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NUR2226 > WK 4: Respiratory Disorders A > Flashcards

WK 4: Respiratory Disorders A Flashcards

1
Q

What are the three pathophysiological concepts of asthma?

A
  1. Airway inflammation
  2. Airway hyper responsiveness
  3. Mucus hyper secretion
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2
Q

Describe the pathophysiology of asthma

A

Airway inflammation, airway hype responsiveness and mucus hyper secretion result in airflow obstruction which leads to the clinical manifestations

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3
Q

What are 3 types of triggers?

A

Allergens e.g. animal hair
Air pollution e.g. perfume, exhaust fumes
Oxidants e.g. cigarette smoking, aerosol

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4
Q

What happens when a patient is exposed to a trigger?

A

A response is initiated which begins with mast cell degranulation and the release of inflammatory mediators `

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5
Q

What are 5 key mediators release during an asthma attack?

A
  • Histamine
  • Interleukin
  • Prostaglandin
  • Leukotriene
  • Nitric Oxide
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6
Q

What can be seen within the inflammatory process of asthma?

A

Increased mucus production
Bronchial smooth muscle spasms
Thickening of airway walls
Increased bronchial hyper responsiveness

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7
Q

Identify the 4 clinical manifestations of asthma

A

Wheeze
SOB
Chest tightness
Coughing

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8
Q

Identify 3 clinical manifestations within a severe/exacerbation

A

Prominent inspiratory/expiratory wheezing
RR >30 bpm
Pulse rate >120 bpm

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9
Q

Identify 2 examples of subjective data within asthma assessment

A

Past medical history?
Asthma management plan?
Medications?

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10
Q

Identify 2 examples of objective data within asthma assessment

A

Is the patient restless? Cyanosis?

Vital signs

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11
Q

Identify the 3 steps for acute management of asthma

A
  1. Correct significant hypoxaemia
  2. Reverse airflow obstruction quickly
  3. Plan to prevent further events
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12
Q

Outline how to correct significant hypoxaemia

A

Oxygen therapy e.g. hudson mask/simple face mask

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13
Q

Outline how to reverse airflow obstruction quickly

A

Reliever medication e.g. immediate relief

Preventer medication e.g. inhaled corticosteroids

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14
Q

Outline how to plan to prevent further events

A

DRSABCDE
Provide oxygen therapy/medications PRN
Esclate to Code blue PRN

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15
Q

Identify 3 areas of education for asthma patients (Nursing intervention)

A
  1. Identification of triggers/reducing exposure
  2. Knowledge of early signs/symptoms
  3. Proper inhalation technique
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16
Q

What does COPD stand for

A

Chronic Obstructive Pulmonary Disorder

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17
Q

What is COPD?

A

Slow progressive obstruction of the airways with periodic exacerbations/increased periods of dyspnoea and sputum production

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18
Q

What is COPD the umbrella term for?

A

Chronic bronchitis

Emphysema

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19
Q

Describe the pathophysiology of chronic bronchitis

A

Airway becomes narrowed due to the airway inflammation with neutrophils and macrophages causing bronchial oedema causing goblet cels to increase in size, thick mucus produced which cannot be cleared

20
Q

Identify the 2 causes of chronic bronchitis

A

Cigarette smoke

Inhalation of harmful particles

21
Q

What is Chronic bronchitis

A

Hyper secretion of mucus and productive cough that occurs for 3> months of the year and has occurred for at least 2 years

22
Q

Describe the pathophysiology of emphysema

A

Destruction of alveolar space leads to alveolar destruction and loss of elastic recoil. Decreased volume of air expired = decreased gas exchange and air trapped in lungs

23
Q

What is emphysema?

