fibrillation
▪️Central Venous Catheters
119
Q 
Respiratory Dysfunctions
(Objective #22)
Most patients die within how long after the onset of a massive emboli?
A

1 - 2 hours

120
Q

Respiratory Dysfunctions
(Objective #22)
If minimal or no other oxygen supply reaches the essential parts of the pulmonary system, either from the airways or from the bronchial arterial circulation, what will occur due to necrosis of the lung tissue?

A

Pulmonary Infarction

121
Q

Respiratory Dysfunctions
(Objective #22)
♿️ What complications can occur secondary to Pulmonary Infarction?

A 
▪️Hemorrhaging
▪️Abscesses
▪️Pulmonary Hypertension
▪️Hypoxic
▪️️Pleural Effusion (Fluid build up between pleural space)
122
Q 
Respiratory Dysfunctions
(Objective #22)
💉 What lab test can be done to determine if pulmonary hypertension or any other damage to the heart has occurred due to a Pulmonary Embolism?
A

Troponin Levels (Troponin i & Troponin T)

123
Q

Respiratory Dysfunctions
(Objective #22)
💉 What is troponin and why are troponin levels tested?

A

Proteins that are found in the heart. Troponin levels are tested because the protein is released when there is damage to the heart such as a MI or CHF.

124
Q

Respiratory Dysfunctions
(Objective #22)
💉 What is know as the “Cardiac Mirror Hormone”?

A

B-Type Natriuretic Peptide (BNP)

125
Q

Respiratory Dysfunctions
(Objective #22)
💉 What hormone in the blood is produced mainly in the L. Ventricle and picks up any Ventricular volume expansion and pressure overload?

A

B-Type Natriuretic Peptide (BNP)

126
Q

Respiratory Dysfunctions
(Objective #22)
💊 What are Tissue Plasminogen Activators used for?

A

Clot busters

127
Q

Respiratory Dysfunctions
(Objective #22)
😷 Nursing Management for a Pulmonary Embolism?

A 
▪️Semi-Fowlers Position
▪️IV access
▪️Oxygen therapy for support
▪️Frequent Assessments
▪️Monitor Lab Results
▪️Emotional Support and Reassurance
️▪️Vital Signs
▪️Cardiac Rhythm
▪️Pulse Oximetry
▪️ABG's if ordered
▪️Listen to Lung Sounds
128
Q

Respiratory Dysfunctions
(Objective #23)
What is the leading cause cancer-related deaths in the US (28%)

A

Lung Cancer

129
Q

Respiratory Dysfunctions
(Objective #23)
🚬 When assessing for risk of Lung Cancer, what are the 3 categories would you place people in?

A

▪️Current Smokers
▪️Past Smokers
▪️Never Smoked

130
Q

Respiratory Dysfunctions
(Objective #23)
🚬 How is the risk for Lung Cancer related to total exposure to tobacco smoke determined?

A 
▪️Total Number of Cigarettes Smoked
▪️Age of Smoking Onset
▪️Depth of Inhalation
▪️Tar and Nicotine Content
▪️Use of Unfiltered Cigarettes
131
Q

Respiratory Dysfunctions
(Objective #23)
🚬 What are the risk factors for Lung Cancer?

A

▪️Total Exposure to Tobacco Smoke
▪️High Levels of Pollution
▪️Radiation
▪️Asbestosis

132
Q

Respiratory Dysfunctions
(Objective #23)
What promotes the development of Lung Cancer Tumors and what determines how fast it grows?

A

Development is promoted by epithelial growth factor and the faster the epithelial lays down, the faster the tumor will grow.

133
Q

Respiratory Dysfunctions
(Objective #23)
💊 Chemotherapy and Radiation can be used as supportive therapy in which two NSCLC?

A

▪️Squamous Cell Carcinoma

▪️Large-Cell Carcinoma

134
Q

Respiratory Dysfunctions
(Objective #23)
Which NSCLC is peripheral located, has moderate growth and is considered for surgery depending on how much it has spread?

A

Adenocarcinoma

135
Q

Respiratory Dysfunctions
(Objective #23)
Which NSCLC accounts for 30-40% of all lung cancers?

A

Adenocarcinoma

136
Q

Respiratory Dysfunctions
(Objective #23)
💊 Which two Lung Cancers use Chemotherapy and Radiation to buy some time because surgery is not indicated

A

▪️Large-Cell Carcinoma - Radiation is used.

▪️Small-Cell Lung Cancer (SCLC) - Chemotherapy is used as mainstay and radiation is used as support.

137
Q

Respiratory Dysfunctions
(Objective #23)
Which Lung Cancer is the most malignant and metastasizes early resulting in a poor prognosis?

