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72 Cards in this Set
- Front
- Back
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Is Asthma a obstructive of restrictive pulmonary disease?
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Obstructive
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What is Asthma characterized by?
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diffuse broncospasm
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A key feature of asthma is that the airway obstruction is?
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Reversible
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What is an asthma attack that does not respont to conventional treatment?
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status asthmaticus
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Bronchospasm that that occurs in response to a provoking agent or agents in the work place?
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Occupational asthma
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Asthma - prone patient has had no increase in symptoms or no need for an in crease in medication for a period of over 4 weeks?
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Stable asthma
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Present when patient experiences increasing asthma symptoms?
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unstable asthma
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Atopic or allergic asthma,that is more common in children and young adults.
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Extrinsic asthma
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Asthma type that has no known allergic cause and tends to occur in the middle-aged.
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intrinsic (or nonallergic) asthma
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Airway obstruction in asthma may be caused by?
(3) |
mucosal edema, bronchospasms and excessive secreations
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Patients with asthma frequently have shat type of secreations?
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thick
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In a asthma patient secretions in the lugs can cause what in the distal airways?
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Plugging
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Airway obstruction in asthma hinders exhalation and leads to what?
(3) |
progressive lung inflation, air trapping, and hyperinglation
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Air trapping increases or decreases the residual volume?
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increases
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What does air trapping do to vital capacity?
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decreases it
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High airway resistance and hyperinflation of the lungs cause the WOB to be increased or decreased?
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Increased
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Patients with asthma frequently have thick secretions in the lungs which causes what in the distal airways?
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Plugging
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Airway obstruction in asthma hinders exhalation and leads to?
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Air trapping
Hyperinflation Decreased airway resistance |
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True or False?
Patients having an asthma attack usually complain of chest tightness, difficulty breathing, and wheezing or cough (or both). |
True
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True or False?
The severity of an asthma attack can be determined by the degree of dypsnea? |
False
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True or False?
Dypsnea and wheezing are diagnosic of asthma. |
False
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True or False?
Diagnosis of asthma can best come fron the patient's age, medical history, physical findings, and radiographic and laboratory results. |
True
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6 Physical findings of asthma?
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1. Rapid RR
2. Active use of accessory muscles 3. Prolonged exhalation 4. Increased AP diameter 5. Presence of wheezing 6. Retractions of the intercostal muscles. |
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An abnormbreath sound produced during movement of rapid airflow through narrowed airways. The "musical" sound can sometimes be heard without a stethoscope.
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Wheezing
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Define Retractions.
What does this sign indicate? |
intermittent depression of the skin around the rib cage occuring with respiratory effort, indicates increased WOB
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Chest retractions are caused by a significan positve or negative intrapleural pressure?
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Negative
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The decrease in intrapleural pressure is responsible for the drip in pulse pressure during inspiration or expiration?
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Inspiration
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Define Paradoxical pulse
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A drop in pulse pressure due to a decrease in ntrapleural pressure.
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What does a chest X-ray in asthma usually reveal?
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hyperinflation
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In evaluating asthma, bedside spirometry is useful for determining?
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Severity of obstructions
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High airway resistance and hyperinflation of the lungs cause the WOB to be increased or decreased?
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Increased
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Patients with asthma frequently have thick secretions in the lungs which causes what in the distal airways?
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Plugging
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Airway obstruction in asthma hinders exhalation and leads to?
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Air trapping
Hyperinflation Decreased airway resistance |
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True or False?
Patients having an asthma attack usually complain of chest tightness, difficulty breathing, and wheezing or cough (or both). |
True
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True or False?
The severity of an asthma attack can be determined by the degree of dypsnea? |
False
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True or False?
Dypsnea and wheezing are diagnosic of asthma. |
False
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True or False?
Diagnosis of asthma can best come fron the patient's age, medical history, physical findings, and radiographic and laboratory results. |
True
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6 Physical findings of asthma?
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1. Rapid RR
2. Active use of accessory muscles 3. Prolonged exhalation 4. Increased AP diameter 5. Presence of wheezing 6. Retractions of the intercostal muscles. |
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An abnormbreath sound produced during movement of rapid airflow through narrowed airways. The "musical" sound can sometimes be heard without a stethoscope.
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Wheezing
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Define Retractions.
What does this sign indicate? |
intermittent depression of the skin around the rib cage occuring with respiratory effort, indicates increased WOB
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Chest retractions are caused by a significan positve or negative intrapleural pressure?
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Negative
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The decrease in intrapleural pressure is responsible for the drip in pulse pressure during inspiration or expiration?
