1 Inquire through: | Professional | Confidential Support
NSG 170 Final Exam Study Guide Questions and
Answers (100% Correct Answers)
Bronchodilators
Ans: *Open Airways
*Decrease bronchospasm
Sympathomimetics
Ans: *Beta 2 selective adrenergic agonists
*Albuterol & Levelalbuteral used for short relief; 2 puffs prn or QID
*Salmeterol (Moderate to severe COPD)
*Adverse Effects: GI upset, cardiac arrhythmias, hypertension, bronchospasm,
sweating, pallor, flushing
*Contraindications: heart dysrhythmias, diabetes, hyperthyroidism, heart disease,
vascular disease
*Take 30-60mins prior to exercise
Anti-Cholinergcs
Ans: *Blocks vagally mediated reflexes by antagonizing the action of acetycholine
*Short Acting: Ipratropium (Atrovent)
*Long Acting: Tiotroprium (Spiriva)
*Maintenance treatment of bronchospasm associated with COPD
*Adverse Effects: Dizziness, headache, fatigue, nervousness, dry mouth, sore throat,
palpitations, urinary retention
*Assess for allergies to soy/peanuts
*Contraindications: narrow angle glaucoma, BPH, bladder/neck obstruction,
conditions aggravated by dry mouth/throat
*Sugarless lozenges to relieve dry mouth
Xanthines
Ans: *Aminophylline and Theophylline
,2 Inquire through: | Professional | Confidential Support
*Direct effect relaxing smooth muscles of the respiratory tract, both in the bronchi
and in the blood vessels
*Symptomatic relief or prevention of bronchial asthma and for reversal of
bronchospasm associated with COPD
*Adverse Effects: GI upset, nausea, tachycardia, seizure, brain damage, death
*Contraindications: GI problems, coronary disease, respiratory dysfunction, renal or
hepatic disease, alcoholism, hyperthyroidism
*Avoid caffeine
Key Points
Ans: *Xanthine-derived drugs affect the smooth muscles of the resp tract. Effects are
directly related to blood levels of theophylline (10-20 mcg/dL). Excess can lead to
coma and death
*Sympathomimetic (beta agonists) replicate the effects of the sympathetic nervous
system; they dilate the bronchi and increase the rate and depth of resp
*Anticholinergics affect the vagus nerve to relax bronchial smooth muscle and
promote bronchodilation.
Corticosteriods
Ans: *Prednisone (end in "one" or "sone")
*Act by altering the inflammatory process that leads to swelling and further
narrowing.
*May be given inhalation or systemic (oral or IV)
*Long term complications of oral include hyperglycemia, increased risk of infection,
swelling/wt gain, and osteoporosis
*Inhaled can be given alone or in combination with a LABA
*Must taper! Esp when switching to inhaled steroid! Adrenal insufficiency.
*If taking a quick acting bronchodilator like Albuterol, should take it prior to the
inhaled steroid
Inhaled Steroid
Ans: *Fluticasone (Flovent); Budesonide DPI (Pulmicort Flexhaler)
*Decrease the inflammatory response in the airway
,3 Inquire through: | Professional | Confidential Support
*Prevention and treatment of asthma
*Treat chronic steroid-dependent bronchial asthma
*Adverse Effects: Sore throat, hoarseness, coughing, dry mouth, Pharyngeal and
laryngeal fungal infections
Fixed Combination Respiratory Drugs
Ans: *LABA/Corticosteriod: Fluticasone/salmeterol (Advair, Advair Discus),
Budesonide/formoterol (Symbicort)
*SABA/Anti-cholinergic: Ipratropium/albuterol (Combivent)
Leukotriene Receptor Antagonists
Ans: *Zafirlukast (Accolate); Montelukast (Singulair)
*Selectively and competitively block or antagonize receptors for the production of
leukotrienes which similar to histamine play a role in "allergic" inflammatory
disorders (i.e. hay fever, asthma)
*Prophylaxis and chronic treatment of bronchial asthma
*Adverse Effects: Headache, dizziness, myalgia, nausea, diarrhea and abdominal
pain, elevated liver enzyme concentrations, vomiting, and generalized pain
*Hepatic or renal impairment (effects metabolism and excretion
*NOT FOR ACUTE ATTACKS!