A

Small-Cell Lung Cancer (SCLC)

138
Q

Respiratory Dysfunctions
(Objective #23)
💹 Which diagnostic test finds approximately 5% of Lung Cancers when performed for unrelated conditions?

A

Chest X-Ray

139
Q 
Respiratory Dysfunctions
(Objective #23)
😷 Acute interventions for Lung Cancer?
A 
▪️Offer support during diagnostic evaluation. Devastating to families and hard to watch. Provide resources they need.
▪️Monitor for stressors
▪️Symptom Management
▪️Patient Teaching
▪️Pain Relief
▪️Monitor for Side Effects
▪️Foster Coping Strategies
▪️Smoking Cessation
▪️Assess Resources - Get Hospice as soon as they can
140
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
What is a chronic inflammatory disorder of the airways that is associated with variable airflow obstruction?
A

Asthma

141
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
😰 Asthma leads to recurrent episodes of symptoms?

A

▪️Wheezing
▪️Breathlessness
▪️Chest Tightness
▪️Cough

142
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
What gender is 76% more likely to have asthma?

A

Woman

143
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬 What are the risk factors / triggers for asthma?

A 
▪️Genetics - Inherited component is complex
▪️Immune Response
▪️Allergens
▪️Exercise
▪️Air Pollutants
▪️Occupational Factors
▪️Respiratory Infections
▪️Nose & Sinus Problems
▪️Drug & Food Additives 
▪️GERD
▪️Emotional Stress
▪️Aspirin Triad
144
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬💥 In what two ways can an immune response be a risk factor or trigger asthma?

A

▪️Hygiene Hypothesis

▪️Overuse of Antibiotics

145
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬💥 What is Hygiene Hypotheses?

A

Increased susceptibility to allergic diseases due to suppressing the natural development of the immune system by lack of early childhood exposure to infectious agents, microorganisms and parasites.

146
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬 How can overuse of Antibiotics cause an immune response that is a risk factor or triggers Asthma?

A

Building up resistance

147
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
🚬 What type of allergen exposure trigger or be a risk factor for Asthma?
A

Overexposure

Cats, Dogs, Fungi, Mold & Seasonal Changes

148
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
🚬 What type of nose and sinus problems can be a risk factor or trigger Asthma?
A

▪️Inflammation of mucus membranes
▪️Polyps that need to be removed
▪️History of allergic rhinitis

149
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬 Sensitivity to what chemical found in aspirin and pain relievers can be a risk factor or trigger Asthma?

A

Salicylates

150
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬💥 What is the most common risk factor / trigger for Asthma?

A

Gastroesophageal Reflux Disease (GERD)

151
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
🚬💥 How does GERD trigger Asthma?
A

Due to drugs (Short Term Agonist)

152
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
🚬💥 How do Short Term Agonist Drugs effect GERD?
A

Short Acting Bronchodilators relax the small airway and smooth muscle → Esophagus / Esophageal Flap gets lazy → Reflux

153
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
🚬💥 What is Aspirin Triad?

A

Complex medical condition that causes patients to have Asthma, Nasal Polyps and Chronic Sinusitis due to sensitivity to Salicylate’s / Aspirin.

154
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
What is the response / role of Macrophages, Eosinophils and Neutrophils?

A

They respond to invaders and fight infection

155
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
When you're exposed to something, what cells attack and remember so that next time they know how to respond to it next time?  They are known to have a long memory.
A

T & B Lymphocytes

156
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
What antibody is present in minute amounts in the body but plays a major role in allergic diseases by binding to allergens → triggers the release of substances from mast cells that cause inflammation → to begin a cascade of allergic reactions?

A

IgE

157
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
What 3 factors cause obstruction in Asthma?
A

▪️Muscle Spasms
▪️Swollen Mucosa
▪️Mucus

158
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
What are the two phases of Asthma?

A

Early & Late

159
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
Symptoms in the Early Phase of Asthma that is common with substances such as cleaning supplies, occurs within what amount of time?

A

30-60 minutes

160
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
The Late Phase response of Asthma occurs within how long after the initial attack?
A

4 - 6 hours

161
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
♿️ What can occur if inflammation of Asthma isn’t treated or resolved?

A

It can lead to irreversible lung damage

162
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What is used to treat inflammation Asthma in Late Phase of the response?

A

Corticosteroids

163
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
Late Phase Response of Asthma can be more severe than early phase and can last for how long?
A

24 hours or longer

164
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
What are the classifications of Asthma?
A

▪️Intermittent
▪️Mild Persistent
▪️Moderate Persistent
▪️Severe Persistent

165
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
How often does Intermittent Asthma occur?
A

Less than or equal to 2 days a week

166
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
How often does Mild Persistent Asthma occur?
A

Greater than 2 days/week but not daily

167
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
How often does Moderate Persistent Asthma occur?
A

Daily

168
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
How often does Severe Persistent Asthma occur?
A

Continuous

169
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
😰 An Acute Asthma Attack usually reveals signs of what symptom?

