Week 5 - Altered Oxygen/ Respiratory Function (12/8/16)

Question 1

Chapter 17: Airflow Disorders

Answer 1

Beta_2-adrenergic agonists
Methylxanthines
Inhaled Anticholinergic
Glucocorticoids
Leukotriene modifiers

Question 2

most important medicine

Answer 2

oxygen

Question 3

Oxygen toxicity

Answer 3

Can result form high concentrations of oxygen (typically greater than 50%), long durations of oxygen therapy (typically more than 24-48 hours), and the severity of lung disease

Question 4

Oxygen devices

Answer 4

Nasal cannula
Simple face mask
Partial rebreather mask
Nonrebreather mask
Venturi mask
Aerosol mask

Question 5

what is FiO2

Answer 5

amount of air per breath per type of oxygen devices

Question 6

Maximum oxygenation for Nasal Cannula

Answer 6

FiO2
24%-44%

flow rate
1-6 L/min

Question 7

rebreather

Answer 7

40%-70%

6-10L/min

Question 8

nonrebreather

Answer 8

60%-100%

10-15 L/min

Question 9

ventori mask

Answer 9

24%-60%

4-12 L/min

Question 10

Beta2-adrenergic agoinists

Answer 10

Prototype med: Albuterol
Purpose: dilate bronchioles
Therapeutic use: 
- prevention of asthma
- treatment for bronchospasm
- long-term control of asthma
S/E:
- tachycardia
- tremors
Contraindications:
- Pregnancy Risk Category C
- Do not give to patients with dysrhythmias
Nursing Administration:
- nurse can give breathing treatment
- listen to lung sounds before / after
- patient get oral care after treatment (oral thrush)
--- Nystatin [antifungal]
- check heart rate before - tachycardia

Question 11

Beta2-adrenergic agonists

prototype medication
other medications

Answer 11

prototype: Albuterol

other; formoterol, levalbuterol, salmeterol, terbutaline

Question 12

Beta2-adrenergic agonists

purpose

Answer 12

bronchodilation

Question 13

Beta2-adrenergic agonists

therapeutic uses

Answer 13

Albuterol, levalbuterol

• prevention of asthma episode (exercise-induced)
• inhaled, short-acting, used for prevention of asthma
• treatment for bronchospasm
• long-term control of asthma

Formoterol, salmeterol

• long-term control of asthma

Terbutaline
- long-term control of asthma

Question 14

Beta2-adrenergic agonists

S/E

Answer 14

• Tachycardia, can lead to angina (stop giving it)

- Tremors (transient)

Question 15

Beta2-adrenergic agonists

Contraindications (pregnancy risk)

Answer 15

Category C

Question 16

Beta2-adrenergic agonists

Nursing administration

Answer 16

• assess patient
• nurses can give breathing treatment
• listen to lung sounds before / after
• patient get oral care after treatment (oral thrush)
• –Nystatin [anti fungal]
• check heart rate after - tachycardia

Question 17

Methyxanthines

Answer 17

prototype: Theophylline
therapeutic level: 10-20
purpose: bronchodilation
therapeutic use: oral theophylline is used for long-term control of chronic asthma or COPD
S/E:
- mild toxicity reaction can include GI distress and restlessness
- toxicity: cardiotoxicity and seizures
— mesaure serum levels
Contraindications:
- pregnancy risk category C
- clients who have heart disease, HTN, liver/kidney dysfxn, and diabetes mellitus
Interaction:
- caffeine
Nursing administration:
- advise client to take medication as prescribed
— if a dose is missed, the following dose should not be doubled
- instruct not to chew or crush sustained-release preparations

Question 18

Methylxanthines

therapeutic level

Answer 18

10-20

Question 19

Methylxanthines

prototype medication

Answer 19

theophylline

Question 20

Methylxanthines

Purpose

Answer 20

bronchodilation

Question 21

Methylxanthines

Therapeutic use

Answer 21

used for long term control for chronic asthma and COPD

Question 22

Methylxanthines

S/E

Answer 22

S/E:
- mild toxicity reaction can include GI distress and restlessness
- toxicity: cardiotoxicity and seizures
— mesaure serum levels
Contraindications:
- pregnancy risk category C
- clients who have heart disease, HTN, liver/kidney dysfxn, and diabetes mellitus
Interaction:
- caffeine
Nursing administration:
- advise client to take medication as prescribed
— if a dose is missed, the following dose should not be doubled
- instruct not to chew or crush sustained-release preparations

