COPD
Name 3 EARLY symptoms of respiratory distress
Restlessness, tachycardia, tachypnea, tripod positioning, anxiety, difficulty speaking, disorientation
(signs that are considered LATE: stupor, bradycardia, cyanosis, intercostal retractions, bradypnea)
Fever, sore throat, cough, HA, loss of taste and smell
Symptoms of COVID-19
Which cells/chemicals/IG are responsible for asthma?
Mast cells, histamine, leukotrienes, prostaglandins, inflammatory mediators, IgE
When using a beta 2 agonist inhaler and glucocorticoid inhaler, the patient should use the ---- first and the ---- last.
B2 agonist THEN glucocorticoid
Gas exchange between the blood and lungs occurs in the ---.
Alveoli
Productive cough, purulent sputum, dyspnea, adventitious lung sounds, dramatic cyanosis, hypoxemia, hypercapnia
S/s of Chronic Bronchitis
Sudden onset of fever, chills, crackles in the lungs, pleuritic pain, tachycardia, sputum production
symptoms of pneumonia
What are some expected physiologic changes during an asthma attack?
Sudden dyspnea, wheezing, tightness in the chest, and diminished breath sounds due to bronchial constriction
Bronchodilator used for long-term maintenance/prophylaxis of asthma, not for acute attacks.
Salmeterol/LABAs
The maximal amount of air that can be moved in and out of the lungs with forced inhalation and exhalation.
Vital Capacity
Enlargement of air spaces and destruction of alveolar walls
Emphysema
Diffuse epithelial cell injury with increased permeability of the alveolar-capillary membrane r/t severe inflammation
ARDS
Name 3 goals of asthma treatment:
Prevent chronic symptoms, maintain normal lung function, maintain normal activity, prevent acute exacerbations, minimize ER/hospital visits
Patients taking inhaled --- should be advised to rinse and spit after each use.
Glucocorticoids
What are the differences between ventilation, perfusion, and diffusion?
Ventilation: Movement of air between the atmosphere and respiratory portion of the lungs
Perfusion: The flow of blood through the lungs
Diffusion: The transfer of gases between the air-filled spaces in the lungs and the blood
Name one disorder that would DECREASE ventilation-perfusion ratio (lung is perfused, but not ventilated) and one that would INCREASE the V-Q ratio (lung is ventilated, but not perfused)
1: Chronic bronchitis, asthma, pulm edema, airway obstruction, pneumonia
2: Emphysema, pulm HTN, heart or liver disease
Low grade fever, runny nose, dry cough, sneezing, most children will have it at least once by age 2
RSV
When educating the patient about the best way to prevent asthma attacks, the nurse should discuss ---.
Identifying and avoiding triggers
Blocks leukotriene receptors and/or synthesis which results in bronchodilation, decreased airway inflammation, and decreased mucus plugging of the airway
Montelukast
Activation of the sympathetic nervous system causes bronchioles to ---.
Dilate
People with COPD are driven to breathe by ___
Low levels of O2 (this is why they sat at 88-92%!)
They are chronically hypercapneic, so they are no longer stimulated to breathe due to high CO2 levels.
A patient comes to the ED after evacuating a house fire. On route, they were stable, but they suddenly begin rapidly breathing with retractions. Crackles and bronchi are present. They are rapidly declining. What does the nurse suspect?
ARDS
Name 3 medications that can be used for maintence/prophylaxis of asthma
Leukotriene modifiers
Long-acting anticholinergics
Glucocorticoids
LABAs
Improves lung function by blocking muscarinic receptors in the bronchi, thereby reducing bronchoconstriction and has anticholinergic side effects
Ipratropium
Increasing pCO2, decreasing pH, and increasing temperature of the body causes a right-shift on the O2-Hemoglobin dissociation curve, otherwise describing ----- ------ for O2.
Decreased affinity (we release oxygen from our Hgb more easily)