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Nursing Semester 2 > Monica - Week 10 - Exam 3 > Flashcards

Monica - Week 10 - Exam 3 Flashcards

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1
Q

what is asthma?

A

chronic disorder of airway; bronchi/bronchioles become narrowed

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2
Q

what are the characteristics of asthma?

A

inflammation, swelling, and mucus production; bronchospasm (acute narrowing)

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3
Q

what are the 5 asthma triggers?

A

o allergens (dust, grass)
o air pollutants (perfume, smoke, exhaust)
o respiratory infections (exacerbate asthma → airway narrowing)
o GERD (exacerbate → weak lower esophageal sphincter → aspirate into bronchioles)
o exercise (loss of heat/H2O, cold/dry air)

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4
Q

characteristics of an asthmatic airway.

A

relaxed smooth muscles; wall inflamed and thickened

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5
Q

characteristics of an asthmatic airway during attack

A

tightened smooth muscles, air trapped in alveoli, and wall inflamed and thickened

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6
Q

where are beta-1 receptors located?

A

the heart

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7
Q

what occurs when beta-1 receptors are activated?

A

↑ contractility, ↑ HR, ↑ conduction

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8
Q

where are beta-2 receptors located?

A

kidneys, vascular and non-vascular smooth muscle

***beta-2 blockers affect the lungs

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9
Q

what occurs when beta-2 are activated?

A

vasodilation

***beta-2 blockers affect the lungs

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10
Q

T/F beta-1 blockers may affect beta-2 receptors

A

TRUE

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11
Q

what do selective beta-2 adrenergics do?

A
  • stimulates beta-2 receptors → bronchodilation
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12
Q

what are the two selective beta-2 adrenergic drugs?

A

albuterol and salmeterol diskus

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13
Q

what are two characteristics of albuterol?

A
  • short acting drug

- “rescue medication”

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14
Q

how does albuterol work?

A
  • facilitates mucus drainage

- inhibits release of inflammatory chemicals

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15
Q

how long does albuterol work?

A

2 - 6 hrs

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16
Q

what are the AEs of albuterol?

A

nervousness, palpitations, and tremors

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17
Q

T/F: albuterol is the drug of choice in acute bronchospasm

A

TRUE

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18
Q

salmeterol is a ____ acting drug

A

long - not used for acute episodes

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19
Q

how long does salmeterol work?

A

up to 12 hrs

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20
Q

what is the indication for salmeterol diskus?

A

asthma prophylaxis and long-term therapy for COPD

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21
Q

what do leukotriene receptor antagonists do?

A
  • leukotrienes released w/ exposure to allergens

- brochoconstriction, airway edema

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22
Q

what are leukotrienes?

A

inflammatory chemicals that cause the airway to tighten

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23
Q

what is the leukotriene receptor antagonist drug?

A

montelukast

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24
Q

how does montelukast work?