A

Hypoxermia

170
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
😰 What breath sounds will be heard during a Minor Asthma Attack?

A

Inspiratory and Expiratory Wheezing

171
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
😰 What breath sounds will be heard during a Major Asthma Attack?

A

“Silent Chest”
Airway is completely restricted
No Wheezing

172
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
😰 What Vital Sign changes are expected during an Asthma Attack?
(BP/HR/Resp)

A

▪️↑B/P
▪️↑HR
▪️↑Resp (>30)

173
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
😰 How do you gauge the severity of an Asthma Attack by the extent of wheezing?
A

Wheezing is unreliable to gauge severity

174
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
😰 During an Asthma Attack, what changes occur related to breathing?
A 
▪️Feeling of suffocation due to difficulty with air movement 
▪️Prolonged Expiration
▪️Cant take a deep breath
▪️Hard time speaking
▪️Using accessory muscles to breathe
175
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
😰 What behavioral changes occur during an Asthma Attack?
A

▪️Restlessness
▪️Anxiety
▪️Panic

176
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
♿️ What are the complications of Asthma?

A

▪️Severe and Life-Threatening Exacerbations

▪️Life-Threatening Asthma

177
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
♿️ When Severe and Life-Threatening Exacerbations occur with Asthma, what is the expected HR and Peak with Flow Reader?

A

▪️Pulse >120

▪️Peak with Flow Reader is 40% at best even when they are at rest

178
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
♿️ What are the S/S of Life-Threatening Asthma?

A 
▪️Cant Speak
▪️Perspiring 
▪️Confused
▪️Drowsy - Low Oxygen
▪️Peak Expiratory Flow Rate <25%
179
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
♿️ What complication of Asthma usually requires admission to ICU?

A

Life-Threatening Asthma

180
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💹 What are the best diagnostic studies for Asthma?

A

▪️Peak Flow Monitoring / PERF

▪️Pulmonary Function Test

181
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💹 Besides the preferred tests (PEFR and Pulmonary function), what other diagnostic study may be used for Asthma?
A

X-Ray

182
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💉 What labs may be drawn on patient with Asthma?

A

ABG’s

183
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
What Worldwide program produce guidelines, reports and resources about Asthma?
A

Global Initiative for Asthma (GINA)

184
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚 When do you teach patients with Asthma?
A

Start at time of diagnosis and integrate through care

185
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What is treatment for Asthma based on?

A

Severity and response to therapy

186
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What treatment is used for Acute Asthma Exacerbations / Respiratory Distress?

A

Rescue Plan → 2-4 puffs of Albuterol Q20 min x3

187
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What treatment is used for Moderate Asthma Exacerbations?

A

▪️Short Term Beta Agonist
▪️Oral Corticosteroids (Advair)
▪️O2 therapy may be started & monitored

188
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What medications are given to treat Severe and Life-Threatening Exacerbations?

A

▪️IV Corticosteroids
▪️IV Magnesium Sulfate
▪️IV Fluid

189
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 How often are IV Corticosteroids administered?

A

Q4-6hrs & then are given orally

190
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What is given as a Bronchodilator for the treatment of Severe and Life-Threatening Exacerbations and relaxes smooth muscle?

A

IV Magnesium Sulfate

191
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What Oxygen therapy is given as treatment for Severe Life-Threatening Exacerbations?

A

▪️Keep oxygenated to improve ventilation
▪️Heliox- (Mixture of Oxygen & Helium)
▪️Supplemental O2 by mask or cannula for 90% Sat.

192
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
😷💥 How often should the patient with Critical, Severe and Life -Threatening Exacerbations be monitored ?

A

Continuous Monitoring

193
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 Heliox (Combination of Helium & Oxygen) is used to treat Severe Life-Threatening Exacerbation because helium has low density and may help improve bronchodilation of what drug?

A

Albuterol

194
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What 3 Anti-Inflammatory Drugs are used for the treatment of Asthma?

A

▪️Conticosteroids
▪️Leukotriene
▪️Monoclonal Antibody (Anti-IgE)

195
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What Anti-Inflammatory Corticosteroid is used for the treatment of Asthma?

A

Flovent

196
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What Leukotriene Modifier drug is used for the treatment of Asthma?

A

Singulair

197
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What drug used for the treatment of Asthma inhibits chemicals your body releases that causes swelling in the lungs and tightening of the muscles in the airways when you breathe in allergen?

A

Montelukast (Singulair)

198
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 Monoclonal Antibody binds to IgE Antibody to decrease what symptom of Asthma?

