T1-Ch 27: Noninfectious LR Problems

Question 1

chronic lower respiratory disorder that causes inflammation that obstructs the airway via bronchoconstriction

Answer 1

asthma

Question 2

Asthma triggers (4)

Answer 2

-specific allergens
-general irritants
(cold air, dry air, fine airborne particles, microorganisms)
-aspirin & other NSAIDs
-WBCs (eosinophils and neutrophils activated by IL-5 or IL-7)

Question 3

Symptoms for asthma control scale: (4)

Answer 3

-Daytime: wheezing, dyspnea, coughing, present more than twice weekly
-Waking from night sleep with symptoms go wheezing, dyspnea, coughing
-Reliever drug needed more than twice weekly
-Activity limited or stopped by symptoms

Question 4

Asthma control level:
no symptoms present

Answer 4

controlled

Question 5

Asthma control level:
1-2 symptoms

Answer 5

Partly controlled

Question 6

Asthma control level:
3-4 symptoms

Answer 6

uncontrolled

Question 7

General asthma s/s (4)

Answer 7

-audible wheeze
-longer breathing cycle w/ prolonged and more effortful exhalation
-decreased ability to speak
-hypoxia

Question 8

Asthma patients ABG will show:

Answer 8

decreased CO2

Question 9

Asthma patients End-vital carbon dioxide levels _____ in later stages

Answer 9

rise

Question 10

Asthma patients have _____ eosinophil count and IgE due to ________

Answer 10

elevated
allergen triggers

Question 11

Most accurate test to diagnose asthma

Answer 11

pulmonary function test

Question 12

How many steps are therein asthma step therapy?

Answer 12

5 steps

Question 13

Asthma Therapy: Step 1

Answer 13

Albuterol PRN

Question 14

Asthma Therapy: Step 2

Answer 14

Albuterol PRN
Daily dose ICS or Leukotriene modifier

Question 15

Asthma Therapy: Step 3

Answer 15

Albuterol PRN
Daily low dose:
1) ICS + Laba
2) medium to high dose ICS
3) low dose ICS + Leukotriene modifier
OR
4) Low dose ICS + SR theophylline

Question 16

Asthma Therapy: Step 4

Answer 16

Albuterol PRN
Daily Step 3 Treatment
Daily:
1) medium/high dose ICS + Laba
OR
2) Leukotriene modifier + SR theophylline

Question 17

Asthma Therapy: Step 5

Answer 17

Albuterol PRN
Daily treatment with Step-4 options
Additional:
1) Oral glucocorticoid
OR
2) IgE antagonist (IL-5 or IL-7)

Question 18

Emergency services are requires for asthma patients when: (5)

Answer 18

-Fingertips or lips are gray/blue
-Difficulty breathing, walking, or talking
-Retractions of the neck, chest, or ribs
-Nasal flaring
-Failure of drugs to control worsening symptoms

Question 19

A destruction of lung’s elastic tissue that reduces its ability to recoil after stretching, leading to hyperinflation of the lungs

Answer 19

Emphysema

Question 20

Hyper-inflated lungs ______ the diaphragm, weakening it

Answer 20

flatten

Question 21

Patients with emphysema use accessory muscles of the ___, ___, and _____ to inhale and exhale

Answer 21

neck, chest wall, and abdomen

Question 22

increased work to breath = increase in oxygen needed = _____

Answer 22

air hunger

Question 23

ABGs of emphysema patients may show chronic ______ _______

Answer 23

respiratory acidosis

Question 24

Emphysema causes include: (3)

Answer 24

-tobacco smoking
-marijuana use
-chronic inhaled particular matter exposure (wood smoke & biomass fuels)

Question 25

Greatest risk factor for COPD

Answer 25

smoking

Question 26

Other risk factors for COPD

Answer 26

-genetic -environmental

Question 27

complications of COPD (5)

Answer 27

-hypoxemia -acidosis -respiratory infection -cardiac failure -cardiac dysrhtymias

Question 28

COPD is classified from mild to very severe on the basis of: (2)

Answer 28

-symptoms -pulmonary function test changes

Question 29

Decreased gas exchanges with COPD is due to: (8)

