ATI: Chapter 21 - Asthma Flashcards
(97 cards)
1
Q
Asthma is a chronic inflammatory disorder of the airways that results in intermittent and reversible airflow obstruction occurs either by inflammation or __________.
A
airway hyper-responsiveness
2
Q
Asthma can occur at any ____. The cause is unknown.
A
age
3
Q
Manifestations of asthma include mucosal edema, bronchoconstriction, and _________.
A
excessive mucus production
4
Q
Advise the client to use _______ and ensure proper ventilation while working in environments that contain carcinogens or particles in the air.
A
protective equipment (mask)
5
Q
Encourage influenza and pneumonia vaccinations for older adults and all clients who have _____.
A
asthma
6
Q
Instruct the client how to recognize and avoid _____.
A
triggers
7
Q
_____ factors, such as changes in temperature (especially warm to cold) and humidity.
A
environmental
8
Q
Air ______ are asthma triggers.
A
pollutants
9
Q
Strong _____ (perfume) are triggers for asthma.
A
odors
10
Q
______ allergens (grass, tree, and weed pollens) and perennial allergens (mold, feathers, dust, roaches, animal dander, foods treated with sulfites) are asthma triggers.
A
seasonal
11
Q
Stress and ______ distress are asthma triggers.
A
emotional
12
Q
_______ such as (aspirin, NSAIDs, beta-blockers, cholinergics) can be asthma triggers.
A
medications
13
Q
_____, including those in laundry detergents can be asthma triggers.
A
enzymes
14
Q
____ (household cleaners) can be asthma triggers.
A
chemicals
15
Q
______ with postnasal drip can be an asthma trigger.
A
sinusitis
16
Q
Viral respiratory tract infection can be an asthma ____.
A
trigger
17
Q
Teach the client how to self-administer ______ (nebulizers and inhalers) for asthma.
A
medications
18
Q
Educate the client regarding infection ________ techniques to asthma pts.
A
prevention
19
Q
Encourage regular ______ as part of asthma therapy.
A
exercise
20
Q
Regular exercise promotes ventilation and perfusion. It also maintains cardiac health. It enhances skeletal muscle strength. Clients can require _______.
A
pre-medication
21
Q
Instruct the client to use hot water to eliminate dust mites in ______.
A
bed linens
22
Q
Diagnosis of asthma is based on symptoms and classified into one of the following four categories: mild intermittent, mild persistent, moderate persistent, and _______.
A
severe persistent
23
Q
______ asthma includes symptoms that occur less than twice a week.
A
mild intermittent
24
Q
______ asthma includes symptoms that arise more than twice a week but not daily.
A
mild persistent
25
______ asthma is daily symptoms occur in conjunction with exacerbations twice a week.
moderate persistent
26
______ asthma is symptoms occur continually, along with frequent exacerbations that limit physical activity and quality of life.
severe persistent
27
Older adult clients have decreased pulmonary reserves due to physiologic _______ that occur with the aging process.
lung changes
28
Older adult clients are more ______ to infections.
susceptible
29
The sensitivity of beta-adrenergic receptors decreases with age. As the beta receptors age and lose ______, they are less able to respond to agonists, which relax smooth muscle and can result in bronchospasms.
sensitivity
30
A family _______ of asthma is a risk factor.
history
31
Smoking is a risk factor for _____.
asthma
32
Secondhand _______ is a risk factor for asthma.
smoke exposure
33
Environmental ______ is a risk factor for asthma.
allergies
34
Exposure to chemical _______ or dust is a risk factor asthma.
irritants
35
_________ reflux disease (GERD) is a risk factor for asthma.
gastroesophageal
36
Expected findings of asthma include dyspnea, chest tightness, and _____ or stress.
anxiety
37
Physical assessment findings of asthma include:
```
coughing
wheezing
mucus production
use of accessory muscles
prolonged exhalation
poor oxygen saturation (low SaO2)
barrel chest or increased chest diameter
```
38
Obtain a history regarding current and previous asthma exacerbations: (6)
onset and duration
precipitating factors (exercise, stress, exposure to irritant)
changes in mes regimen
meds that relieve symptoms
other meds taken
self-care methods used to relieve symptoms
39
Lab Tests for Asthma
ABG and Sputum Cultures
40
ABGs test for ______ which is when PaO2 less than 80 mm Hg.
