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45 Cards in this Set

  • Front
  • Back
__________ is defined as asthma resulting from repeated and prolonged exposure to industrial inhalants
Occupational Asthma
Asthma is an air way disorder characterized by bronchoconstriction, inflammation and __________ to various stimuli
Hyperreactivity
_________ is a high pitched whistling sound caused by turbulent airflow through an obstructed airway
Wheezing
Acurte symptoms of asthma may be precipitated by numerous stimuli and hyperreactivity to such stimuli may initiated both inflammation and ___________
Bronchoconstrition
Some clients are allergic to _______ and may experience life threatening asthma attacks if they ingest foods processed with these preservatives. ( Ex. beer, wine , and dried fruit)
Sulfites
Topical corticosteroids for inhalation
Beclomethasone Budesonide, flunisolide, Fluticasone, mometasone, and triamcinolone
Strong chemical mediators of bronchoconstriction and inflammation
Leukotrienes
Short acting beta2 adrenergic agonists
Albuterol and levalbuterol
The main xanthine used clinically
Theophylline
Used only for prophylaxis of acute bronchoconstriction
Formoterol and salmeterol
___________ is an airway disorder that is characterized by bronchoconstriction, inflammation and hyperreactivity to various stimuli.
Asthma
What are the symptoms of Asthma
Dyspnea wheezing chest tightness cough and sputum production. Turbulent airflow through an obstructed airway.
True or false

Symptoms of asthma vary in incidence and severity from occasional episodes of mild respiratory distress with normal functioning between attacks to persistent daily or continual respiratory distress if not adiquately controlled. Inflammation and damaged airway mucosa are chronically present even when clients appear symptom free.
True
True or false

Asthma symptoms may persist for days or weeks after the viral infection resolves
True
True or false

Clients with severe asthma should be cautioned against ingesting food and drug products containing sulfites or metabisulfits.
True
___________ a common disorder characterized by heartburn and esophagitis is also associated with asthma.
Gastroesophageal reflux disease (GERD)
True or false

Asthma that worsens at night may be associated with nighttime acid reflux
True
The main xanthine used clinically is ___________
Theophylline
True or false

Theophylline has been used for many years however, the drugs mechanism of action is unknown
True
Mrs Gomez presents to the ER with acutely deteriorating asthma. Her husband shows you salmerterol when you ask what medications his wife takes at home. He them tells you taht he gave her three extra puffs when she became Ill. Which of the following statements in correct in this situation?

a. The husband made the correct decision in giving the extra doses.

b. The extra doses facilitated bronchodilation and probably saved her life.

c. Salmeterol is contraindicated based on his wifes condition.

d. The physician will most likely order continuation of the salmeterol with increased dosage.
C. Rationale: The FDA has issued a black box warning that initiating salmeterol in individuals with significantly worsening or acutely deteriorating asthma may be life threatening.
Because of the risk of _________ the FDA has issued a black box warning for omalizumab.
Anaphyaxis
Mr. Benedict presents to the ER with a bronchospasm. He has a history of smoking tow packs per day for 20yrs and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3yrs ago. Based on the clients history which of the following would you expect the physician to order?

a. A modified dose of aminophylline

b. The standard dose of aminophylline

c. A drug other than aminophylline

d. Phenytoin intravenously.
a. A modified dose of amiophylline. Rational: Cigarette smoking and drugs that stimulate drug metabolizing enzymes in the liver (ex. phenobarbital, phenytoin) increase the rate of metabolism and therefore the dosage requirements of aminophylline
Mrs. Anderson diagnoses include diabetes type 2 atrial fibrillation asthma and hyperlipidemia. You are concerned because the over the counter aerosol product she uses to control her asthma most likely contains which of the following substances?

a. Corticosteroids

b. Aspirin

c. A glucose base

d. Epinephrine
d. Epinephrine. Rationale: Almost all OTC aerosol products promoted for use in asthma contain epinephrine which may produce hazardous cardiac stimulation and other adverse effects.
Mr. Belliveau is concerned because ever since he began his anti-asthma medication his GERD symptoms are worse. You explain that his symptoms are worse because his asthma medication have which of the following effects?

a. They cause acid indigestion

b. They tighten the gastroesophageal sphincter.

c. They relax the gastroesophageal sphincter.

