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pn 141 test 2 book- burke: pg 551

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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