Term
| ____ is a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway. |
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Definition
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Term
| Acute symptoms of asthma may be precipitated by numerus stimuli, and hyperreactivity to such stimuli may initiate both inflammation and ___? |
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Definition
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Term
| Name a short-acting beta 2 adrenergic agonists? |
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Definition
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Term
| Name a topical corticosteroids for inhalation? |
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Definition
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Term
| Strong chemical mediators of bronchoonstriction and inflammation? |
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Definition
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Term
| The main 2nd line xanthine used clinically? |
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Definition
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Term
T/F?
Asthma may occur at any age but is especially common in children. |
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Definition
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Term
T/F?
Children who are exposed to allergens and airway irritants (tobacco smoke) during infancy are at high risk for developing asthma? |
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Definition
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Term
| Asthma is an airay disorder characterized by by bronchoconstriction, inflammation, and ____ to various stimuli? |
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Definition
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Term
| What are the symptoms of asthma? |
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Definition
| dyspnea, chest tightness, wheezing, cough & increased sputum production |
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Term
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Definition
gastroesophageal reflux disease
associated with night time worsening of symptoms |
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Term
| What is the signs of GERD? |
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Definition
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Term
| Mr. B is coerned ecause ever since he began his antiasthma medication his GERD symptoms are worse because hisasthma medications have which effect? |
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Definition
| They relax the gastroesophageal sphincter. |
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Term
| What are the bronchoconstrictive disorder characteristics? |
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Definition
Bronchoconstriction
Inflammatio & mucosal edema
Excessive mucus production
Asthma, bronchitis, emphysema, copd |
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Term
Pathophysiology
Bronchoconsrction ____ airways.
____ action can completely occlude airways.
Aggravated by ____, mucosal ____, excessive mucus |
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Definition
narrows
Sphincter
inflammation, edema |
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Term
Pathophysiology
When lung tissues are exposed to causative stmuli ___ cells release substances that cause bronchoconstriction and ____? |
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Definition
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Term
Pathophysiology
When sensitized mast cells in the lungs or eosinophils in the blood are exposed to allergens or irritants multiple cytokines and five other chemical mediators are released, name them? |
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Definition
cytokines
acetylcholine
histamine
interlukins
leukotrienes |
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Term
COPD
Chronic bronchitis & emphysema usually develops with long standing exposure to aiway irritants. Name the #1 irritant? |
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Definition
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Term
COPD
Chronic bronchitis & emphysema symptoms are ___ constant & ____ reversible. |
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Definition
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Term
COPD
Chronic bronchitis & emphysema symptoms
activty intolerance and is called ____? And usually affects ____ age and ____ adults |
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Definition
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Term
Bronchoconstriction drug therapy
What are the two classifications? |
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Definition
Long-term control (Prophylactic)
Quick relief (Rescue) |
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Term
Bronchoconstriction drug therapy
Long-term control (Prophylactic)is? |
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Definition
| Achieve and maintain control of persistent asthma |
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Term
Bronchoconstriction drug therapy
Quick relief (Rescue)is? |
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Definition
| Used during periods of acute symptoms and exacerbations (asthma attacks) |
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Term
| Two major groups of drugs used to treat asthma, acute and chronic bronchitis, and emphysema are ____ and ____-____ drugs |
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Definition
| bronchodialators and anti-imflammatory |
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Term
| Bronchodialtors prevent and treat? |
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Definition
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Term
| Anti-inflammatory medications prevent and treat ___ inflammation and reduce ____? |
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Definition
airways
bronchoconstriction |
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Term
Brochodialators
Adrenergics stimulate receptors in bronchi and bronchioles producing ____? |
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Definition
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Term
Bronchodialators
Adrenergics adverse effects are? |
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Definition
Cardia stimulation
increased in heart rae |
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Term
Bronchodialators
Adrenergics what are the contrandications? |
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Definition
| in pts wih cardiac tachydysrhythmias and coronay artery disease |
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Term