d. They stimulate peristalsis
c. Rationale: Asthma may aggravate GERD because anti asthma medications that dilate the airways also relax muscle tone in the gastroesophageal sphincter and may increase acid reflux.
Aerosols are often the drugs of choice to treat asthma because of which of the following characteristics? (select all that apply)

a. They act directly on the airways

b. They can usually be given in smaller doses.

c. They produce fewer adverse effects than oral or parenteral drugs.

d. They may be given less frequently.
a, b, c
Mr. Gateau presents with symptoms of bronchospasm that occurred diring a birthday party for his grandson. Which of the following medication would you expect the physician to give him?

a. Albuterol

b. Asthmacort

c. Theophylline

d. Omalizumab
a
Two major groups of drugs used to treat asthma, acute and chronic bronchitis and emphysema are bronchodilators and ____________ drugs
Anti inflammatory
During the dummer Ms. dennis experiences increased period of acute symptoms of her asthma. The physician increases the dose frequency of which of her medications?

a. Epinephrine

b. Omalizumab

c. Salmeterol

d. Albuterol
d.
Which of the following is one method used to monitor clients with asthma?

a. Incentive spirometer

b. Monometer

c. Peak flow monitor

d. Trough flow monitor
c
With theophylline the home care nurse needs to assess the clients and the environment for substances that may do which of the following?

a. Affect metabolism of the theophylline

b. Decrease therapeutic effects

c. Increase therapeutic effects

d. Increase adverse effects
a, b, d
Mr. Banks is experiencing dysphasia secondary to a mild stroke that he had 3 wks ago. He states that his asthma medications are not working as well or as long as they did in the past. Which of the following do you suspect is the reason for this?

a. He is crushing the medication

b. He is administering the wrong medication.

c. He is experiencing confusion.

d. He is experiencing postural hypotension.
a
In children high doses of nebulized albuteral have been associated with which of the following conditions? ( select all that apply)

a. Lower the dose of the montelukast.

b. Discontinue the medication and prescribe another.

c. Increase the dose of the montelukast

d. Maintain the same dose of the montelukast.
d.
Mr. Bart is prescribed cromolyn and uses it to successfully to manage his exercise induced asthma. He develops chronic renal insufficiency. Which of the following would you expect the physician do?

a. Reduce the dosage of the medication

b. Increase the dosage of the medication

c. Maintain the current dose of the medication

d. Titrate the dosage of the medication upward.
a
Mr. Bronson age 75 is diagnosed with COPD. His physician orders an adrenergic bronchodilator via inhaler and a spacer. Which of the following are the main risks associated with the drug for this patient? ( select all that apply)

a. Excessive cardiac stimulation

b. Bradycardia

c. hypotension

d. CNS stimulation
a,d
Mr. Smith age 45 is 6 ft tall and weighs 300 pounds. He is diagnosed with asthma, and the physician orders a combination of an antiasthmatic and theophylline. On which factor is the dose of theophylline based?

a. The clients weight

b. The clients ideal body weight

c. the clients symptomathology

d. The clients comorbidities
b.
Cromolyn aerosol solutions may be used in children 5 yrs of age and older and the nebulizer solution is used in children _____ years of age
2 years
Mrs. Jones is prescribed systemic corticosteroids for her asthma. For which of the following is she at risk?

a. Pituitary insufficiency

b. pancreatic insufficiency

c. Adrenal insufficiency

d. Renal insufficiency
c.
Mr. Reese is brought to the ER by his son with alteration in consciousness. The physician suspects theophylline overdose. Which of the following would you expect the physician to order?

a. Dextrose and water intravenously

b. Gastric lavage

c. Antiemetic

d. Saline 0.9 % intravenously
b
____________ is necessary for energy for cellular metabolism
Oxygen
__________ the movement of air between the atmospher and the alveoli of the lungs
Ventilation
___________ blood flow through the lungs
Perfusion
__________ the process by which O2 and CO2 are transferred between alveoli and blood and between blood and body cells
Diffusion
The ____________ is a series of branching tubes with progressively smaller diameters
Respiratory tract
What is the function of the nose pharynx larynx trechea bronchi and bronchioles
They filter, warm, and humidify incoming air
___________ are tiny hair like projections taht sweep mucus toward the pharynx.
Cilia