Lower Respiratory

Question 1

Asthma

Answer 1

-chronic disease that occurs intermittently
-inflammation and airway tissue sensitivity
-well controlled asthma are temporary and reversible

Question 2

Asthma Symptoms

Answer 2

-daytime wheezing, dyspnea, coughing present more than twice weekly
-waking from night sleep with symptoms of wheezing, dyspnea, coughing
-relieved (rescue) drug needed more than twice weekly
-number of times per week activity was limited or stopped by sympotoms

Question 3

Asthma: Recognize Cues

Answer 3

History
-pt w asthma usually have a history of dyspnea (perceived SOB, chest tightness, coughing, wheezing, and increased mucus production)
-some pt have symptoms 4-8 weeks after a cold or upper resp infection
-pt with atopic (allergic) asthma also may have other allergic problems

Question 4

Questions to Ask: Asthma

Answer 4

-do the symptoms occur continuously, seasonally, in association with specific activities, or exposures, at work, or more frequently at night?
-does anyone in your family have asthma or resp problems?
-do you currently smoke or have you smoked in the past?

Question 5

Physical Assessment of Asthma

Answer 5

-mild to moderate asthma may have no symptoms between asthma attacks
-acute episodes: audible wheezing, and increased resp rate
-inflammation: coughing may increase
-use accessory muscles to help breath
-pt may be unable to speak
-hypoxia occurs with severe attacks
-pulse oximetry shows hypoxemia
-examine oral mucosa and nail bed for cyanosis, assess for changes in levels of cognition or consciousness and tachycardia
-anxiety, restless, confused when hypoxia occurs

Question 6

Pulmonary Function Test: Asthma

Answer 6

-forced vital capacity (FVC)
-forced expiratory volume in first second (FEV1)
-peak expiratory rate flow (PERF)

Question 7

Interventions: Asthma

Answer 7

-control and prevent episodes
-improve airflow and gas exchange
-relieve symptoms
-self-management education

Question 8

Status Asthmaticus

Answer 8

-severe, life-threatening, acute episode or airway obstruction
-intensifies once it begins, often does not respond to common therapy
-treatment-IV fluid, potent systemic bronchodilators, steroids, epinephrine, oxygen
-prepare for emergency intubation