A

Abnormal and permanent enlargement of gas exchange airways accompanied by the destruction of alveolar walls

24
Q

Identify 3 clinical manifestations of COPD

A

Persistent cough
Dyspnoea
Digital clubbing
Fatigue

25
Q

Outline three areas of acute management for COPD

A

Oxygen therapy PRN
Pt education/reassurance
Airway clearance

26
Q

Outline 3 common goals of COPD

A

Improve gas exchange (Increased O2/Decraesed CO2
Improve airway clearance
Improve breathing pattern/rate

27
Q

What is pneumonia?

A

Acute infection of the lung parenchyma caused by pathogens

28
Q

Outline the 3 organisms that cause pneumonia

A
  1. Aspiration of normal flora from nasopharynx/oropharyna
  2. Inhalation of microbes present in the air
  3. Haemotogenous spread of infection from another area in the body
29
Q

Identify the 4 types of pneumonia

A
  1. Community acquired pneumonia
  2. Medical care associated pneumonia
  3. Aspiration pneumonia
  4. Opportunitic pneumonia
30
Q

Describe community acquired pneumonia

A

A lung infection that develops in people outside of hospital e.g. from bacteria viruses or fungi

31
Q

Describe medical care associated pneumonia

A

A lung infection that devleops 48hrs> hospital admission

32
Q

Describe aspiration pneumonia

A

Occurs when food, saliva, liquids or vomit is breathed into the lungs or airways instead of the stomach

33
Q

Describe opportunistic pneumonia

A

Patients who are immunocompromised or have an increased susceptibility to infection. Organisms cause infection when they typically wouldn’t in a normal individual

34
Q

Describe the pathophysiology of pneumonia

A

Acute inflammatory response occurs due to a microorganism entering to Lower respiratory tract. This causes damage to the bronchial mucus membranes and an accumulation of WBC, cellular debris etc. impairing gas exchange

35
Q

Identify 3 clinical manifestations of pneumonia

A 
Increased respiratory rate 
Increased WOB/SOB
Accessory muscle use 
Cyanosis 
Productive cough
36
Q

Identify 3 areas of acute management in pneumonia

A

Correct hypoxia via oxygen therapy
Maintain medication administration
Encourage deep breathing/coughing exercises

37
Q

Identify 3 areas of acute management in severe life threatening exacerbations

A

DRSABCDE
Oxygen therapy PRN
Medication administration PRN

38
Q

Identify 3 nursing considerations of pneumonia

A

Be mindful of HAI
Ensure pt has been provided with adequate education
Support pt with ADL’s

39
Q

What is tuberculosis?

A

An infection caused by mycobacterium tuberculosis which is a gram positive acid fast bacillus

40
Q

Describe the pathophysiology of TB

A

Spread by droplets and transmitted via inhalation, macrophages released to fight the bacilli. If it dights it off, TB is latent, if not, it can grow and destroy the macrophages. When it settles in the lung it causes inflammation and TB continues to multiply. WBC attempt to engulf bacteria and cause lesions called tubercles, dies and becomes necrotic

41
Q

Identify 3 clinical manifestations of an active infection

A 
Chronic cough 
Sputum production 
Loss of appetite 
Weight loss 
Fever
42
Q

Identify clinical manifestations of latent infection

A

Usually asymptomatic

43
Q

What is the form of diagnosis for TB?

A

Positive tuberculin skin test (Many false positives)
Interferon gamma release assay blood test
Sputum culture
Chest X ray

44
Q

Describe the treatment for TB

A 
Antibiotic therapy for minimum 6 months 
Combination therapy (2> drugs) e.g. Rifampin, Ethambutol, Isoniazid
45
Q

Identify 3 nursing considerations of those with TB

A

Droplet precautions
Adequate education
Support pt with ADLs

46
Q

Identify the 4 areas of patient assessment for respiratory conditions

A
  1. Apply appropriate assessment for relevant disorder
  2. Primary assessment
  3. Secondary assessment (Head to toe, VS, Pain assessment, general appearance)
  4. Respiratory focused assessment

NUR2226 (8 decks)

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