Answer 29

-alveolar-capillary membrane changes -reduced airway size -ventilatory muscle fatigue -excessive mucus production -airway obstruction -diaphragm flattening -fatigue -decreased energy

Question 30

Weight loss in COPD patients is due to: (4)

Answer 30

-dyspnea -excessive secretions -anorexia -fatigue

Question 31

Anxiety in COPD patients is often due to: (2)

Answer 31

-changes in health status -situational crisis

Question 32

Decreased endurance in COPD patients is due to: (3)

Answer 32

-fatigue -dyspnea -imbalance between oxygen supply and demand

Question 33

COPD cues (5)

Answer 33

-decreased gas exchange -weight loss -anxiety -decreased endurance -pneumonia/respiratory infection

Question 34

Before a nurse conducts an intervention on COPD patient they should assess (4)

Answer 34

-breathing rate -rhythm -depth -use of accessory muscles

Question 35

Nursing care for COPD patients

Answer 35

-assess breathing before interventions -conduct interventions -teach effective coughing & exercise conditioning -Use oxygen therapy, suctioning, and ensure hydration

Question 36

Nursing interventions for COPD patients

Answer 36

-ensure consistency prescribed drug therapy use for airway maintenance -monitor for improvements -use breathing techniques -reposition patients

Question 37

COPD severity classification: FEV > 80% predicted

Answer 37

Gold 1: Mild

Question 38

COPD severity classification: FEV 50-79% predicted

Answer 38

Gold 2: Moderate

Question 39

COPD severity classification: FEV 30-49% predicted

Answer 39

Gold 3: Severe

Question 40

COPD severity classification: FEV < 30% predicted

Answer 40

Gold 4: very severe

Question 41

Breathing techniques: (2)

Answer 41

-pursed-lip breathing -diaphragmatic or abdominal breathing

Question 42

Steps for diaphragmatic/abdominal breathing

Answer 42

-lie on you back with knees bent (or sitting in chair if unable to lie down) -Place your hands or a book on your abdomen to create resistance -begin breathing from your abdomen while keeping your chest still (look for rise/fall of book or hand)

Question 43

Steps for Pursed-Lip Breathing (3)

Answer 43

-Close your mouth and breath in through your nose -Purse your lips as you would to whistle; breath out slowly through your mouth, without puffing your cheeks; spend twice the amount of time it took you to breath in -Use your abdominal muscles to squeeze out every bit of air possible

Question 44

an autosomal recessive genetic disease that affects many organs with most impairment occurring to pancreatic and/or lung function

Answer 44

Cystic Fibrosis

Question 45

Organs most commonly impaired in Cystic Fibrosis patients (5)

Answer 45

-pancreas -lungs -liver -salivary glands -testes

Question 46

How are babies screened for Cystic Fibrosis?

Answer 46

Sweat test

Question 47

In pts with Cystic Fibrosis, poor ______ transport causes the formation of mucus that has little water content and is _______

Answer 47

-chloride transport -thick

Question 48

Non-pulmonary problems of COPD patients include: (6)

Answer 48

-pancreatic insufficiency -malnutrition -intestinal obstruction -poor growth -male sterility -cirrhosis of the liver

Question 49

_____ & ______ are concerns of cystic fibrosis pts due to nutritional issues

Answer 49

-osteoporosis -diabetes mellitus

Question 50

Main cause of death for Cystic Fibrosis pts

Answer 50

Respiratory Failure

Question 51

Cystic Fibrosis ABG ABG shows _____ : _____ arterial oxygen levels _____ arterial carbon dioxide _____ bicarb

Answer 51

acidosis -greatly reduced arterial oxygen level -increased arterial carbon dioxide levels -increased bicarbonate

Question 52

Cystic fibrosis management includes: (8)

Answer 52

-drug therapy -infection prevention -pulmonary hygiene -nutrition & vitamin supplements -Oxygen therapy -treatment for respiratory infections -gene therapy -sometime surgery

Question 53

Major issues of lung transplants in cystic fibrosis patients (3)

Answer 53

-bleeding -infection -transplant rejection