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Nur210 Respiratory
Pharmacology respiratory
| Question | Answer |
|---|---|
| Where does gas exchange occur? | In the alveoli of the lungs. |
| What is ventilation? | The body's ability to get air in and out; chest expansion |
| What is compliance? | Ability to expand bronchioles and alveoli Compliance is decreased by inflammation, infection, and increased mucus production which can be manifested by bronchospasms, mucus, CHF, pulmonary edema, and atelectasis |
| What are factors that affect diffusion? | Decreased surface area Thickness of alveoli membrane Perfusion inadequate to alveoli More vasculature in lower part of lungs because of gravity pulling blood downward |
| What affects transportation of oxygen and carbon dioxide? | Decreased cardiac output Decreased hemoglobin |
| Is it ventilation compliance, diffusion or transportation? | Pneumonia (bacteria in alveoli) diffusion Bronchitis (bronchials affected) compliance Anesthesia (loss of sensation) Ventilation Fractured ribs ventilation Anemia Transportation CHF Transportation and diffusion Asthma compliance PE transp/diffusion |
| What are symptoms of acute hypoxia? | Agitated, confused Respiratory rate increases Pulse rate goes up |
| What are symptoms of chronic hypoxia? | Fatigue and lethargy Increased hemoglobin - makes blood thicker, so harder to breathe Increased muscle use |
| What are some assessment findings of respiratory status? | Tachypnea - fast breathing Bradypnea - slow breating Hyperventilation - faster, deeper breaths Hypoventilation - slower, shallow breaths SOB - shortness of breath Dyspnea - difficulty breathing/objective Orthopnea - cardiac patients; SOB while lay |
| Breathing pattern symptoms of hypoxia are? | Rales occur in alveoli Rhonci occur in bronchioles (mucus, fluid) Wheezing - tubing system collapsing on itself |
| What are some diagnostic tests for respiratory status? | PEFR - peak expiratory flow rate Chest x-ray Lung scan Thoracentesis Endoscopy Pulse oximetry, < 86% emergency; < 80% life threatening Arterial blood gases Sputum specimens |
| What are nursing interventions for respiratory distress? | Monitor - symptoms of hypoxia, breathing pattern, lung sounds, diagnostic tests Actions - maintain open airway, elevate HOB, TC & DB, chest physiotherapy (massage), suctioning, nebulization |
| Major causes of airway obstruction are? | Problems with compliance Bronchial smooth muscle contraction Mucus hypersecretion Inflammation - chronic bronchitis, asthma Infection - pneumonia |
| What are medications used to improve respiratory function? | Antibiotics to treat bacterial infections Bronchodilators Glucocroticoid steroids |
| How are inhaled medications classified? | Bronchodilators - selective beta-2-agonists Metered dose inhaler (MDI), nebulizer Relievers -SABA - immediate relief Controllers - LABA - delayed onset |
| What are ADRs of bronchodilators? | Increased pulse Increased BP Fine muscle tremors Anxiety |
| What is a glucocorticoid? | Inhaled steroid Inhibits inflammation First line of therapy for moderate to severe asthma |
| What are ADRs of glucocorticoids? | Oropharyngeal candidiasis (fungal infection) Dysphonia (hoarseness) Promotes bone loss (less than oral steroids, though) |
| What education should nurses give to patients about glucocorticoids? | Gargle after administration Use a spacer Take calcium with vitamin D One minute between dosages Hold breath after administration and breathe through pursed lips Administer bronchodilator before steroid |
| What is oral steroid therapy used for? | When symptoms not controlled with safer drugs Used for rheumatoid arthritis, systemic lupus, inflammatory bowel disease, allergies |
| What are primary uses of oral steroid therapy? | Anti-inflammatory K+ loss Na+ retention Immunosuppressor Too many side effects with long-term therapy |
| What are nursing interventions with oral steroids? | Monitor for K+ levels (hypokalemia), fluid retention (retaining Na+), osteoporosis, gastric ulcers, infections Actions - increase K+ intake, prevent infection, increase Ca2+ intake |
| What must patients be taught about oral steroids? | Do not stop taking abruptly Mood swings possible Take with food No NSAIDs - increase GI ulcer incidence |
| What are some properties of methylxanthines? | Caffeine, theophylline (oral), aminophylline (IV) Bronchodilators - relax smooth muscle of bronchi Narrow TI Toxicity - arrythmias and seizures Early sign of ADR - nausea |
Created by:
ssbourbon
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