Medsurgery- [A] Asthma/bronchitis/emphysema

Front 1

intermittant and reversible airflow obstruction that affects ONLY the airways not the alveoli

Back 1

asthma

Front 2

airway obstruction occurs due to

Back 2

inflammation

airway hyperresponsiveness

Front 3

what results from an increased production of leukotrine when other inflammatory pathways are supressed

Back 3

aspirin/NSAIDS related asthma symptoms

Front 4

barrel chest, audible wheezing, increased rr and use of accessory muscles are what

Back 4

physical assessment and clinical manifestations of asthma

Front 5

arterial oxygen level may _________ during an acute asthma attack

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decrease

Front 6

what level may decrease early in an attack and increase later indicating a "poor gas exchange"

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arterial carbon dioxide level

Front 7

during an asthma attack you must first assess the

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arterial blood gas level

Front 8

what is the most accurate measure for asthma using the spirometery

Back 8

pulmonary function tests

Front 9

pulmonary function tests are
FVC - forced vital capacity
FEV1 - forced expiratory volume in first second

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PERF - peak expiratory flow rate
CHEST XRAYS (rule out other causes)

Front 10

clients can co-manage asthma as a disease and due to this the most important intervention for asthma is

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client education

Front 11

what can be used twice daily by client

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peak flow meter

Front 12

what are some drug therapy for asthma (pharmacologic)

Back 12

bronchodilators, beta2 agonists, short acting beta2 , long acting beta2 agonists, cholinergic atntagonists

Front 13

what is recomended therapy and treatment for asthma that promotes ventilation and perfusion

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excercise
activity

Front 14

what is delivered via mask, nasal cannula or endotracheal tube in acute asthma attacks

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oxygen therapy

Front 15

a severe life threatening acute episode of airway obstruction that intensifies once it begins and often does not respond to therapy

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status asthmaticus

Front 16

status ashtmaticus is an emergency if the condition is not reversed causing

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pneumothorax and or cardiac /resp arrest

Front 17

a collapsed lung is known as

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pneumothorax

Front 18

NON REVERSIBLE chronic lung diseases of chronic airflow obstruction are

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chronic bronchitis
pulmonory emphasthema

Front 19

what includes emphysema and chronic bronchitis classified by bronchospasms and dyspnea

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chronic obstructive pulmonary disease
COPD

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AN AIRWAY problem is

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chronic bronchitis

Front 21

an ALVEOLAR problem is

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pulmonary emphysema

Front 22

in pulmonary emphysema the loss of lung elasticity and hyperinflation of the lung causes

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dyspnea (difficulty breathing) and need for increased RR

Front 23

Emphysema causes the collapse of small airways known as

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bronchioles

Front 24

percussion =

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hyperresonnasance

Front 25

Emphysema causing destruction of the entire alveolis

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Panlobular Emphysema

Front 26

Emphysema causing openings occuring in the bronchioles that allow spaces to develop as tissue walls break down

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Centrilobular Emphysema

Front 27

Emphysema causing confined to the alveolar ducts and alveoluar sacs

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Paraseptal Emphysema

Front 28

inflammation of the bronchi and bronchioles caused by chronic exposure to irritants (tobacco smoke)

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CHronic Bronchitis

Front 29

Inflammation, vasodilation, congestion, swelling and bronchospasms that affects only the AIRWAYS and NOT the alveoli, producing large amounts of thick music w/. the MAIN SYMPTOM A CHRONIC COUGH

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Chronic Bronchitis

Front 30

Hypoxemia and Acidosis
Respiratory Infections
Cardiac Failure
Cardiac Dysrhythmias

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complications of COPD

Front 31

a complication of COPD w/ Low concentartion of dissolved oxygen in arterial blood is known as

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hypoxemia

Front 32

unplanned weight loss
loss of muscle mass in extermities
large neck muscles
sitting forward bennt
are signs of

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COPD physical assessment

Front 33

look at the lab assessment of

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status of ABG for abnormal oxygenation, ventilation and acid base status.
sputum test
chest xray
pulmonary function test
HGB and HCT blood test

Front 34

surgical operation where an excision of giant bullae from the lung in emphysema to improve pulmonary function.

Back 34

bullectomy

Front 35

for client with COPD , assess

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impaired gas exchange
ineffective breathing pattern
inneffective airway clearance
imbalanced nutrition
ineffective coping r/t

Front 36

assess breath sounds before and after interventions to look for

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innefective airway clearance

Front 37

name some interventions for compromised breathing

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drugs
controlled cough
suctioning
hydration via humidifier
postural drainage in sitting position
tracheostomy

Front 38

help pt realize that anxiety will only

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worsen symptoms

help client to develop realistic goals

Front 39

COPD patients must learn to

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stop smoking
pursed lip diaphramatic breathing
relaxation therapy
counseling

Front 40

gradually increase activity and use supplemtal o2 to increase the

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activity level

Front 41

interventions for potential pneumonia or respiratory infections

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avoid large crowds
pneumonia vaccination
yearly influenza vaccine

Front 42

the ETIOLOGY of asthma is

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hyperresponsiveness

Front 43

an overreaction of bronchi
causing thickening of airway
muscle spasms and
INCREASED MUCUS

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asthma (bronchial)

Front 44

Asthma does NOT affect the

Back 44

alveoli

Front 45

Is bronchial asthma Intermittent and Reversible?

