Term
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Definition
| Wheezing from bronchoconstriction |
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Term
| When are sx of asthma typically worse? |
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Definition
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Term
| Which race, sex, and living areas tend to have higher incidences of asthma? |
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Definition
| Black > white, Male > female, and urban > rural |
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Term
| Describe etiology of asthma |
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Definition
| Genetic predisposition, exposure to inhaled alllergens increases airway inflammation |
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Term
| Describe pathophysiology of immune response during an asthma attack |
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Definition
| inhaled antigen - activates mast cells - T cell mediated immune response - CD4 helper cells - release inflammatory cytokines |
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Term
| How does the prolonged inflammatory response affect airways? |
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Definition
| Causes hyperthrophy of bronchial smooth muscle, and hypertrophy of mucus glands plugging the airways |
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Term
|
Definition
| Wheezing, dyspnea, cough, sputum, tachypnea, CP |
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Term
|
Definition
| Reactive airway disease (RAD), exercise induced asthma, cough variant asthma, typical asthma |
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Term
|
Definition
| Only have sx like wheezing whean affected by a respiratory illness (usually will grow out of it) |
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Term
| What is exercise induced asthma? |
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Definition
| Bronchoconstriction 3-5 min /p exercise, resolves in 30-60 min |
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Term
| Is airway inflammation present in exercise induced? |
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Definition
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Term
| How is exercise induced tx? |
|
Definition
| Short acting bronchodilator |
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Term
| What would you expect breathing to be like in a severe, prolonged asthma attack? |
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Definition
| can have diminished breath sounds without wheezing or labored breathing with accessory muscles and possible inspiratory wheezing |
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Term
| What would you find in hematologic studies of asthma pts? |
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Definition
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Term
|
Definition
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Term
| Why would you check sputum samples in a pt suspected of having asthma? |
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Definition
| To check for active infection - should be no bacterial growth if it is asthma |
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Term
| What would a CXR of a pt w/ asthma look like? |
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Definition
| Typically normal - only used to exclude DDx |
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Term
| How are ABGs and pulse-ox measurements affected in asthma pts? |
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Definition
| Usually normal unless severe AE - not generally necessary |
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Term
| Would you use PFTs to monitor asthma pts? |
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Definition
| Yes - peak flow and spirometry w/ pre and post bronchodilator testing |
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Term
| What lung volume is altered in asthma pts? |
|
Definition
| Increased RV d/t difficulty /c expiration |
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Term
| How can ABGs be affected in severe exacerbations? |
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Definition
| Can cause alkalosis d/t rapid respiration - PO2 and pH decrease and CO2 increases |
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Term
| Define crtiteria for mild intermittent classification of chronic asthma in regards to sx, FEV1 and peak flow |
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Definition
| Sx < biw, FEV1 or peak flow > or = 80% predicted |
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Term
|
Definition
| Sx > biw, FEV1 or peak flow > 80% |
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Term
|
Definition
| Daily sx, FEV1 or peak flow > 60% < 80% predicted |
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Term
|
Definition
| continual sx, FEV1 or peak flow < or = 60% |
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Term
| What are the main goals of asthma therapy? |
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Definition
| Reducing impairment (prevent sx, less inhaler use, normal PFTs, normal activity) and reducing risk (decrease AE and ER visits, prevent loss of lung fx, less med adverse affects) |
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Term
| What asthma triggers can be avoided or tx to aid in the management of asthma? |
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Definition
| environmental factors, allergic rhinitis, sinusitis, GERD, obesity, OSA, stress/depression |
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Term
| What meds are used to tx asthma? |
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Definition
| short-acting bronchodilators (beta-agonist), steroids, long-acting bronchodilators, combo LAB/inhaled corticosteroids, leukotriene modifiers |
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Term
| Ex. of short acting bronchodilator? |
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Definition
|
|
Term
| Ex. of steroid used to tx asthma? |
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Definition
|
|
Term
| Ex. of combo LAB/inhaled corticosteroids |
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Definition
| Advair (serevent/flovent)- preferred long-term control therapy in all ages |
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|
Term
| Ex. of leukotriene modifier? |
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Definition
|
|
Term
| What is the rule of Two's? |
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Definition
| - Had to use rescue inhaler twice in 1 wk, 2 nocturnal wakening w/ sx in a mth, or need > 2 inhaler refills in a year |
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