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Asthma
pn 141 test 2 book- burke: pg 551
| Question | Answer |
|---|---|
| what is asthma | a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, |
| what is it characterized by | recurrent episodes of wheezing, breathlessness, chest tightness, coughing |
| who is it more comon in | children |
| what % of adults have it | 5% |
| is there airways inflammation during a s/s free period | very little |
| what can trigger an acute inflammatory response | allergens, environmental pollutants (smoking, smog), workplace pollutants, resp. infections, exercise in cold dry air, emotional stress, |
| what drugs can trigger an attack | aspirin, NSAIDS, sulfates, beta blockers |
| what is the acute and early response to a trigger | inflammatory mediaters are released, leading to bronchoconstriction and increased capillary permeability |
| acute and early response: what are the inflammatory mediaters | histamine, prostaglandins |
| acute and early response: bronchoconstriction and increased capillary permeability causes what | edema and increased mucous production |
| acute and early response: edema and increased mucous production narrows what | the airways |
| acute and early response: when airflow is reduced what happens to breathing | the work of it increases |
| acute and early response: when the stimulus causes inflammation; what three things occur | epithelial damage, edema, increased mucous production (leading to increased airway resistence, obstruction and air flow limitation) |
| late phase response: when does this develop (hours ) | 4-12 hours after exposure to the trigger |
| late phase response: what does this do to the attack | it prolongs it |
| late phase response: activation of the inflammatory cells do what | they damage the airway epithelium |
| late phase response: damage the airway epithelium does what | produces mucosal edema, impairs ariway clearance, prolongs bronchoconstriction |
| late phase response: what happens to the distal narrowed airways | air is trapped there and it distended the alveoli |
| late phase response: the trapped air mixes with what; this reducing what | inspired air; available Oxygen for gas exchange |
| late phase response: what happens to the blood flow in distended alveoli | it is reduced |
| late phase response: what develops | hypoxemia |
| s/s: what varies | the frequancy and severity of attacks |
| s/s: onset is it abrupt or slow | both |
| s/s: what are they | chest tighness, difficulty breathing, wheezing and coughing, expiration is prolonged |
| s/s: what are associated s/s | tachypnea, tachycardia, anxiety, apprehension |
| s/s: use of what accessory muscle may be present in a severe attack | respiration, intercostal retractions, |
| s/s: severe dyspnea may allow the pt to speak how | only one or two works per breath |
| s/s: what are s/s of resperatoy failure | inaudible breath sounds, reduced wheezing, ineffective cough |
| s/s: is resperatoy failure a medical emergency | yes |
| s/s: what is status asthmaticus | severe prolonged asthma that does not respond to routine treatment |
| s/s: what can status asthmaticus lead to | resp. failure |
| how is it Dx | by the clients Hx and manifestations |
| why are diagnostic tests used | to identify possible triggers and to evaluate respiratory function during and between acute attacks |
| diagnostic tests: why is a peak expiratory flow rate (PEFR) used | it assess airflow restriction and the effectiveness of treatment |
| diagnostic tests: pt with peak expiratory flow rate (PEFR) use this to monitor what | airflow and the need for Tx on a continued basis |
| diagnostic tests: pulse oximetry and ABGs are used for what | to eval oxygenation during an acute attack |
| diagnostic tests: skin testing are used for what | to identify specific allergens that may trigger asthma attacks |
| what is tx focused on | controlling s/s and preventing acute attacks, when an attack occurs therapy focuses on restoring airflow and alveolar ventilation |
| preventive measures: what are they | avoid allergens, modify the home, remove pet,s eliminate tobacco smoke, |
| preventive measures: how might one modify the home | control dust, remove carpet, covering mattress and pillows, installing an airfilter, remove pets, early tx of respiratory infections |
| preventive measures: for exercise induced asthma | wearing a mask that retains humidity and warm air when exercising in cold weather |
| meds: what are they used for | to prevent and control stham s/s, reduce the frequency and severity of attacks and reverse airway obstruction |
| meds: what ones are used for long term control | anti-inflammatory agents, long acting bronchodilators, leukotriene modifiers |
| meds: what are quick relief ones | rpids acting bronchodilators, anticholinergic drugs, and systemic corticosteroids |
| meds: when are quick relief ones give n | to relieve bronchoconstriction and ariflow obstruction |
| slow shallow respiration, faint breath sounds, decreased wheezing, and ineffective cough are s/s of what | exhaustion, and possible respiratory failure |
| s/s of worsening hypoxemia | cyanosis, cool clammy skin, LOC change, |
| pulse ox and ABGs indicate what | the effectiveness of Tx and effective gas exchange |
| what positioning reduces the work of breathing and increase lung expansion | high fowlers |
| what does humidity do | help release secretions |
| what does increased fluids do | thin secretions |
| what are breathing techniques that help control breathing pattern | pursed lip breathing to keep airways open, abdominal breathing improves lung expansion, |
| how to use a metered dose inhaler: directions | shake vigorously for 3-5 seconds, exhale slowly and completely, press down and inhaler slowly for 3-5 seconds, hold breath for 10 seconds. wait 20-30 seconds before next puff, rinse mouth afterward, rinse mouth piece once a day |
| nursing assessment | vitals, O2 sats, lungs, skin, Hx, PFts, ABgs, sputum, CXR |
| goal of treatment | prevention of acute attacks, improve breathing |
| what does the green red and yeloow zone mean in the peak flow meter | shows how well your lungs are expanding |
Created by:
jmkettel
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