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Inspiration
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Define Paradoxical pulse
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A drop in pulse pressure due to a decrease in ntrapleural pressure.
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What does a chest X-ray in asthma usually reveal?
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hyperinflation
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In evaluating asthma, bedside spirometry is useful for determining?
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Severity of obstructions
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At the onset of an asthma attack ABGS typically show an increased, decreased, or normal PCO2?
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Decreased
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If the the airway obstruction in asthma is severe or the the patient is becoming fatiqued, the Paco2 will be increased or decreased?
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Increased
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B - Adrenergics, xanthines, and parasympatholytics are some medications that promote?
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Bronchodialation
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Steroids are used to decrease airway?
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Inflammation
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4 advantages of inhaled and oral bronchodialtors?
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1. rapid onset
2. lower dosage 3. fewer side effects 4. better protection of the airways against provoking agents |
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MDI stands for
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Metered dose Inhaler
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MDI is common among patients with asthma or airway obstruction because it is convenient or inexpensive?
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Convenient
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SVN stands for
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Small Volume Nebulizer
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Who are candidates for oral or intravenous theophylline?
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Patients who fail to respond to aerosolized B - agonists or who have sever asthma
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The anti - inflammatory effects of corticosteroids for asthma may not be apparent for several minutes, hours, or days.
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Hours
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Why shouln't a patient be given sedatives during an asthma attackin?
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Sedatives cause ventilatory failure
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Mucomyst, cromolyn sodium, and dense aerosols should not be given to patient suring an asthma attack why?
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they may increase the incidence of bronchospasm
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How does hydration of the airways and lungs help the patient?
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helps the patient to expectorate the pulmonary secretionsient
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What are 5 symtoms that would lead a patient with asthma to be admitted to the hospital
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1. use of accessory muscles at rest
2. paradoxic pulse 3. Inspiratory and expiratory wheezing present 4. Peak flow < 100 L/min 5. hyperventilation on a CXR |
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2 signs that the parient is not respoding to initial therapy
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1. continued use of respiratory muscles
2. PaO2 responds minimally to O2 therapy |
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Patient should be intubated and mechanically ventilated if the patient fatiques and?
(4) |
PaCO2 increases
Decrease in sensorium Presence of abdominal paradox Decreasing PIP |
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Respiratory failure is present when the following signs are observed?
(3) |
Hypoxemia despite high FIO2
respiratory acidemia pH < 7.25 Centeral cyanosis is present |
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Cardiopulmonary arrest is observed when what signs are observed?
(3) |
Pulse and RR absent
Pallor is present patient becomes unconsious |
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Preventing or reducing the incidence of astma attacks is done by?
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decreasing airway responsiveness, avoid triggers
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What can be used by an asthma patient to monitor his degree of airway obstruction?
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Peak flow meter
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How does cromolyn sodium help asthma?
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It stabilizes the mast cells that release mediators such as histamine that can cause bronchospasm
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ASTHMA
Definition |
obstructive pulmonary disease characterized by diffuse bronchospasm due to an increased reactivity of the airways to various stimuli and chronic inflammation of the airways. Although not curable asthma is reversible.
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Extrinsic (6)
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Caused by external or environmental agents
Occurs in an ATOPIC person AKA: Atopic or Allergic asthma Genetically predisposed to Atopy Excessive amounts of IgE Ab present 10-20% of population is ATOPIC Prevalent in children and adults <30 |
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Intrinsic (6)
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AKA non-allergic or non-atopic asthma
Not directly linked to a specific allergen Not hypersensitive to environmental agents Normal IgE levels Usual onset is >40 No strong genetic component Non specific stimuli |
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Extrinsic Pathophysiology (6)
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Excessive amounts of IgE present
IgE attaches to surface of cell (mast cells) Respiratory tract has high concentration of mast cells Exposure to Ag’s causes an Ag/Ab reaction Ag binds to IgE Ab on mast cell Degranulation occurs & mediators released |
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Intrinsic/Extrinsic
Pathophysiology (7) |
Mediators released
Histamine, eosinophils, neutrophils, leukotriennes, prostaglandins Mediators stimulate parasympathetic NS Increase permeability of capillary bed Dilation of blood vessels & tissue edema Smooth muscle hypertrophy (3x’s normal) Proliferation of goblet cells |
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I/E Pathophysiology continued
(10) |
Enlargement of bronchial mucus glands
Increase mucus production Increase mucus viscosity Decrease airway diameter Bronchoconstriciton Damaged muco-ciliary transport Mucus plugging Air trapping and alveolar hyperinflation V/Q mismatching Cholinergic response |