A

Bronchoconstriction

199
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 Beclomethasone and Budesonide are what type of drugs used to treat Asthma?
A

Inhaled Corticosteroids (ICS)

200
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What patient using Corticosteroids for the treatment of Asthma need to make sure they're taking more Calcium, Vitamin D and doing weight bearing exercises?
A

Post-Menopausal

201
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 What type of Corticosteroid is used for long-tern control?
A

Inhaled form

202
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What are the side effects of Corticosteroids?

A

▪️Thrush
▪️Dry Hacking Cough
▪️Hoarseness

203
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 What drug is used to treat thrush caused by Corticosteroid therapy?

A

Nystatin

204
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What can the patient do to reduce the dry, hacking cough caused by Corticosteroid therapy?
A

▪️Use a spacer

▪️Gargle / Rinse after each use

205
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What form of Corticosteroid is used to control Exacerbations and manage Persistent Asthma?

A

Systemic

206
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What drug used for the treatment of Asthma suppresses inflammatory response, reduces bronchial hyper-responsiveness and decreases mucus production?

A

Corticosteroid

207
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 Zafirlukast, Montelukast, and Zileuton are what type of drugs used for the treatment of Asthma?
A

Leukotriene Modifiers / Inhibitors

208
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What Leukotriene Modifier Drug that is used to treat or prevent Asthma is used as prophylaxis and maintenance therapy?
A

Montelukast (Singulair)

209
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What drugs have both Bronchodilator and Anti-Inflammatory effects but is not indicated for acute attacks?

A

Leukotriene Modifiers / Inhibitors

210
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 Xolair is what type of drug used for the treatment of Asthma?
A

Anti-IgE

211
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊💥 How often and by what route are Anti-IgE drugs administered?

A

SubQ injection Q2-4 Weeks

212
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What is important to remember if it is the patients first dose of Anti-IgE?
A

1st Dose given in MD office

213
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 Why is the first dose of Anti-IgE drugs given at the MD office?
A

Because they can have a severe allergic reaction.

214
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 What 3 types of Bronchodilators are used for the treatment of Asthma?
A

▪️β-Adrenergic Blocker
▪️Anticholinergics
▪️Methylxanthines

215
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 Which Bronchodilator is most likely not going to be used due to is its side effects and reaction with other medications?

A

Methylxanthines- Theophylline

216
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 Albuterol and Pirbuterol are what type of drug used for the treatment of Asthma?
A

β-Adrenergic Agonist (SABA’s)

217
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
💊 What drug is effective for relieving acute bronchospasms r/t Asthma?

A

β-Adrenergic Agonist (SABA’s)

218
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊 How long is the onset of action and duration of β-Adrenergic Agonist (SABA's) used for the treatment ofAsthma?
A 
Onset = within minutes
Duration = 4 - 8 hours
219
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What Bronchodilator alleviates the early phase of Asthma attacks but has little effect on bronchial hyper-responsiveness, is considered a less effective long-term Bronchodilator and has a 💥NARROW MARGIN OF SAFETY?
A

Methylxanthines

220
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What are the two different types of inhalers that are used as a means of delivering Asthma medication?
A

▪️Metered Dose Inhaler (MDI)

▪️Dry Powder Inhaler (DPI)

221
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What type of inhaler gives a specific amount of medication into the lungs?
A

Metered Dose Inhaler (MDI)

222
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What type of inhaler is used to administer Advair for the treatment of Asthma?
A

Dry Powder Inhaler (DPI)

223
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
💊💥 What type of inhaler is usually easier to use for the treatment of Asthma?
A

Dry Powder Inhaler (DPI)

Advair is in a diskus

224
Q

Respiratory Dysfunctions
(Unit II C, Objectives 3-5)
📚 What should you teach patients with Asthma about non-prescription drugs?

A

Non-Prescription combination drugs should be avoided.

225
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚 What should patients with Asthma be taught to do if bronchospasms occur?
A

Seek medical attention.

226
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚💥 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what three color zones will you teach them about?
A

🚦Green Zone
🚦Yellow Zone
🚦Red Zone

227
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what information do they need to know about the "Green Zone"?
A

To remain on their medication

228
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what information do they need to know about the "Yellow Zone"?
A

That it indicates caution and something is triggering asthma.

229
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what information do they need to know about the "Red Zone"?
A

It indicates that the regimen isn’t working. There is a serious problem and action must be taken with the HCP.

230
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚💥 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what percentage is within the "Green Zone"?
A

> 80%

231
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚💥 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what percentage is within the "Yellow Zone"
A

50-80%

232
Q 
Respiratory Dysfunctions 
(Unit II C, Objectives 3-5)
📚💥 When teaching patients with Asthma about reading / interpreting Peak Flow Meter results, what percentage is within the "Red Zone"?
A

<50%

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