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Chronic Respiratory (Exam 2) Flashcards

(51 cards)

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1
Q

Athma (Reactive Airway Disease)

A

Chronic inflammatory airway disorder consist of airway obstruction, bronchial irritability, edema of mucous membranes, congestion, and spasms of smooth muscles of the bronchi and bronchioles

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2
Q

What type of immune response is asthma?

A

Type 1 hypersensitivity

IgE mediated. Mast cells release histamine and leukotrienes:
1. inflammation and edema of mucous membranes
2. accumulation of secretions
3. smooth muscle spasms

Clogged and thick air passages that are becoming inflamed

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3
Q

How is Asthma Classified

A
  1. Frequency and severity of symptoms:
    -Severe persistent
    -Moderate persistent
    -Mild persistent
    -Mild intermittent
  2. Levels of Control
    -Controlled
    -Parly controlled
    -Uncontrolled
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4
Q

Asthma Triggers

A

Stress

Pets

Exercise

Pollen

Bugs in house

Chemical fumes

Cold air

Fungus spores

Dust

Smoke

Strong odors

Pollution

Anger

WE NEED TO ELIMINATE TO CONTROL

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5
Q

Asthma Risk Factors

A

Age (males)

Heredity

Gender

Obesity

Ethnicity

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6
Q

Asthma: Clinical Manifestations

A

-DYSPNEA

-WHEEZING

-COUGH

-Diaphoresis

-Hacking non productive cough

-Prolong expiratory phase

-Anxious / restlessness

-Coarse rhonchi

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7
Q

Asthma: Signs of Respiratory distress

A

Nasal flaring

Cyanosis

Intercostal Retractions

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8
Q

Diagnosis of Asthma

A

Med Hx

Physical exam

Lab results
-PFTS

PEFR
-peak expiratory flow rate

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9
Q

PEFR

A

Peak Expiratory Flow Rate

Maximum flow of air that can be forcefully exhaled in 1 second measure in liters per minute

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10
Q

PEFR: Can be used to

A

Short term monitor

Manage exacerbations

Daily long-term monitoring

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11
Q

PEFR: Zone

A

Green = 80-100% of personal best
-Do not need anything

Yellow = 50-79% of personal best
-Need rescue medications

Red = 50% of personal best
-Take rescue medications and seek emergency care

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12
Q

Goal of Asthma Management

A

Maintain normal activity levels

Maintain pulmonary function

Prevent chronic symptoms

Provide optimal drug therapy

Assist the child to live a normal and happy life

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13
Q

Asthma: Allergen Control

A

Environmental Controls

Avoiding triggers

Humididty 35=50%

Air conditioners

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14
Q

Asthma: Environmental control

A

Dust mite control

Pillow and mattress in covers

Cock roach control

Wash linens in hot water twice weekly

Vacuum weekly

Remove animals

Avoid kerosene or wood heat

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15
Q

Drug Therapy of Asthma

A

Controllers (prevent)
-Inhaled Corticosteroids
-Long Acting Beta 2 adrenergic agonists
-Mast cell stabilizers
-Leukotriene inhibitors
-Methylxanthines
-Omalizumab

Relievers (rescue)
-Short acting Beta 2 Adrenergic agonists
-Magnesium sulfate

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16
Q

Why do we have patients wash mouth out with inhaled corticosteroids?

A

It can cause thrush

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17
Q

What do you use if a child cannot take all their inhaler meds with one breath and hold for 10 seconds

A

A spacer and a face mask if cannot make a good seal around the spacer

Can give rescue meds through nebulizer

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18
Q

How to take asthma inhaler

A

Sit up

Shake med

Breath out

Seal

Push down

Breath in

Hold for 10 seconds

Wait 1 min between pufffs

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19
Q

Nursing Considerations for asthma in outpatient setting

A

General and PHysical assessment

Medication assessment

Review action plan every 6 months (personal best numbers should be increase as they grow)

Plan regular check up and immunizations UTD

Prevent URI

Regular exercise

Discuss how much missed school

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20
Q

Asthma Exacerbation

A

Episode of worsening SOB, coughing, wheezing, chest tightness or combinations

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21
Q

Asthma Exacerbation: Nursing Intervention

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A

High fowler’s

Assessments

O2 and vitals

Teach to use diaphragm to pull in and expel air

Control panic and stress

IV access

Administer rescue drugs then transition to regular meds

22
Q

How do children with asthma prepare for sports?