hypoxemia
41
ABGs test for _______ which is when PaCO2 is less than 35 mm Hg: early in attack)
hypocarbia
42
ABGs test for _______ which is when PaCO2 is increased greater than 45 mm Hg: later in the attack.
hypercarbia
43
Sputum cultures for asthma look at bacteria which can indicate _______.
infection
44
________ are the most accurate tests for diagnosing asthma and its severity.
pulmonary function tests (PFTs)
45
________ is the volume of air exhaled from full inhalation to full exhalation.
forced vital capacity (FVC)
46
_______ in the first second is the volume of air blown out as hard and fast as possible during the first second of the most forceful exhalation after the greatest full inhalation.
Forced expiratory volume (FEV1)
47
Peak expiratory flow is the fastest airflow rate reached during ________.
exhalation
48
A decrease in FEV1 (forced expiratory volume) by ____ to _____% below the expected value is common in clients who have asthma. An increase in these values by 12% following the administration of bronchodilators is diagnostic for asthma.
15 to 20%
49
A _____ is used to diagnose changes in chest structure over time.
chest x-ray
50
An asthma patient should be positioned in _______ to maximize ventilation.
high-Fowlers
51
With asthma patients you should administer ________ therapy as prescribed.
oxygen therapy
52
With asthma patients you should monitor _______ and rhythm for changes during an acute attack (can be irregular, tachycardia, or with PVCs).
cardiac rate
53
Asthma patients should have IV access and _______ it.
maintain
54
Maintain a clam and _______ demeanor with asthma patients.
reassurance
55
Provide rest periods for older adult clients who have _________. Design room and walkways with opportunities for rest. Incorporate rest with ADLs.
dyspnea
56
Encourage prompt medical attention for ________ and appropriate vaccinations for asthma patients.
infections
57
The four types of bronchodilators (inhalers)
short-actign beta2 agonists
anticholinergic medications
Methylxanthines
Long acting beta2 agonists
58
________ such as albuterol, provide rapid relief of acute symptoms and prevent exercise-induced asthma.
short-acting beta2 agonists
59
________, such as ipratropium, blocks the parasympathetic nervous system. This allows for the sympathetic nervous system effects of increased bronchodilation and decreased pulmonary secretions. These medications are long-acting and used to prevent bronchospasms.
anticholinergic medications
60
_______, such as theophylline, require close monitoring of serum medication levels due to a narrow therapeutic range. Use only when other treatments are ineffective.
Methylxanthines
61
__________, such as salmeterol, primarily are used for asthma attack prevention.
Long-acting beta2 agonists
62
With albuterol watch for tremors and _______.
tachycardia
63
With Ipratropium observe for ______.
dry mouth
64
Wtih theophylline monitor serum levels for toxicity. Side effects include tachycardia, nausea, and ______.
diarrhea
65
With ______: advise the client to suck on hard candies to help relieve dry mouth;; increase fluid intake, and report headache, blurred vision, or palpitations, which can indicate toxicity of ________. Monitor _______.
Ipratropium (anticholinergic meds)
Ipratropium
HR
66
_________: advise the client to use to prevent an asthma attack and not at the onset of an attack.
Salmeterol (long-acting beta2 agonists)
67
_______ agents are used for prophylaxis and are used to decrease airway inflammation.
anti-inflammatory agents
68
Anti-inflammatory agents (4)
corticosteroids = fluticasone and prednisone
leukotriene antagonists = montelukast
mast cell stabilizers = cromolyn
monoclonal antiboides = omalizumab
69
With the use of anti-inflammatory agents watch for decreased ________ function.
immunity
70
With the use of anti-inflammatory agents monitor for ________.
hyperglycemia
71
With the use of anti-inflammatory agents advise the client to report _______ stool.
black, tarry
72
With the use of anti-inflammatory agents observe for fluid retention and _______. This can be common.
weight gain
73
With the use of anti-inflammatory agents monitor the throat and mouth for ______.