Bronchodialators
Adrenergics what are the cautions? |
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Definition
hypetension
hyperthyroidism
diabetes
seizure disorders |
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Term
Common Drugs Adrenergic/Bronchodilators
Epinephrine (Adrenalin) |
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Definition
oInjected subcutaneously
oEmergency room, Given IM
oCaution; excess causes cardiac stimulation |
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Term
Common Drugs Adrenergic/Bronchodilators
Albuterol (Proventil) |
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Definition
-1st treatment of choice in acute asthma attack
-Inhaled (nebulizer or aerosol)
-Act more selectively on beta 2 receptors causing less cardiac stimulation
-Usually self administered by multi-dose inhaler (MDI)
-May be prescribed every 4 – 6 hours
-If overused can lose their bronchodilation effects |
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Term
Common Drugs Adrenergic/Bronchodilators
Metaproterenol (Alupent) |
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Definition
-Intermediate acting
-Orally or MDI
-Exercise induced
-Caution cardiac & CNS stimulation |
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Term
| Mr. B age 75 is diagnosed with COPD. His Dr. orders an adrenergic bronchodilator via inhaler and a spacer. What are the main risks associated with the drug for this pt? |
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Definition
Excessive cardiac stimulation
CNS stimulation |
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Term
| Toxicity of bronchodilator overdose |
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Definition
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Term
Toxicity of bronchodilator overdose
What are the adverse effects of excessive cardiac stimulation? |
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Definition
| angina, tachycardia, palpitations, serious dysrhythmias, cardiac arrest. |
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Term
Toxicity of bronchodilator overdose
What are the adverse effects of excessive CNS stimulation? |
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Definition
| agitation, anxiety, insomnia, seizures, tremors |
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Term
Toxicity of bronchodilator overdose
Theophylline overdose |
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Definition
| anorexia,N&V, agitation, nervousness, insomnia, tachycardia, dyshythmias, tonic-clonic seizures. |
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Term
| Drug Selection & Administration Guidelines |
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Definition
-Selective, short-acting adrenergic agonist is initial drug of choice for acute bronchospasm
-Direct action of inhaled medications on airways can be given in smaller doses with fewer adverse effects than oral or parenteral medications
-Inhaled corticosteroids are used early in disease process when inflammation is established as major asthmatic component
-In chronic disorders, inhaled corticosteroids should be taken on regular schedule using lowest dose required to control symptoms
-Multidrug regimens offer advantage of smaller doses of each medication, which can decrease adverse effects, allow dosage increase as needed in exacerbations
-Drug dosing must be individualized to attain most therapeutic effects with fewest adverse effects |
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Term
| Patient teaching guidelines |
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Definition
Education about disease and all medications
-Rescue versus maintenance administration
-Maintain regular administration schedule
-Avoid infections
-Early recognition and seeking treatment
-Keep adequate supplies on hand
-Use MDI accurately
-Avoid airway irritants
-Avoid excess caffeine
-Influenza vaccine yearly & pneumococcal vaccine once
-Inhalers
-Shake well prior to use
-Exhale to end of a normal breath
-Insert inhaler into mouth form a tight seal around mouthpiece
-While pressing down take slow deep breath and hold breath approximately 10 seconds
-Rinse mouth with water after each use
-Rinse mouthpiece
-Wait 3-5 mins before taking 2nd dose |
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Term
| With theophylline, the home care nurse needs to assess the client and the environment for substances that may do which of the following? |
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Definition
Affect metabolism of theoplylline.
Decrease therapeutic effects.
Increased adverse effect. |
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Term
Mr. Grant is presribed montelukast(Singular)and uses it successfully to manage his asthma. He develops hepatitis C.
What do you expect the physician to do? |
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Definition
maintain the same dose.
produce higher blood levels and are eliminated more slowly in pts with hepatic impairment. No dosage adjustment is recommended for pts with mild to moderate hepatic impairment. |
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Term
Mr Bart is perscribed cromolyn and uses it successfully to manage his exercised induced asthma. He develops chronic renal insufficience.
What do you expect the physician to do? |
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Definition
Reduce the dosage of medication.
It is eliminated by renal & biliary excretion. the drug should be given in reduced doses if at all with pt. w/ renal impairment |
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Term
Mr. Smith age 45, is 6ft tall and weighs 300 lbs. He is diagnosed with asthma and the dr. orders a combo of anti-asthmatic & theophylline.
On which factor is the dose of theooplylline based? |
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Definition
| The client ideal body weight |
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Term
Mast cell stabilizer
Cromolyn(Intal)aerosol solution may be used in children 5 years of age and older, and the nebulizer solution is used in children ___ years and older |
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Definition
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Term
| Mrs. Jones is prescribed systemic corticosteroids for her asthma. What is considered a risk? |
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Definition
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Term
| Mr. Reese is bought to the emergency dept. by her son with alteration in consciousness. The dr. suspects theoplylline overdose. What do you expect the dr. to order? |
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Definition
| gastic lavage(stomach pumping |
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