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Mary's Patho Exam - Nov 2015 > Chapter 31- Respiratory (Asthma) > Flashcards

Chapter 31- Respiratory (Asthma) Flashcards

1
Q

what is the most common trigger of asthma

A

cold weather

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2
Q

what medication should you not give a patient with asthma?

A

NSAIDS
beta blockers
ACE inhibitors

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3
Q

What is the purpose of a peak flow rate monitor in patients with asthma?

A

can determine the severity of airway constriction (can determine whether as asthma attack is imminent).
Above 80% is considered okay!

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4
Q

What is the purpose of albuterol?

A

it is a rescue medication to prevent bronchospasms in people who asthma or reversible airway disease.

  • Bronchodilates
  • short term
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5
Q

When should you give epinephrine and when should you not give epinephrine?

A

Give: when you hear inspiratory stridor (high pitched wheezing signifying obstruction)

DONT: when patient has V TAC

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6
Q

What is an anticholinergic?

A

long term management drug for asthma, emphysema or chronic bronchitis. It blocks muscarinic (mucous) receptors in bronchi.

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7
Q

two drugs in the anticholinergic class…

A

Spiriva (24 hour bronchodilator)
Ipratropium

both are effective in relieving acute bronchospasms and act synergistically with other adrenergic bronchodilators.

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8
Q

What is the purpose of a corticosteroid?

A

helps suppress airway inflammation and repair damaged epithelium

BE ALERT FOR!!!— hyperglycemia, osteoporosis, ADRENAL INSUFFICIENCY!, and fluid retention

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9
Q

What are leukotrines?

A

fatty substances that are release when there is injury, inflammation or infection. They secrete mucus secretion and mucosal edema in respiratory tract

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10
Q

Montelukast (Singular)

A

effective for those who do not response to other asthma medications– prevents bronchoconstriction and is used long term.

take at night since it can reduce night time symptoms (when asthma is the worst)

not used for acute asthma attacks

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11
Q

Cromolyn

A

mast cell stabilizer- adjuvant medication

prevents asthma attacks but does not treat acute asthma

Prevents the release of brochoconstrictive inflammatory substances.

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12
Q

INH (Isoniazid)

A

TB medication for latent TB, VERY HARD ON THE LIVER!!
watch for: jaundice,

always give this in combination with Rifampin if TB is active.

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13
Q

Corticosteroids and Weight gain:

If a patient gains initial weight, is this normal??

if a patient continues to gain weight, is this normal??

A

Corticosteroids may cause initial weight gain due to increased appetite

Later weight gain or continued weight gain may be a cause of fluid retention

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14
Q

why do you need to use decreased doses of corticosteroids in older adults?

A

there is a decrease in muscle mass, plasma volume and hepatic metabolism

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15
Q

Prednisone may cause…

A

Cushings Syndrome (moon face)

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16
Q

hypoxemia signs and symptoms:

A

increased HR, slight increase in BP, polycythemia, perioheral vasoconstriction, pulmonary vessel constriction, pulmonary hypertension

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17
Q

hypoxemia

A

decrease in blood oxygen levels that results in decrease tissue oxygenation. occurs as a result of hypoventilation.

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18
Q

Pleuritis aka Pleurisy

A

pain is unilateral and made worse by deep breathing or chest movements, abrupt pain in onset

19
Q

treatment for pleurisy/pleuritis

A

NSAIDS

20
Q

Are tidal volumes kept small or large in Pleurisy

A

SMALL (think:: if they are in a lot of pain, they will not be taking in as much air)

21
Q

What is Pleural Effusion?

A

fluid in the pleural cavity and it occurs when the rate of fluid exceeds the rate at which it is removed

It can be unilateral or bilateral

22
Q

What is Pneumothorax

A

presence of AIR in the pleural space, partial or complete collapse of the affected lung

23
Q

Three categories of Pneumothorax

A

Spontaneous: blister or bleb bursts, causing a hole on the surface of the lung

Traumatic: occurs when there is a direct puncture to the lung (as in car accident, rib fracture, etc.)

Tension: too much pressure caused by injury to chest

24
Q

What is Atelectasis

A

incomplete lung expansion, airway obstruction, occurs after surgery, cough or deep breathing and early ambulation.

Be sure to change the patients body positions.

25
Q

Clinical Manifestations of Atelectasis

A

Tachypnea, tachycardia, cyanosis, hypoxemia.

26
Q

A pulmonary embolism can be caused from

A

thrombus, air, fat, amniotic fluid

MAJOR CAUSE: DVT

27
Q

emphysema has a increased or decreased total lung capacity?

A

increased (think:: they are taking in more than they are putting out)

28
Q

During COPD, which ventricle of the heart will work harder?

A

RIGHT ventricle

29
Q

prolonged immobility can cause…

A

atelectasis and pulmonary embolisms

30
Q

central chemoreceptors

A

located at the respiratory center of the medulla, bathed in CSF, end up with extra hydrogen ions (sensitive to changes in oxygen)

31
Q

Hydrogen affects..

A

pH.. it may decrease the pH

32
Q

most CO2 is considered

A

Bicarbonate

33
Q

if a patient has a fever, decreased pH, increased Co2 levels,..

A

oxygen can release more easily, causing a Rt. Sided dissociation curve and a decrease in affinity

34
Q

if a patient has an increased pH, decreased Co2, decreased BT, or is sleeping..

A

oxygen will continue to bind to the heme, causing a left sided dissociation curve and an increase in affinity

35
Q

Name a First generation: H1 receptor Antagonists

A

Diphenhydramine (Benadryl):
Has anticholinergic effects, vision may be affected since pupils may change

H1 makes you very drowsy

36
Q

Name a Second generation: H2 receptor

A

Allegra and Zyrtec

Cetirizine- Zyrtec- use when mowing grass

H2 does not make you drowsy because it does not cross the blood brain barrier

37
Q

What is Innate Immunity

A

natural immunity, response in minutes to hours, your bodys 1st line in defense.

Problem: microbes has evolved and evaded innate defenses

38
Q

What is adaptive immunity

A

acquired, delayed but more effective than innate, develops specific responses for each substance.

39
Q

Dendrite Cells are phagocytic cells that..

A

initiate an immune response and are considered the intermediary between innate and adaptive.

They capture foreign antigens to B and T lymphocytes

40
Q

Name this type of hypersensitivity disorder:

Patient has allergic rhinitis, is allergic to milk, has a mild form of asthma, and displays urticaria.

A

TYPE 1

41
Q

Name this type of hypersensitivity disorder:

patient develops an allergic reaction after a blood transfusion

A

TYPE 2

42
Q

Name this type of hypersensitivity disorder:

Patient developed serum sickness and Rheumatoid arthritis

A

TYPE 3

43
Q

Name this type of hypersensitivity disorder:

You treat a patient with poision IVY

A

TYPE 4

Mary's Patho Exam - Nov 2015 (9 decks)

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