Mast Cell Stabilizers
Ans: *Cromolyn (Nasalcrom)
*Works at the cellular level to inhibit the release of histamine and inhibits the release
of SRSA
*Treatment of chronic bronchial asthma, exercise induced asthma, and allergic
rhinitis
*Few adverse effects
*NOT USED FOR ACUTE ATTACKS!
Key Points
Ans: *Corticosteroids decrease the inflammatory response. The inhalable form is
associated with fewer systemic effects than other routes
, 4 Inquire through: | Professional | Confidential Support
*To block various signs and symptoms of asthma, the leukotriene receptor
antagonists block or antagonize the receptors for the productions of leukotrienes
(responsible for allergic type inflammation similar to histamine)
*The mast cell stabilizer cromolyn blocks the release of histamine and other
chemicals associated with an allergic reaction. This decreases the inflammatory
reactions.
Pulmonary Function Test
Ans: *Uses spirometer hooked to measuring device (resp tech)
*Determines lung volume, ventilation, and gas exchange
*Wide range of normals: Ht, Wt, Age, Gender
*No smoking 4-6 hours prior
*No bronchodilators or opioids 6 hours prior
Peak Flow Meter
Ans: *Peak Expiratory Flow Rate: At home by patient's to monitor. Based on patient's
personal best.
Arterial Blood Gases
Ans: *Measurement of arterial oxygenation and carbon dioxide levels as well as acid-
base balance.
*Note the patient's body temperature and any O2 or mechanical ventilation used (Pre-
Procedure)
*Allen's Test (Pre-Procedure)
COPD
Ans: *"A preventable and treatable disease with significant extra-pulmonary effects
that may contribute to the severity in individual patients. Its pulmonary component
is characterized by airflow limitation that is not fully reversible. The airflow
limitation is progressive and associated with an abnormal inflammatory response of
the lung to noxious particles or gases"
*Defined by GOLD (Global initiative for chronic Obstructive Lung Disease)
*A Leading cause of death and disability.
*COPD includes diseases that cause airflow obstruction (emphysema, chronic
bronchitis)
*Periods of acute exacerbation
NSG 170 Final Exam Study Guide Questions and
Answers (100% Correct Answers)
Bronchodilators
Ans: *Open Airways
*Decrease bronchospasm
Sympathomimetics
Ans: *Beta 2 selective adrenergic agonists
*Albuterol & Levelalbuteral used for short relief; 2 puffs prn or QID
*Salmeterol (Moderate to severe COPD)
*Adverse Effects: GI upset, cardiac arrhythmias, hypertension, bronchospasm,
sweating, pallor, flushing
*Contraindications: heart dysrhythmias, diabetes, hyperthyroidism, heart disease,
vascular disease
*Take 30-60mins prior to exercise
Anti-Cholinergcs
Ans: *Blocks vagally mediated reflexes by antagonizing the action of acetycholine
*Short Acting: Ipratropium (Atrovent)
*Long Acting: Tiotroprium (Spiriva)
*Maintenance treatment of bronchospasm associated with COPD
*Adverse Effects: Dizziness, headache, fatigue, nervousness, dry mouth, sore throat,
palpitations, urinary retention
*Assess for allergies to soy/peanuts
*Contraindications: narrow angle glaucoma, BPH, bladder/neck obstruction,
conditions aggravated by dry mouth/throat
*Sugarless lozenges to relieve dry mouth
Xanthines
Ans: *Aminophylline and Theophylline
,2 Inquire through: | Professional | Confidential Support
*Direct effect relaxing smooth muscles of the respiratory tract, both in the bronchi
and in the blood vessels
*Symptomatic relief or prevention of bronchial asthma and for reversal of
bronchospasm associated with COPD
*Adverse Effects: GI upset, nausea, tachycardia, seizure, brain damage, death
*Contraindications: GI problems, coronary disease, respiratory dysfunction, renal or
hepatic disease, alcoholism, hyperthyroidism
*Avoid caffeine
Key Points
Ans: *Xanthine-derived drugs affect the smooth muscles of the resp tract. Effects are
directly related to blood levels of theophylline (10-20 mcg/dL). Excess can lead to
coma and death
*Sympathomimetic (beta agonists) replicate the effects of the sympathetic nervous
system; they dilate the bronchi and increase the rate and depth of resp
*Anticholinergics affect the vagus nerve to relax bronchial smooth muscle and
promote bronchodilation.
