COPD
Asthma
CF
Sickle Cell
ABG
100

Primary cause of COPD

smoking

100

Symptoms of asthma, name a few. 

dry, nonproductive cough

wheezing

SOB

apprehension

anxiety

prolonged expiration

100

First manifestation of cystic fibrosis

Meconium ileus

100

What is a common trigger for sickle cell crises?

infection --> often pneumonia as most common


Others: blood loss, stress, acidosis, 

100

Interpret this ABG:

pH 7.28

CO2: 84

HCO3: 28

Respiratory acidosis

200

What is the defining feature of a COPD exacerbation?

airflow limitation during forced EXPiration

200

What is the most effective drug for relieving a BRONCHOSPASM?

B2 adrenergic agonists i.e. albuterol

200

What is the diagnostic test for cf?

Sweat test  (normal sweat is <40mg/dL, in CF pt usually >60)
200
Nursing management for SC crisis

PCA

Transfusion

tx underyling cause i.e. fever

200

What is the major cause of respiratory acidosis?

What about respiratory alkalosis?

Hypoventilation


Alk: hyperventilation

300

Name four S/S of COPD exacerbation


  • INC wheezing, acue change in usual patterns of dyspnea, cough or sputum, malaise, fatigue, confusion, depression, anxiety

  • SEVERE:

    • use of accessory muscles, central cyanosis, AMS, edema in LE/signs of RSHF, unstable BP

300

what is the most effective anti-asthmatic drug?

corticosteroids i.e. flovent
300

A child diagnosed with CF is experiencing an acute exacerbation. What is a nursing intervention that will help with this exacerbation?


Ambulate pt

300

What is the role of hydroxyurea for sickle cell patients?

Inc hgb conc, dec sickled cells, reduces destruction of RBC

NOT used in acute SC crisis

300
Interpret this ABG:


pH: 7.5

CO2: 60

HCO3: 48

Compensated?

Interpretation: Metabolic alkalosis 

(HCO3 and pH are alkalotic)


Compensated: Partial;

pH, bicarb and co2 are all abnormal.


400

You have a COPD patient who is on 2L NC w SpO2 98%.  Is this okay/expected SpO2?

No; COPD pt target spo2 is 88-92. Higher Spo2 places pt at risk for hypercapnia

400

tx for asthma exacerbation list a few



  • Humidified O2

  • Hydration

  • Pt positioning

  • Quiet environment, rest, support

  • Medication

400

Dietary modifications for CF patients

decrease fat soluble vitamins (ADEK) 

high protein, high calorie


400
List some education points for pediatrics w SCD

- fluids : inc w exercise, warm weather, stress, do not limit fluids at night --> maybe try inc bathroom visits overnight instead.

- reproductive risks (1/4 chance of children acquiring

- avoid high altitude, immunize

- retinopahty assessments beginning at 10 

400

Name some causes of metabolic acidosis

renal failure

diarrhea

DKA

starvation/malnutrition



500

Explain pulmonary htn and cor pulmonae. 

Pulmonary hypertension: hypoxia --> constricted pulmonary vessels + viscous blood --> inc pulmonary pressure


Cor pulmonae: inc pulm pressure = inc pressure in R side of heart --> RSHF sx

500

Is dec wheezing a goos sign for asthma exac? Why or why not?

BAD! Means airway is constricting more

500

A 12-year-old female with cystic fibrosis presents to the clinic for a routine check-up. Her mother reports that the patient has been experiencing frequent greasy stools, poor weight gain, and fatigue. The patient’s BMI is in the 5th percentile, and her recent sputum culture shows colonization with Staphylococcus aureus. The healthcare provider suspects that her pancreatic enzyme replacement therapy (PERT) may be insufficient.

Which of the following is the most appropriate nursing intervention for managing the patient’s symptoms?

a. Increase the dosage of pancreatic enzymes and educate the patient on taking them with all meals and snacks.
b. Initiate a low-fat diet to reduce fat malabsorption and help with stool consistency.
c. Discontinue pancreatic enzyme therapy and switch to a protein-rich, low-carbohydrate diet.
d. Begin a course of corticosteroids to reduce inflammation and improve nutrient absorption.

A) Increase the dosage of pancreatic enzymes and educate the patient on taking them with all meals and snacks.

500

A 24-year-old female with a history of sickle cell disease is admitted to the emergency department with severe generalized pain, especially in her chest and lower back. Her vital signs show a heart rate of 118 bpm, respiratory rate of 28 breaths per minute, blood pressure of 96/58 mmHg, and oxygen saturation of 91% on room air. She reports that she has not urinated much in the last 12 hours, despite drinking fluids. Laboratory results reveal an elevated white blood cell count, decreased hemoglobin, and elevated reticulocyte count. The healthcare team suspects an acute vaso-occlusive crisis (VOC).

Which of the following is the priority nursing intervention for this patient?

a. Administer IV fluids to promote hydration and reduce blood viscosity.
b. Administer oxygen to improve tissue perfusion and prevent further sickling.
c. Administer a blood transfusion to increase hemoglobin and alleviate anemia.
d. Initiate intravenous opioids to manage pain and reduce stress on the body.

B: Admin O2

500

Interpret this ABG

pH: 7.38

CO2: 48

HCO3: 30


Compensation?

Fully compensated respiratory acidosis


Fully compensated BC pH WNL but still leaning towards acidosis. 

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