aphthous lesions (canker sores)
74
With the use of anti-inflammatory agents with _________ be careful it can cause anaphylaxis.
omalizumab (monoclonal antibodies)
75
When taking anti-inflammatory agents encourage the client to ______ of fluids to promote hydration.
drink plenty
76
Encourage the client to take _____ with food.
predinsone
77
When taking anti-inflammatory agents encourage the client to use this medication to prevent _______, not for the onset of an attack.
asthma
78
When taking anti-inflammatory agents encourage the client to avoid people who have ______.
respiratory infections
79
When taking anti-inflammatory agents encourage the client to use good _____ care.
mouth
80
When taking anti-inflammatory agents warn the client _____ to discontinue this type of medicine suddenly.
not
81
If prescribed separately for inhalation administration at the same time, administer the _______ first in order to increase the absorption of the anti-inflammatory agent.
bronchodilator
82
Combination agents (bronchodialtor and anti-inflammatory)
Ipratropium and albuterol
Fluticasone and salmeterol
83
______ services should be consulted for inhalers and breathing treatments for airway management.
Respiratory
84
Nutritional services can be contacted for weight loss or gain related to ________ or ______.
medication or diagnosis
85
_______ can be consulted if the client has prolonged weakness and needs assistance with increasing levels of activities.
rehabilitation
86
Complications of asthma include respiratory failure and _________.
status asthmaticus
87
Peristent hypoxemia related to asthma can lead to _______.
respiratory failutr.
88
When dealing with the complication of respiratory failure, monitor _______ levels and acid-base balance.
oxygenation
89
When dealing with the complication of respiratory failure, prepare for intubation and ________.
mechanical ventilation
90
_______ is a life-threatening episode of airway obstruction that is often unresponsive to common treatment. It involves extreme wheezing, labored breathing, use of accessory muscles, distended neck veins, and creates a risk for cardiac and/or respiratory arrest.
status asthmaticus
91
With status asthmaticus prepare for emergency ______.
intubation
92
With status asthmaticus administer IV fluids, oxygen, bronchodilators, and epinephrine. Initiate systemic ________.
steroid therapy
93
A nurse in the emergency department is caring for a client who is having an acute asthma attack. Which of the following assessments indicates that the respiratory status is declining? (select all that apply)
```
A. SaO2 95%
B. Wheezing
C. Retraction of sternal muscles
D. Pink mucous membranes
E. Premature ventricular complexes (PVCs)
```
B. Wheezing is a manifestation indicating that the client's respiratory status is declining
C. Retraction of sternal muscles is a manifestation that the client's respiratory status is declining
E. PVCs are a manifestation that the client's respiratory status is declining.
95% is an expected finding w/in the respiratory system and exhibits no signs of distress
Pink mucous membranes is an expected findings
94
A nurse is caring for a client 2 hr after admission. The client has an SaO2 of 91%, exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expect to administer?
A. Antibiotic
B. Beta-blocker
C. Antiviral
D. Beta2 agonist
D. The nurse should administer a beta2 agonist, which causes dilation of the bronchioles to relieve symptoms.
95
A nurse is providing discharge teaching to a client who has a new prescription for prednisone for asthma. Which of the following client statements indicates an understanding of the teaching?
A. " i will decrease my fluid intake while taking this med"
B. "I will expect to have black, tarry stools."
C. " I will take my meds with meals."
D. " I will monitor for weight loss while on this med."
C. Take meds with food. Taking prednisone on an empty stomach can cause GI distress.
96
A nurse is assessing a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma?
A. Gender
B. Environmental allergies
C. Alcohol use
D. Race
B. Environmental allergies are a risk factor associated with asthma. A client who has environmental allergies typically has other allergic problems, such as rhinitis or a skin rash.
97
A nurse is reinforcing teaching with a client on the purpose of taking a bronchodilator. Which of the following client statements indicates an understanding of the teaching?
A. " This medication can decrease my immune response."
B. "I take this medication to prevent asthma attacks."
C. "I need to take this med with food."
D. This med has a slow onset to treat my symptoms."
B. A bronchodilator can prevent asthma attacks from occurring.
A bronchodilator has a fast onset to relief asthma attack symptoms.