Question 23

MEthylxanthines

contraindications

Answer 23

Contraindications
- preg C
clients who have heart disease, HTN, liver/kidney dysfxn, and diabetes mellitus

Question 24

Methylxanthines

interactions

Answer 24

caffeine

Question 25

Methylxanthines Nursing administration

Answer 25

- advise client to take medication as prescribed - -- if a dose is missed, the following dose should not be doubled - instruct not to chew or crus sustained-release preparations

Question 26

Leukotriene modifiers S/E contraindications

Answer 26

S/E - depression, suicidal thoughts - hepatotoxicity (zileuton and zafirlukast) contraindications: pregnancy category B (montelukast and zafirlukast) pregnancy category C (zileuton)

Question 27

Leukotriene modifiers interactions nursing administration

Answer 27

interactions - zileuton and zafirlukast inhibit metabolism of warfarin and theophylline, leading to increased warfarin and theophylline levels - montelukast used concurrently with phenytoin can inhibit effects of montelukast nursing administration: - food prevent absorption - advise clients to take zileuton as prescribed, 1 hour before or 2 hours after meals

Question 28

Leukotriene modifiers interactions nursing administration

Answer 28

interactions - zileuton and zafirlukast inhibit metabolism of warfarin and theophylline, leading to increased warfarin and theophylline levels - montelukast used concurrently with phenytoin can inhibit effects of montelukast nursing administration: - food prevent absorption - advise clients to take zileuton as prescribed, 1 hour before or 2 hours after meals

Question 29

Antitussives: Opioids prototype other purpose therapeutic use

Answer 29

prototype Codeine other: hydrocodone purpose suppresses cough through its action on the CNS therapeutic use used for chronic nonproductive cough to decrease the frequency and intensity

Question 30

Antitussives: Opioids S/E

Answer 30

- CNS effects (dizziness, lightheadedness, drowsiness, respiratory depression) - GI distress (nausea, vomiting, constipation) - Opioid use disorder

Question 31

Antitussives: opioids contraindication nursing administration

Answer 31

contraindication preg risk C contraindicated in clients who have resp depression, acute asthma, head trauma, liver/renal dysfxn, acute alcohol use disorder nursing administration - advise to avoid activities that require alertness - advise to change positions slowly - avoid alcohol and other CNS depressants

Question 32

Antitussives: nonopioids prototype other purpose therapeutic use

Answer 32

``` prototype Dextromethorphan (robutussin) other benzonatate diphenhydramine ``` purpose suppresses cough therapeutic use cough suppression

Question 33

ANtitussives: nonopioids S/E

Answer 33

- mild nausea, dizziness, sedation can occur - GI: nausea - medicine does not work for kids

Question 34

Antitussives: nonopioids contraindication nursing administration

Answer 34

contraindication preg risk C nursing administration

Question 35

Expectorants prototype purpose therapeutic use

Answer 35

prototype: Guaifenesin (Mucenix) purpose promotes increased cough production by increasing and thinning mucous secretions (allow decrease chest congestion by coughing out secretions) therapeutic use

Question 36

Expectorants S/E (are mild)

Answer 36

- GI upset - drowsiness, dizziness - allergic reaction (rash) - doesn't work for pediatrics - -- (kids just need fluids and rest)

Question 37

Expectorants contraindication nursing administration

Answer 37

contraindication preg risk C nursing administration advise to increase fluid intake when taking guaifenesin

Question 38

Mucolytics prototype other purpose therapeutic use

Answer 38

prototype acetylcysteine other hypertonic saline purpose thin and enhance the flow of secretions in the respiratory passages therapeutic use

Question 39

Mucolytics S/E nursing administration

Answer 39

liquify dry mucous inhaler IV - OD antidote for tylenol aspirate: causes bronchospasm given: situp at least 30 min need to be chilled (PO form) because of bad taste (on ice) smells like rotten eggs IV dosing depend on amount of Tylenol taken Tylenol and antidote causes hepatotoxicity

Question 40

Mucolytics contraindication nursing administration

Answer 40

``` contraindication preg risk B not used in client shwo are hypersensitive to acetylcysteine - - ``` nursing adminstration advise odor administered by inhalation to liquefy nasal oral IV