A
  • bind to leukotriene receptors
  • vasodilate airway muscles
  • ↓ airway edema
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25
what are the indications for montelukast?
- prevention and tx of chronic asthma | - prevention of exercise-induced bronchoconstriction
26
what ware 5 ways to reduce or avoid triggers that can cause symptoms of attacks?
- Keep windows closed during pollen season - Clean home environment - Reduce pet dander - Cover nose and mouth in cold environments - Control heartburn and GERD w/ meds
27
what are the two different types of medications used to manage attacks and when are they used?
- short term: acute attacks | - long term: management
28
how is chronic obstructive pulmonary disease (COPD) described?
- persistent airflow limitation - chronic bronchitis and emphysema
29
what are the 2 characteristics of chronic bronchitis?
- cough and sputum production | - occurs for at least 3 mo. in a 2 year period
30
what are 3 characteristics of emphysema?
- chronic inflammation - loss of elasticity of bronchioles and damage to alveoli - air trapping, ↓ perfusion, ↓gas exchange
31
what are the risk factors for COPD, emphysema, and chronic bronchitis?
- exposure to cigarette smoke, fumes, dust, chemicals, air pollutants
32
what are all the clinical manifestations of COPD? (10)
- chronic cough - sputum production - dyspnea - barrel-chest - wheezing - clubbed fingers - fatigue and weakness - activity intolerance - gas exchange abnormalities - ↑ susceptibility to infections - exacerbations
33
health promotions and lifestyle modification to prevent tx of complications and maintain lung capacity
- Smoking cessation and avoidance of 2nd hand smoke - Breathing exercises (pursed lip breath) - Nutrition (takes energy, smaller, frequent meals, high caloric high protein intake; ↑ mucus ↓ taste) - Increase fluid intake (dehyrdation, liquid secretion) - Exercise (last in day before meals) - Prevention (flu /pneumonia shots) - Low level oxygen therapy (85 - 90% O2 sat)
34
T/F: COPD pts are accustomed to CO2 drive so too much O2 may stop drive
TRUE
35
what do anticholinergics target and what do they do?
- acetylcholine receptors on bronchial tree | - acetylcholine binding → bronchial vasoconstriction
36
what is the short acting anticholinergic?
ipratropium inhaler
37
when is ipratropium inhaler indicated? what is it administered with? how many times is it administered?
o relieves and prevents bronchospasm of asthma/COPD o administered w/albuterol (DuoNeb) o up to 4 or more times per day
38
what is the long acting anticholinergic?
tiotropium dry powder inhaler (DPI)
39
when is tiotropium dry powder inhaler used? and what is the indication?
- daily dosing | - maintenance/prophylaxis of bronchospasm w/COPD
40
what are the 3 different inhaler corticosteroids?
fluticasone dry powder inhaler (DPI) + fluticasone/salmeterol (Advair) + fluticasone/vilanterol (Breo)
41
what are the four characteristics of fluticasone dry powder inhaler (DPI) ?
o anti-inflammatory o ↓ edema and mucus secretion o long-term management of asthma or COPD o ↓ frequency and severity of asthma attacks
42
what kind of combo are both fluticasone/salmeterol (Advair) + fluticasone/vilanterol (Breo)?
combo corticosteroid and bronchodilator
43
what are the AEs of corticosteroid inhalers?
HA, hoarseness, hyperglycemia, | oral/esophageal candidiasis
44
T/F it's important to rinse mouth after use of corticosteroid inhalers?
TRUE
45
what are the names of the systemic corticosteroid drugs?
methylprednisolone (IV → ST) | perdnisone (ST/LT)
46
what is the indication for systemic corticosteroid?
- anti-inflammatory - short term tx for acute asthma and COPD exacerbations
47
what does systemic corticosteroid do?
↓ mucus production and edema (swelling/↓ airway constriction)
48
for how long are systemic corticosteroids prescribed?
- prescribed for 5 to 7 days -tapering dose ↓ to prevent adrenal insufficiency
49
what are the AE of systemic corticosteroids?
hyperglycemia, euphoria, depression, HTN, ↓ wound | healing, ecchymoses, peptic ulceration
50
what is the purpose for pulmonary function tests? (PFT)
- differentiate b/t obstructive diseases - disease progression, assess bronchodilator response - measure lung volumes and airflow * depends on age, weight, height, gender
51
what do PFTs measure?
- total lung capacity - residual volume (air left after expiration) - forced vital capacity (amt air that can be quickly and forcefully exhaled before taking another breath)
52
what are the 3 characteristics of acid-base balance?
- metabolic and respiratory processes maintain H+ levels - pH is a measure of acidity or alkalinity - imbalances are a sx of an underlying health problem
53
what are the 3 mechanisms to regulate the acid-base balance?
- buffer system - respiratory system - renal system (metabolic system)
54
how does the buffer system work?
- neutralizing strong acids to weaker | - primary buffers HCO3- and phosphate
55
how does the respiratory response work?
- CO2 removed during exhalation - hypoventilation → retain CO2 → acidosis - hyperventilation → expel CO2 → alkalosis
56
how does the renal (metabolic) response?
- acidosis → kidneys reabsorb HCO3- and secrete more H+ | - alkalosis → kidneys excrete HCO3 and reduce H+ secretion
57
what are the acidic pH levels?
< 7.35
58
what are normal pH levels
7.35 - 7.45; NORMAL: 7.4
59
what are the alkaline pH levels?
> 7.45
60
what are the acidic CO2 levels?
> 45
61
what are the normal CO2 levels?
35 - 45
62
what are the alkalotic CO2 levels?
< 35
63
what are the acidic HCO3 levels?
< 22
64
what are the normal HCO3 levels?
22 - 26
65
what are the alkalotic HCO3 levels?
> 26
66
T/F : ABGs will also show fully compensated, partially compensated or uncompensated
TRUE
67
what are the possible causes of metabolic acidosis?
DKA, Shock, Diarrhea, Salicylate OD, Renal failure , Sepsis
68
what are the possible causes of metabolic alkalosis?
Loss of gastric secretions Overuse of antacids K+-wasting diuretics
69
what are the possible causes of respiratory acidosis?
Hypoventilation r/t: COPD Chest trauma Drug OD Airway obstruction Neuromuscular disorder
70
what are the possible causes of respiratory alkalosis?
Hyperventilation r/t: Anxiety High altitude Fever

Nursing Semester 2 (21 decks)

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