NURS 5461 Final Exam Questions and Answers Verified 100% Correct

NURS 5461 Final Exam Questions and Answers Verified 100% Correct Asthma Symptoms are caused by? - ANSWER -Symptoms are associated with variable expiratory airflow, i.e. difficulty breathing air out of the lungs due to Bronchoconstriction Airway wall thickening Increased mucus Most likely to be asthma if? - ANSWER -More than one type of symptom (wheeze, shortness of breath, cough, chest tightness) Symptoms often worse at night or in the early morning Symptoms vary over time and in intensity Symptoms are triggered by viral infections, exercise, allergen exposure, changes in weather, laughter, irritants such as car exhaust fumes, smoke, or strong smells Diagnosis of Asthma - ANSWER -An increase in FEV1 of 12% with a minimum increase of*200 mL in FEV1* *after bronchodilator* establishes the presence of airflow reversibility Best test to rule OUT asthma is a methalcholine challenge...if that is negative, then the person does not have asthma Document that FEV1/FVC is reduced (at least once, when FEV1 is low) FEV1/ FVC ratio is normally 0.75 - 0.80 in healthy adults Assessment of Asthma - ANSWER -Asthma control - two domains Assess symptom control over the last 4 weeks Assess risk factors for poor outcomes, including low lung function Treatment issues Check inhaler technique and adherence Ask about side-effects Does the patient have a written asthma action plan? What are the patient's attitudes and goals for their asthma? Comorbidities Think of rhinosinusitis, GERD, obesity, obstructive sleep apnea, depression, anxiety These may contribute to symptoms and poor quality of life When should you measure lung function after asthma diagnosis - ANSWER -3-6 months after starting treatment What is the most common controller for asthma? - ANSWER -AN ICS Anticholinergics such as tiotropium can help do what? - ANSWER Bronchodilation by reducing parasympathetic nerve reflexes that cause a reduced airway. MUSCARINIC receptor binding and inhibits acetylcholine What is a good add on medication for Stage 5 asthmatics with severe allergic asthma? - ANSWER -anti-IgE (omalizumab) What is a good add on medication for stage 5 asthmatics with eosinophilic asthma - ANSWER -anti-IL5 (mepolizumab (SC) or reslizumab (IV) How often should you review your asthma? - ANSWER -1-3 months after treatment started, then every 3-12 months During pregnancy, every 4-6 weeks After an exacerbation, within 1 week What are two med classes to be cautious with for those with asthma? - ANSWER -NSAIDS (bronchospasm)- due to leukotrienes BETA BLOCKERS- asthma exacerbation What is COPD - ANSWER -a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. What are some prevalent factors about COPD? - ANSWER -►Prevalence of COPD was higher in smokers and ex-smokers compared to non-smokers ►Higher in ≥ 40 year group compared to those 40 ►Higher in men than women What is a key diagnostic for COPD? - ANSWER -Spirometry is required to make the diagnosis; the presence of a post- bronchodilator FEV1/FVC 0.70 confirms the presence of persistent airflow limitation. Classification of airflow limitation severity in COPD (POST BD) - ANSWER GOLD 1- Mild- FEV1 80% predicted or total GOLD 2- moderate- 50%FEV1, 80% predicted GOLD 3- Severe- 30%FEV1, 50% predicted GOLD 4- very severe- FEV1, 30% predicted What is an important assessment tool for COPD? - ANSWER -ABCD assessment tool. Takes into account GOLD classification, mMRC, CAT What genetic screening might be done for those with COPD? - ANSWER -Alpha 1 antitrypsin deficiency (AATD) A low concentration ( 20% normal) is highly suggestive of homozygous deficiency. What form of ventilation is best for copd exacerbations - ANSWER -Noninvasive ventilation (NIV) in the form of noninvasive positive pressure ventilation (NPPV) is the standard of care for decreasing morbidity and mortality in patients hospitalized with an exacerbation of COPD and acute respiratory failure. What is preferred pharmacological treatment in stable COPD - ANSWER -LABA or LAMA over a short acting agent Rescue short-acting bronchodilators should be prescribed to all patients for immediate symptom relief What are the four main risk factors for CVD? - ANSWER -• Hypertension • Diabetes mellitus • Dyslipidemia