Nurs 171 Exam III (Respiratory)

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JChristie20
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72337
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Nurs 171 Exam III (Respiratory)
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2011-03-13 20:17:06
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Nurs Exam III Respiratory
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Respiratory
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  1. with this resp. disease early stages are usually symptom free
    TB
  2. S/S of the resp disease are fatigue, anorexia, weight loss, low-grade fever, night sweats
    -cough becomes freq. produces white frothy sputum
    TB
  3. this form of TB spreads to other organ systems
    Miliary
  4. TB pneumonias manifertations include
    • leukocytosis
    • pleuric pain
    • cough
    • chills
    • fever
  5. A chest x-ray of TB will show ____ _____ infiltrates, ______ infiltrates, and _____ ______ involvement
    • Upper lobe
    • cavitary
    • lymph node
  6. Patients with TB are treated with ____ for ___ to ____ months
    • INH
    • 6-9
  7. this vaccine is currently used to prevent TB in many parts of the world; can result in positive PPD reaction
    Bacille Calmette-Guerin (BCG)
  8. in a patient with TB you need to assess for:
    • productive cough
    • night sweats
    • afternoon temp ^
    • weight loss
  9. causes airway hyperresponsiveness leading to wheezing, breathlessness, chest tightness and cough
    asthma
  10. allergens, exercise, air pollutants, and nose and sinus problems are all triggers of ____
    asthma
  11. the asthma triad includes:
    • nasal polyps
    • asthma
    • sensitivity to aspirin and NSAIDS
  12. early phase responses to asthma include production of thick mucous, .....
    • vascular congestion
    • edema formation
    • bronchial spasm
    • thickening of the airway walls
  13. with asthma expiration my be ______ and air takes _____ to move out
    • prolonged
    • longer
  14. an acute attack of asthma usually reveals these physical signs
    • restlessness
    • increases anxiety
    • increased pulse and B/P
    • pulsus paradoxus
  15. clinical manifestations of this disease include edema, mucous plugging, bronchospasm, resp. acidosis
    status asthmaticus
  16. the causes of this disease are viral illnesses, ingestion of aspirin or other NSAIDS, allergens, emotional stress, Beta Blockers
    status asthmaticus
  17. Tx for acute astham attacks include
    Beta adrenergic agonists by metered dose inhaler
  18. a pt with asthma should have a fluid intake of ___ to ____L a day
    2-3
  19. 4th leading cause of death
    airflow limitation not reversible
    includes chronic bronchitis and emphysema
    COPD
  20. abnormal permanent enlargement of the air space distal to the terminal bronchioles w/o obvious fibosis
    COPD
  21. the air in your lungs can not get out with this disease
    COPD
  22. pulmonary vascular changes for COPD include
    • blood vessels thicken
    • surface area for diffusion of 02 decreases
  23. common characteristics of COPD include
    • mucous hypersecretion
    • dysfunctional cilia
    • hyperinflaton of lungs
  24. the physical findings of COPD include
    • prolonged expiratory phase
    • wheezes
    • becreased breath counds
    • bluish-red color of skin
  25. complications of this disease include cor pulmonale (RHF), acute resp. failure, peptic ulcer disease, depression/anxiety
    COPD
  26. ABG typical findings for this disease include:
    Low PaO2
    ^ PaCO2
    Low pH
    ^HCO3
    COPD
  27. drug therapy for this disease includes bronchodilators and inhaled corticosteroids therapy
    COPD
  28. gravity assists in bronchial drainage; techniques individualized according to patients pulmonary condition and response to intial treatment
    postural drainage
  29. facilitates movement of secretions to larger airways
    vibration
  30. produces vibration in lungs to loosen mucus for expectoration
    flutter mucus clearance device
  31. inflatable vest that vibrates the chest, works on all lobes, more effective then CPT
    High freq. chest compression
  32. vibrates lungs to shake free mucus plugs; improves clearance of secretions; faster and more tolerable then CPT
    Acapella
  33. Patients with COPD should have a fluid intake of
    3L
  34. this type of histamine blocker is used to reduce gastric acid in peptic ulcer disease
    • H2 blockers/antagonists
    • -tagamet
    • -zantac
    • -pepcid
  35. these histamine blockers are referred to as antihistimines and are also anticholinergic(drying), and sedatives
    H1 antagonists
  36. -prevents adverse conseq. of histimine stimulation.
    -these compete with histimine at the unoccupied receptors; cannot push histimine off receptor is already bound
    antihistimines
  37. what effects does histimine have on the cardiovascular system?
    dilation and increased permeability
  38. what effects does antihistimine have on the cardiovascular system?
