EXAM 2 chronic respiratory

Question 1

asthma overview

Answer 1

> 6 months
airway obstruction, bronchial irritability, edema,

Question 2

asthma pathophysiology

Answer 2

type 1 immune response
IGE mediated. mast cells release histamine and leukotriens

Question 3

manifestations of asthma

Answer 3

wheezing, cough, prolonged expiration, exacerbations, resp distress, rhonchi, chest tightness, sweating

nasal flaring, cyanosis, intercostal retractions=distress

Question 4

exacerbation of asthma triggers

Answer 4

dust, pets, cold, stress, cigarette smoke, plants

Question 5

asthma risk factors

Answer 5

age, heredity, gender, obesity, ethnicity

Question 6

asthma diagnosis

Answer 6

medical hx, exam, lab results
pulmonary function tests are helpful, peak expiratory flow rate

Question 7

PEFR guidelines

Answer 7

green=80-100 of personal best
yellow=50-79 of personal best
red= below 50 of personal best

Question 8

asthma drug therapy-controllers

Answer 8

corticosteroids (Qvar, pulmicort, flovent)
long acting beta 2 adrenergic agonist
mast cell stabilizers
leukocite inhibitors: singulair

rinse mouth after corticosteroids

Question 9

asthma rescue meds

Answer 9

short acting beta 2 adronergic agonist, bronchodilators=proventil, xopenex, albuterol
magnesium sulfate

Question 10

nursing considerations for asthma

Answer 10

assess precipitating factors, are meds being used correctly? modify environment, encourage immunizations, prevent URI, exercises

Question 11

asthma nursing interventions

Answer 11

high fowlers, assessment, oxygen monitoring, HR and BP

teach pt to use diaphragm to expel air, control panic, maintain calm approach, may need IV, administer rescue drugs,

Question 12

Cystic fibrosis ethnicity

Answer 12

most common in caucasians, 30,000 people in the US

Question 13

pathophys of cystic fibrosis

Answer 13

disrupts exocrine glands related to nacl transport via cystic fibrosis transmembrane regulator protein

impaired fluid secretions and abnormally thick exocrine secretions

Question 14

multiorgan effect of cystic fibrosis

Answer 14

respiratory, endocrine, GI, reproductive, hepatic

girls-delay in puberty
boys-may be steril

Question 15

CF pulmonary effects

Answer 15

repeated bronchitis, obstructive airway emphesema, wheezy cough, thick rattling, cyanosis, pna, clubbed digits

Question 16

endocrine effects of CF

Answer 16

islet of langerhands may decrease in number as pancreatic fibrosis develops

cystic fibrosis related diabetes

Question 17

gi effects of CF

Answer 17

small intestine=obstructions
pancreatic ducts=degenerate, diabetes,

signs: appetite changes, weight loss, tissue wasting, distended abdomen, anemia

Question 18

hepatic effects of CF

Answer 18

bile ducts=biliary fibrosis and cirrhosis, portal hypertension

signs: ascites, gi bleeds, jaundice

Question 19

major CF side effects

Answer 19

delayed puberty and infertility

SALTY SWEAT

Question 20

diagnosis of CF

Answer 20

prenatal-dna analysis
newborn screening
sweat chloride test
stool for fecal test

Question 21

CF prognosis

Answer 21

decreased life expectancy, maximize potential with pulmonary hygiene
nutrition
prevention and early infection treatment

Question 22

CF medical management

Answer 22

CFTR modulation, pulmonary toilet, nutritional therapy, antibiotic use

Question 23

respiratory management of CF

Answer 23

airway clearance, percussion, PEP mask, chest percussion, flutter device, postural drainage, breathing and physical exercise

Question 24

CF meds

Answer 24

bronchodilators
mucolytics, donase alfa
chloride channel activators and sodium channel blockers
antibiotics for treatment and prevention

Question 25

GI management of CF

Answer 25

pancreatic enzymes by mouth, vitamin A,D,E,K stool softenters nacl tablets in hot weather iron monitor blood glucose

Question 26

nursing considerations of CF

Answer 26

resp assessment, watch chest pt and respiratory, continuous iv assessment and abx administration enzyme replacement isolation? high calorie foods!!