Asthma/COPD
What assessment findings would indicate severe asthma?
Inspiratory and expiratory wheezes, labored breathing, etc.
What are common side effects of albuterol treatments?
Dry mouth, throat irritation, bad taste, tachycardia, tremors, GI irritation n/v
How can RSV best be prevented?
Hand washing
When is a chest tube indicated?
Pneumothorax, Hemothorax
What type of diet should a client with COPD eat? Why?
High protein and fats without excess carbohydrates to minimize CO2 production during metabolism. Small, frequent meals.
Provide instructions on how bronchodilators should be used.
Use bronchodilator first, wait 1 min, then admin 2nd med to reduce inflammation
How can RSV be spread?
Direct -kissing
Indirect- touching surfaces
Pt should be on contact/droplet precautions
What are some modifiable risk factors that effect oxygenation?
Smoking, obesity, T2DM, stress, anxiety
What is a nursing diagnosis related to asthma and why?
Ineffective breathing pattern – increased resp rate, wheezes
When should Cromolyn be used? Why?
It should be used as prophylaxis for asthma because it is a mast cell stabilizer and can prevent bronchospasm in children who are subject to exercise-induced asthma.
Which ethnicity is at greatest risk for RSV?
Alaska native infants (responsible for 1/3 of hospitalizations of children under 3 in Alaska)
What are some nursing interventions for you patient who has thick secretions?
Encourage hydration and mobility, humidification w/ O2, use of a flutter valve
What are the manifestations of COPD as it progresses?
Early: Coughing in AM with clear sputum
As it progresses, the body produces more RBCs and clog the small blood vessels of fingers leading to cyanotic nail beds and clubbing of fingertips.
Late: Possible Left ventricular enlargement that results in dysrhythmias.
What would you include in the teaching for Zileuton?
MONITOR LIVER FUNCTION
Zileuton can injure the liver. Therefore, ALT should be monitored once a month for 3 months, then every 2 to 3 months for the remainder of the first year, and periodically thereafter. Zileuton is an oral, not an inhaled, medication that is rapidly absorbed with or without food. Zileuton is used for asthma prophylaxis.
What is the plan of care for newborns and infants with RSV?
Monitor breathing patterns, maintain patent airways, promote adequate fluid and caloric intake, supporting appropriate developmental behaviors, Resp Therapy, Play therapist
Does grunting improve gas exchange? Why?
Grunting improves gas exchange because it increases expiratory pressure and promotes end diastolic pressure and promotes gas exchange.