    • reduce dilation of blood vessels
    • reduce increase permeability of blood vessels
  39. what effects does histimine have on smooth muscles (endocrine glands)
    stimulate salivary, gastric, lacrimal and bronchial secretions
  40. what effects does antihistimine have on the smooth muscles (endocrine glands)
    reduce salivary, gastric, lacrimal and bronchial secretions
  41. what are the histimine effects of the immune system
    mast cells release histimine and other substances, resulting in allergic reaction
  42. what are the effects of antihistimine on the immune system
    binds to histimine receptors, preventing histimine from causin gresponse
  43. the most common adverse effects of antihistimines are
    • dry mouth
    • difficulty urinating
    • constipation
    • changes in vision
  44. these antihistimines work both peripherally and centrally
    -have drying effect
    -traditional (old)
    • benadryl
    • chlor-trimeton
  45. newer antihistimines
    -nonsedating/peripheral acting
    -developed to eliminate unwanted adverse effects, mainly sedation
    • allegra
    • claritin
    • zyrtec
  46. antihistimes should be used with caution in cases of a patient having:
    • -cardiac or renal disease
    • -HTN
    • -asthma
    • -COPD
    • -peptic ulcer disease
  47. the largest group of decongestants
    -sympathomimetics
    adrenergics
  48. less commonly used decongestants
    -parasympatholytics
    anticholinergics
  49. topical or intranasal steroids used as decongestants
    corticosteroids
  50. this dosage type of decongestants have a delayed onset but prolonged effects
    -exclusively adrenergics
    -Sudafed
    Oral decongestants
  51. these decongestants have a prompt onset, are potent
    -can not use for more then 3 days
    topical nasal adrenergics
  52. these work to turn off the immune system cells involved in the inflammatory response; include flonase and nasalide
    intranasal steroids
  53. this type of nasal decongestant constricts small blood vessels that supply URI structure, resulting in the tissue to shrink
    -swollen membranes better to drain
    -nasal stiffness relieved
    nasal adrenergics
  54. what are the adverse effects of nasal adrenergics
    • nervousness
    • insomnia
    • palpitations
    • tremors
  55. what are the adverse effects of nasal steroids
    local mucosal dryness and irritation
  56. decongestants should be avoided in cases where patients have:
    • HTN
    • palpitations
    • CNS stimulation
  57. these are used ONLY for nonproductive coughs
    antitussives
  58. this form of antitussive suppresses the cough reflex by direct action on the cough center of the medulla
    -cause sedation, N/V, lightheadedness
    • opiods
    • -codeine
    • -hydrocodone
  59. these antitussives suppress the cough reflex by numbing the stretch receptors in the resp. tract and preventing the cough reflex
    -dizziness, headache, sedation, nausea
    • non-opiods
    • -tesslon perles
    • -vicks 44
    • -robitussin DM
  60. drugs that aid in the expectoration of mucus; reduce the viscosity of secretions and disintegrate and thin secretions
    expectorants
  61. this drug causes irritation of the GI tract; loosening and thinning of repiratory tract secretions occur in response to this irritation
    expectorants
  62. patients taking this type of drug should increase thier fluids to helps loosen and liquefy secretions
    expectorants
  63. used during acute phase of asthmatic attacks
    -quickly reduce airway constriction and restore nomal airflow
    bronchodilators
  64. stimulate only B2 receptors
    -relaxes smooth muscles of the airway and results in bronchial dilation and ^ airflow
    Albuterol
  65. if this is used too frequently is loses its B2 specific actions at larger doses and then B1 is stimulated, causing nausea, ^ anxiety, palpitations, tremors, ^ HR
    Albuterol
  66. causes bronchial constriction and narrowing of the airways
    -bronchoconstriction is prevented, airways dilate
    • acetylcholine
    • -atrovent
    • -spiriva
  67. causes relief of bronchospasm and greater airflow into and out of the lungs, smooth muscle relaxation
    -^ levels of energy producing cAMP
    -CNS/cardio stimulation
    • Xanthine Derivatives
    • -caffine
    • -theobromine
    • -theophylline
  68. adjunct drug in the management of copd
    -caution use with cardiac disease, PUD
    • xanthine derivatives
    • -theophlline
    • -caffine
  69. prevent s leukotrienes from attaching to receptors on cells in the lungs and in circulation
    -inflamm. of the lungs in blocked
    • antileukotrienes
    • -singular
    • -accolate
    • -zyflo
  70. this medication should be taken every night on a continuous schedule, even if asthma symptoms improve
    -used for chronic asthma
    antileukotrienes
  71. NOT considered first line drugs for management of acute asthmatic attacks or status asthmaticus
    • inhaled corticosteroids
    • -azmacort
    • -flovent
    • -flonase
  72. teach patients to gargle and rinse the mouth with luke warm water afterward to prevent the development of oral fungal infections
    • inhaled corticosteroids
    • -azmacort
    • -flovent
    • -flonase
  73. the adverse effects of inhaled corticosteroids is:
    • -pharyngeal irritation
    • -coughing
    • -dry mouth
    • -oral funal infections

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