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WorksheetsAsthma and COPD
Total questions: 25
Worksheet time: 18mins
Chronic inflammatory lung disease involving recurrent breathing problems, shortness of breath, chest tightness, pressure, coughing, wheezing.
-multicellular reaction causing inflammation of the airway and hyper-responsiveness to a variety of triggers
(a)
Body reacts to a trigger which results in bronchoconstriction, mucus secretion, mucosal edema, and ineffective air way clearance
(a)
Common causes of asthma exacerbations:
irritants (smoke, dust, pollen, cold air)
allergens
stress/emotional distress
Obesity
Signs and symptoms of asthma
hypoxemia
tachypnea
tachycardia
shortness of breath
increased sputum production
Status asthmaticus is a medical
(a)
Progressive acute event that does not respond to treatment within 30 minutes
-diminished/absent breath sounds
-altered mental status
Asthma exacerbation.
Measures how fast air can be forced out of the lungs
Pulmonary Function Tests (PFT)
Peak Expiratory Flow Rate (PEFR)
Allergy testing
Nonpharmacological Management for Asthma
Avoid triggers
Control allergen and environmental factors
Smoking cessation
Deep pursed breathing
How well air moved in and out of lungs
Pulmonary Function Test (PFT)
Peak Expiratory Flow Rate (PEFR)
Allergy Test
"Maintenance”-will not help during
an acute exacerbation
Reduces inflammation and swelling
fluticasone (Flovent)
budesonide (Pulmicort)
Can cause thrush-educate the
patient on rinsing mouth after
taking
Inhaled Corticosteroids
Long-Acting Beta Agonists (LABA's)
Leukotriene Modifiers
Short Acting Beta Agonists (SABA's)
Used in conjunction with
corticosteroids
Relaxes the muscles surrounding
the airway.
formoterol (Symbicort)
salmeterol (Advair)
Long-Acting Beta Agonists (LABA's)
Inhaled Corticosteroids
Leukotriene Modifiers
Short Acting Beta Agonists (SABA's)
Block the effects of leukotrienes
(released during and allergic
reaction) that cause inflammation
and airway constriction
Leukotriene Modifiers
Short Acting Beta Agonists (SABA's)
Inhaled Corticosteroids
Long-Acting Beta Agonists (LABA's)
• Attach to beta-receptors that
relax the muscles in your lungs
• Sometimes referred to as
“bronchodilators”
• “Rescue inhaler”
• albuterol (Airsupra)
• albuterol sulfate (Pro Air)
• Can cause tachycardia
Short Acting Beta Agonists (SABA's)
Leukotriene Modifiers
Inhaled Corticosteroids
Long-Acting Beta Agonists (LABA's)
What is the mnemonic to remember the main medications in asthma?
(a)
• Child arrives with labored breathing and
audible wheezing.
• RR 28, HR 120, O2 sat 89% on room air.
• Reports rescue inhaler not providing
relief.
Which nursing interventions are most appropriate based on the progression of the child's condition?
Encourage child to use incentive spirometer every hour
Contact provider regarding uncontrolled symptoms
Educate the parent on limiting the child's activity until symptoms improve
Administer prescribed albuterol via nebulizer
Iniatiate oxygen therapy to maintain SpO2 >94%
• Severe respiratory distress, using
accessory muscles.
• RR 34, HR 140, O₂ sat 85% despite
oxygen.
• Patient is anxious, diaphoretic, speaking
in single words.
• Breath sounds now diminished with
very little air movement.
Which interventions are a priority for this patient?
Prepare for possible intubation and mechanical ventilation
Administer IV corticosteroids as prescribed
Provide a sedative to help the child relax
Continue administering short-acting-beta-agonists via nebulizer
Place child in high fowler's position
Lung condition characterized by inflammation and progressive airway obstruction
-not curable but treatable and managed with pharmacologic therapy and lifestyle changes
(a)
What are characteristics of COPD
Slowly alters the structures of the
respiratory system over time causing
irreversible damage to the lungs/function
Causes airways to narrow
Resistance to airflow increases
Expiration becomes slow and difficult
COPD symptoms
Chronic coughing
Persistent dyspnea
Sputum Production
Symptoms worsen over time
• Inflammation of the bronchioles
• Edema
• Increased mucous production
• Can have this without being
labeled “COPD”. COPD needs an airway
blockage.
• Cough for at least 3 months with
reoccurring episodes over 2 consecutive
years
Emphysema
• Destruction of alveolar walls.
• Abnormal enlargement of airspace.
• Significant limitation of airflow.
• Reduction in the protective enzyme- Alpha-
1 antitrypsin (Aat) (protective enzyme).
• A person with this has COPD. Not
everyone with COPD has this.
• Pursed Lip Breathing
COPD Pathophysiology
Repeated exposure to respiratory irritants --> damage large and small airway passages
Damage = increased mucus and excessive fluid --> causes edema
Edema narrows airways and traps air in lungs during exhalation
Over time, the air trapping then causes lungs to hyperinflate
COPD vs Healthy Lung
Hyperinflation
Flattened diaphragm
Increased chest diameter
Narrow, elongated heart
Pharmacological management for COPD
Bronchodilators for improved gas exchange
Corticosteroid therapy for anti-inflammatory effect
Oxygen therapy
Leukotriene modifiers for restricting inflammation and constricted airway
Oxygen therapy for COPD patients
Improves exercise tolerance
Reduces rates of hospitalization
At home therapy
Can be used intermittent, at night, continuous
