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Flashcards

Respiratory

cpeters Block 5 College-Level Nursing English 43 cards

Cards in this deck (43)

  1. 1ICSInhaled Corticosteroid
  2. 2What's the next approach after a bronchodilator if it's not working?Inhaled coricosteroid
  3. 3salmeterol (Servent)long-acting beta agonist for maintenance – shake MDI before using – daily use (another one is Advair)
  4. 4albuterol (Proventil, Ventolin)short-acting beta agonist for rescue –– have pt carry MDI at all times; can inc. HR, cause jitteriness and excitement
  5. 5Ipatropium (Atrovent)cholinergic antagonist – can be used for maintenance or rescue – carry at all times, shake before use, causes dry mouth, report visual changes/palpitations/ tremors ( another one is Spiriva and Combivent)
  6. 6Theophylline (Theo-Dur, Theolair)smooth muscle relaxant – maintenance - taken po – check serum drug levels – do not use with caffeine or other stimulants, can cause inc. HR, cause jitteriness and excitement which may mean level is too high (can be used IV as aminophylline for a severe, persistent attack)
  7. 7Fluticasone (Flovent)steroid – maintenance – rinse mouth after using MDI – use daily – do not d/c abruptly
  8. 8Prednisone (Deltasone)steroid – maintenance or after an attack – only used of other meds fail – taken po - side effects (wt gain, hyperglycemia, BP changes, ulcers) – take with food, do not d/c abruptly
  9. 9Nedocromil (Tilade)prevents inflammation – maintenance – use MDI daily
  10. 10cromolyn sodium (NasalCrom)anti-inflammatory by mast cell stabilization
  11. 11Montelukast (Singular)prevents inflammation – maintenance – taken po – take daily in the evening
  12. 12Omalizumab (Xolair)antibody – maintenance – given every 2-3 weeks in facility, watch closely for allergic reaction with first 30-60 min., may not be effective for months
  13. 13status asthmaticuslife-threatening emergency where patient's airway becomes obstructed. may need epi or intubation.
  14. 14Which diseases comprise COPD?Emphysema – a lung tissue issue
    Chronic Bronchitis – an airway issue
  15. 15Proteases (enzymes) in emphysemain higher levels can damage alveoli and small airways by breaking down elastin→ alveoli lose elasticity and small airways collapse → less areas for gas exchange
  16. 16Why are emphsema patient's referred to as pink puffers?Pink= pink, frothy sputum
    Puffer= peripheral edema from right sided HF
  17. 17What happens to emphysema patients?Floppy alveoli leads to air trapping in lungs → flattening of diaphragm
    Results in hypercarbia and resp. acidosis – often can get O2 in but not CO2 out
  18. 18What does chronic bronchitis do?Due to the increase in inflammation in airway, there is an increase in # of mucus glands so more thick mucus is made
    Bronchial walls eventually thicken adding to impaired airflow. Mucus and thickening will block some smaller airways. Can lead to cor pulmonale with resultant edema – thus “blue bloater”
  19. 19List the ways COPD can be diagnosedPhysical assessment & report of s/s
    CXR & pulmonary function tests
    - PFTs will be decreased with both
    - CXR will show hyperinflation with emphysema
    Bronchoscopy – chronic bronchitis will have thickened airways
    Sputum evaluation – may have infection
    Lung scan – r/o cancer
  20. 20Which medications are commonly used for COPD patients?Asthma meds, acetylcysteine (Mucomyst), and guiafenesin (Mucinex, Robitussin)
  21. 21Cor pulmonaleright sided heart failure – with increased lung pressure → blood flow from lungs back up to the right side of heart eventually weakening it
  22. 22What is a complication of emphysema?blebs or bullae can form on the lung surface, if they burst the pt will have a pneumothorax
  23. 23What are the 3 types of pneumonia?- Lobar- confined to one area
    - Bronchopneumonia- scattered throughout
    - Hypostatic- R/T hypoventilation (prolonged bedrest)
  24. 24What can pneumonia cause?Atelectasis, exudates, consolidation, necrosis
    Can lead to heart failure, empyema, pleurisy, septicemia even shock and death
  25. 25Levofloxacin (Levoquin)given po/IV, do not take with mag and aluminum antacids, may incr. effect of warfarin, w/steroid use may ↑ risk of tendon rupture, w/antidiabetic meds can ↓ blood sugar
  26. 26ceftriaxone (Rocephin)given IM or IV, often used in ER to start tx, poss. nausea/vomiting, inject deep into muscle and massage after, may add lidocaine to decrease pain, IV over 10-30 minutes
  27. 27azithromycin (Zithromax)given po or IV, watch for nausea / diarrhea/ pseudomembranous colitis, don’t take with mag and aluminum antacids, take on empty stomach, may affect blood levels of digoxin, theophylline, carbamazepine, phenytoin – pt needs to take full prescription until complete
  28. 28What precaution should be taken when TB infection is suspected?pt needs to be in a negative airflow room on resp. isolation until the test results come back !!!!!
  29. 29What is the combination RIPE therapy?R-- rifampin
    I – isoniazid
    P – pyrazinamide
    E – ethambutol
  30. 30Rifampin (RIF)given po on empty stomach
    reddish brown discoloration of the skin, saliva, urine, feces, sweat, and tears
    If on oral contraceptives, need to change to an alternate method of birth control
    No alcohol while on med (liver damage)
    Teach signs of liver damage (jaundice, bleeding)
    Monitor hepatic function
    May get N/V/D
  31. 31Isoniazid (INH)given po (can be with food)
    No alcohol while on med (liver damage)
    Teach signs of liver damage (jaundice, bleeding)
    Monitor hepatic function
    May get peripheral neuropathy (take B6)
    Avoid tyramine foods (aged cheeses, red wine, chocolate, etc.)
  32. 32What is hypoxic drive?The drive to breathe in order to increase oxygen rather than breathe off CO2
  33. 33How saturated is arterial hemoglobin with oxygen versus venous?Arterial Hgb is 97.4% saturated
    Venous blood is 75% saturated
  34. 34Tidal Volumethe amount of air inhaled or exhaled during normal breathing.
  35. 35Total Lung Capacitythe total volume of lungs when maximally inflated.
  36. 36Forced expiratory volumethe volume of air expired during the first, second, and third seconds of the forced vital capacity (FVC) test
  37. 37Peak Expiratory Flow Rate (PEFR)the maximum volume during forced expiration
  38. 38Why might a patient need a bronchoscopy?visualize, take a sputum culture, obtain a biopsy, or clean out mucus
  39. 39What is a thoracentesis?Fluid or air is removed from the pleural space with a needle and syringe and possibly suction
  40. 40Ventilation Perfusion (VQ) ScanFollows air and blood flow in and out of the lungs
    While pt is breathing, a radioactive substance is either inhaled, injected, or both
    Body is non-radioactive after about 8 hours
  41. 41What percentage of room air is oxygen?21%
  42. 42What is the proper technique for using an MDI?After pressing down on the canister the client should breathe in slowly over 3 to 5 seconds and then hold her breath for 10 seconds to let the medication reach deep into the lungs
  43. 43How is sleep apnea diagnosed?Breathing disruption during sleep that lasts at least 10 seconds and occurs a min of 5 times in an hour

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Flashcards from our ppt on respiratory issues.
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cpeters
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