Corticosteriods
Ans: *Prednisone (end in "one" or "sone")
*Act by altering the inflammatory process that leads to swelling and further
narrowing.
*May be given inhalation or systemic (oral or IV)
*Long term complications of oral include hyperglycemia, increased risk of infection,
swelling/wt gain, and osteoporosis
*Inhaled can be given alone or in combination with a LABA
*Must taper! Esp when switching to inhaled steroid! Adrenal insufficiency.
*If taking a quick acting bronchodilator like Albuterol, should take it prior to the
inhaled steroid
Inhaled Steroid
Ans: *Fluticasone (Flovent); Budesonide DPI (Pulmicort Flexhaler)
*Decrease the inflammatory response in the airway
,3 Inquire through: | Professional | Confidential Support
*Prevention and treatment of asthma
*Treat chronic steroid-dependent bronchial asthma
*Adverse Effects: Sore throat, hoarseness, coughing, dry mouth, Pharyngeal and
laryngeal fungal infections
Fixed Combination Respiratory Drugs
Ans: *LABA/Corticosteriod: Fluticasone/salmeterol (Advair, Advair Discus),
Budesonide/formoterol (Symbicort)
*SABA/Anti-cholinergic: Ipratropium/albuterol (Combivent)
Leukotriene Receptor Antagonists
Ans: *Zafirlukast (Accolate); Montelukast (Singulair)
*Selectively and competitively block or antagonize receptors for the production of
leukotrienes which similar to histamine play a role in "allergic" inflammatory
disorders (i.e. hay fever, asthma)
*Prophylaxis and chronic treatment of bronchial asthma
*Adverse Effects: Headache, dizziness, myalgia, nausea, diarrhea and abdominal
pain, elevated liver enzyme concentrations, vomiting, and generalized pain
*Hepatic or renal impairment (effects metabolism and excretion
*NOT FOR ACUTE ATTACKS!
Mast Cell Stabilizers
Ans: *Cromolyn (Nasalcrom)
*Works at the cellular level to inhibit the release of histamine and inhibits the release
of SRSA
*Treatment of chronic bronchial asthma, exercise induced asthma, and allergic
rhinitis
*Few adverse effects
*NOT USED FOR ACUTE ATTACKS!
Key Points
Ans: *Corticosteroids decrease the inflammatory response. The inhalable form is
associated with fewer systemic effects than other routes
, 4 Inquire through: | Professional | Confidential Support
*To block various signs and symptoms of asthma, the leukotriene receptor
antagonists block or antagonize the receptors for the productions of leukotrienes
(responsible for allergic type inflammation similar to histamine)
*The mast cell stabilizer cromolyn blocks the release of histamine and other
chemicals associated with an allergic reaction. This decreases the inflammatory
reactions.
Pulmonary Function Test
Ans: *Uses spirometer hooked to measuring device (resp tech)
*Determines lung volume, ventilation, and gas exchange
*Wide range of normals: Ht, Wt, Age, Gender
*No smoking 4-6 hours prior
*No bronchodilators or opioids 6 hours prior
Peak Flow Meter
Ans: *Peak Expiratory Flow Rate: At home by patient's to monitor. Based on patient's
personal best.
Arterial Blood Gases
Ans: *Measurement of arterial oxygenation and carbon dioxide levels as well as acid-
base balance.
*Note the patient's body temperature and any O2 or mechanical ventilation used (Pre-
Procedure)
*Allen's Test (Pre-Procedure)
COPD
Ans: *"A preventable and treatable disease with significant extra-pulmonary effects
that may contribute to the severity in individual patients. Its pulmonary component
is characterized by airflow limitation that is not fully reversible. The airflow
limitation is progressive and associated with an abnormal inflammatory response of
the lung to noxious particles or gases"
*Defined by GOLD (Global initiative for chronic Obstructive Lung Disease)
*A Leading cause of death and disability.
*COPD includes diseases that cause airflow obstruction (emphysema, chronic
bronchitis)
*Periods of acute exacerbation