Study These Flashcards
A

bronchodilators before the sports start

23
Q

EIB

Study These Flashcards
A

Exercise Induced Bronchospasm

24
Q

What is the most common lethal inherited disease in caucasians?

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A

Cystic Fibrosis

Affects 30,000 people in the uS

25
What is CF
disrupts the normal function of the exocrine glands related to sodium & chloride transport via the cystic fibrosis transmembrane regular (CFTR) protein the gene mutation is located on the long arm of chromosome 7
26
What type of disorder is CF
Autosomal Recessive If both parents carry the gene, child has 25% chance of having CF
27
CF: Pathophysiology
Disrupts the normal functions of the exocrine glands related to sodium and chloride transport via the CFTR protein Results in impaired fluid secretion and abnormally thick exocrine secretions Affects all body systems
28
CF: Endocrine Effects
Islets of langerhans cell may decrease in number --> malabsorption… 50% of CF pts develop DM
29
CF: Pulmonary Effects S/S
Repeated bronchitis --> chronic bronchial pneumonia Obstructive emphysema S/S -Wheezy cough -Increased dyspnea -Thick rattling -Pneumonia -Polyps in nose -Clubbed digits -Chronic sinusitis
30
CF: GI Effects
-15 to 20% of newborns w/ CF will develop a meconium ilius (earliest sign) -appetite changes -malabsorption, wt loss -distended abdomen -sallow skin -anemia -oily stools
31
Earliest post natal S/S of CF
Meconium ileus
32
CF: Hepatic Effects
bile ducts -> biliary fibrosis -> biliary cirrhosis - portal HTN -S/s: ascites, GI bleeding, jaundice
33
CF: Reproductive System Effects
-delayed puberty -infertility 95% of males are sterile
34
CF: Salivary and Seat Glands Effects
-electrolyte loses -salty sweat -dehydration -hyponatremia -heat stroke
35
Diagnosis of CF
-prenatal diagnosis: DNA analysis of chorionic villi or amniotic fluid samples -new born screening -pilocarpine electrophoresis (sweat chloride test) >60mEq -stool for fecal fat
36
Factors of maximizing health potential of CF pts
-Pulmonary hygiene (use meds, vest, & low infections) -Nutrition -Prevention/early aggressive treatment of infection
37
Goal of CF Therapy
Prevent or minimize pulmonary complications Ensure adequate nutrition for growth Encourage appropriate physical activity Promote a reasonable quality of life
38
Treatment of CF
CFTR modulation Aggressive pulmonary toilet Nutritional therapy Antibiotic Use
39
CFTR Modulators
40
Non Pharm Management of CF
-Anti inflammatory agents and protease inhibitors -Immunizations including yearly influenza -Lung transplant will give 5-10 more years
41
Medical Management of CF Respiratory
Aggressive airway clearance (BID) Airway clearance therapy Postural drainage Breathing exercise Physical exercise
42
Drugs of CF
Bronchodilators Mucolytics Chloride channel activators and sodium channel blockers Antibiotic therapy
43
What do CF patients take before meals?
Pancreatic enzymes by mouth
44
Supplements for CF pts
Fat sol vitamines Stool softeners NaCL tabs when hot out Iron (for growth) Insulin
45
How would you give pancreatic enzymes to an infant?
Sprinkle on a food like applesauce Does not dissolve in water
46
What electrolytes does CF cause a problem with?
Sodium and Chloride
47
Nursing Consideration in a CF child
-careful respiratory assessment -constant assessment of IV site -enzyme replacement -exercise & fun -possible isolation CF pts cannot mix w/ other CF pt -high cal, full fat foods & nutrition evals -family impact -hospital & home care -picc line care
48
Asthma classification: Moderate persistent
daily symptoms, nighttime symptoms 3-4x per week / month, uses beta agonist daily
49
asthma classification: severe persistent
continual symptoms throughout the day, frequent nighttime symptoms, have to use short acting beta agonist for symptom control several times a day
50
asthma classification: mild persistent
symptoms more than 2x / wk but less than 1x / day, night symptoms 1-2x / month & rescue meds more than 2x / wk but not daily
51
asthma classification: mild intermittent
goal -symptoms less than 2 days a week -night symptoms less than 2x / month -rescue meds less than 2 day / wk

Pediatrics (16 decks)

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