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yes

Front 46

NSAIDS and ASPIRIN produce asthma attacks due to the production of

Back 46

leukotreine

Front 47

chronic airflow limitation - groups chronic lung diseases is called

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CAL

Front 48

Asthma is a _________ disease with no cure

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chronic

Front 49

always start HISTORY - the labs are

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ABG, Pulse Ox, CO2 and O2 level

Front 50

an increase ofWBC (esinophil) show

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parasite or allergy

Front 51

an ATOPIC reaction is also known as an

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allergic reaction

Front 52

permanant airway change that is irreversible if not treated is known as

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airway remodeling

Front 53

bronchodilators DO NOT fix

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inflammation

Front 54

helps muscle relax and opens airway but does not treat inflammation

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bronchodilators

Front 55

block parasymoathetic nervous system, decrease mucus and spasms

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cholinergic antagonist drugs

Front 56

binds to IGE (mast cells)

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monocional antibodies

Front 57

2 side effects of bronchodilators

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anxiety, shaky

Front 58

hold breath for how long between inhalder puffs

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10 seconds

Front 59

how long between puffs

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1 full minute

Front 60

a collapsed lung is called

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pneumothorax

Front 61

chronic bronchitis and pulmonary emphsema are reversible / non reversible

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NON REVERSIBLE

Front 62

The cardinal symptom of EMPHYSEMA is

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dyspnea and increased RR

Front 63

what stimulates emphysema patients to breathe

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low 02 levels

do not give pt too much O2

Front 64

lungs become stiff and over inflated causing shortness of breath, increased RR, dyspnea and barrel chest

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emphysema

Front 65

located at the terminal ends of the lungs

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alveoli

Front 66

upper alveoli destroyed, openings occuring in bronchioles that allow spaces to develop as tissue walls break down

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centrilobular

Front 67

LOWER AREA, DESTRUCTION OF ENTIRE ALVEOLIS

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panlobular

Front 68

confined to teh alveolar ducts and alveolar sacs is

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paraseptal

Front 69

genetic, AAT- type of emphysema

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antitrypsin

Front 70

chardinal symptom of bronchitis is

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chronic cough/bronchitis

Front 71

COPD complications come with hypoxemia which is

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low O2 and high CO2

Front 72

at risk for COPD is

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cig smokers
environmental factors

Front 73

chronic bronchitis comes with an increase in

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mucus

Front 74

#1 cause of emphysema patients

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smoking

Front 75

excessive RBC - body increase O2 and makes more RBC to excess, this is called

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polycythemia

Front 76

a patient with COPD disease becomes

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thin, barrel chest, decreased muscle mass

Front 77

airway management, monitoring client every 2 hours, o2 theraqpy and energy management are interventions for what RN diagnoses

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impaired gas exchange (airway)

Front 78

assesing client, respiratiory infectionm, pulm rehab therapy, breathing technique, position to alleviate dyspnea, excercise and energy conservation are interventions for what RN diagnoses

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inaffectivebreathing pattern (airway)

Front 79

Assessment of breath sounds for Inaffective Airwayclearance - you must assess breath sounds when?

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before AND after interventions

Front 80

if you hear adverntitious breath sounds, have pt

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cough to clear

Front 81

why is it important to put patient in a sitting position?

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to promote postural drainage and shake muscus loose

Front 82

interventions for imabalanced nutrition are to

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eat small, meals, more times daily

Front 83

diaphragm pills down on stomach causing patients to have what during meals

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SOB
full faster

Front 84

a decrease in ALBUMIN is indicative of

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malnutrtion

Front 85

Teach patient to

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alternative activity w rest

independant ADL

verbalize reasons why to conserve energy

encourage client to pace themselfs

Front 86

Risk for pneumonia or other respiratory infections are greater for

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older patients, elderly

Front 87

patients at risk for pneumonia such as elderly should have

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excellent hygiene
avoid large crowds
pneumonia vacc
flu vacc

Front 88

explain the elderly and why they are at risk for pneumona

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cilia is flat, not working as well, increase mucus and become a warm area that is a host enviromment for bacteria.

Front 89

hyperreactivity, inflammation in lungs, can cause inflammation adn is reversible, not chronic explains

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ASTHMA

Front 90

A CHRONIC DISEASE that is progressive, little or no effect on inflammation c cough, dyspnea

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COPD