{solved} NURS 372 Final Exam Questions and Correct
Answers | The following are asthma symptoms that may
present themselves SATA:
The following are asthma symptoms that may present themselves SATA:
A. Crackles heard bilaterally on lung bases on auscultation
B. Daytime symptoms of wheezing, dyspnea, coughing present more than twice
weekly
C. Waking from night sleep with symptoms of wheezing, dyspnea, coughing
D. Dyspnea on exertion with activity
E. Reliever (rescue) drug needed more than twice weekly
F. Activity limited or stopped by symptoms more than twice weekly
B, C, E, F
During an acute asthma exacerbation, wheezing can be heard on ______
exhalation
The following conditions may cause patients to have a barrel chest or increased
anteroposterior (AP) diameter of the chest SATA:
A. Bronchitis
B. COPD
C. Asthma
D. Pneumonia
E. Cystic Fibrosis
B, C
Which tests can be used to assess for asthma? Select all that apply.
1) Blood gas
2) Basic Metabolic Panel
3) Prothrombin Time
4) Immunoglobulin E level
5) Pulmonary Function Test
6) Eosinophil level
1, 4, 5, 6
The most accurate tests for measuring airflow in asthma are _____
pulmonary function tests (PFTs)
Provide patient teaching on how to properly manage asthma
Avoid potential environmental asthma such as smoke, dust, mold, weather changes,
etc.
Avoid drugs that may trigger asthma such as aspirin, NSAIDs, and beta blockers
avoid food that has been prepared with MSG or metabisulfate
For exercise, use the reliever inhaler 30 min before workout to reduce bronchospasm
Wash all bedding with hot water to destroy dust mites
Get adequate rest and sleep
For the patient with hx of asthma, seek immediate emergency care if you
experience:
Gray or blue fingertips or lips
Difficulty breathing, walking, or talking
,Retractions of the neck, chest, or ribs
Nasal flaring
Failure of drugs to control worsening symptoms
Primarily used as a fast-acting reliever (rescue) drug; Induces rapid
bronchodilation through relaxing beta 2 receptors in lungs; Given to improve
bronchospasm within 5-15 min; can control symptoms for up to 6 hours
Short acting Beta Agonists (SABA)
Examples of short acting beta agonist medications
Levalbuterol (Xenopex)
Albuterol
Patient education for SABA drugs
Carry drug on you at all times to reduce a chance of life-threatening
bronchoconstriction.
Patient needs to monitor heart rate because excessive use of albuterol causes
tachycardia
When taking this drug with any other inhaled drugs, teach patient to use them at least 5
minutes before the other inhaled drugs
Use the correct technique for MDI or DPR to ensure the drug reaches the site of action
Causes bronchodilation through relaxing bronchiolar smooth muscle by binding
to and activating pulmonary beta2 receptors. Given for bronchospasms but onset
slow with long duration (within 15-30mins; helps control symptoms for approx. 12
hrs). Primary use is prevention of an asthma attack
Long acting Beta 2 Agonists (LABA)
Examples of long acting beta 2 receptors
Salmeterol (inhaled drug); Indacaterol (COPD only) (inhaled drug); Formoterol
Arformoterol (COPD only)
Patient education for LABA drugs
Do not use these drugs as reliever drugs because they have a slow onset of action and
do not relieve acute symptoms.
Teach patient the correct technique for using the MDI or DPI to ensure that the drug
reaches the site of action
Should never be prescribed as the only drug therapy for asthma and are not to be used
during an acute asthma attack or bronchospasm.
Use daily even when no asthma symptoms are present
Disrupt production pathways of inflammatory mediators. The main purpose is to
prevent an asthma attack caused by inflammation or allergies (controller drug).
Corticosteroids
Examples of corticosteroids
Fluticasone (MDI inhaled drug); Beclomethasone (MDI inhaled drug); Budesonide (MDI
inhaled drug)
Patient education for Corticosteroid drugs (inhaler and PO)
Use the drug daily, even when no symptoms are present, because maximum
effectiveness requires continued use for 48-72 hours and depends on regular use.
Do not use these drugs as reliever drugs because they have a slow onset of action and
do not relieve acute symptoms.
Use MDI to ensure the drug reaches the site of action.
, Teach patient to avoid anyone who has an upper respiratory infection because the drug
reduces all protective inflammatory responses, increasing the risk for infection
Teach patient to take drug with food to help reduce the side effect of GI ulceration.
Teach patient not to suddenly stop taking the drug for any reason because the drug
suppresses adrenal production of corticosteroids, which are essential for life.
Teach patient to avoid activities that lead to injury because blood vessels become more
fragile, leading to bruising and petechiae.
Why is it important for patients taking corticosteroids to practice good oral care ?
use good mouth care and check mouth daily for lesions or drainage because these
drugs reduce local immunity and increase the risk for local infections, especially
Candida albicans (yeast)
Blocks the leukotriene receptor, preventing the inflammatory mediator from
stimulating inflammation. Purpose is to prevent asthma attack triggered by
inflammation or allergens.
Leukotriene Modifiers
Patient education for Montelukast drugs
use the drug daily, even when no symptoms are present, because maximum
effectiveness requires continued use for 48-72 hours and depends on regular use.
Do not decrease the dose of or stop taking any other asthma drugs unless instructed by
the health care professional because this drug is for long-term asthma control and does
not replace other drugs, especially corticosteroids and reliever (rescue) drugs.
Risk factors of COPD
Cigarette smoking, environmental factors, genetics, asthma, Alpha 1 -antitrypsin
deficiency, hx of asthma
Normal ABGs
pH: 7.35 - 7.45
PaCO2: 35 - 45
HCO3: 22 - 26
PaO2: 80 - 100
T/F: Ensure that no open flames (e.g., smoking, fireplaces, burning candles) or
other combustion hazards are in rooms where oxygen is in use.
True
a severe, life-threatening acute episode of airway obstruction that intensifies
once it begins and often does not respond to usual therapy; If the condition is not
reversed, the patient may develop pneumothorax and cardiac or respiratory
arrest.
Status Asthmaticus
Intervention for status asthmaticus
IV fluids, potent systemic bronchodilators, steroids, epinephrine, and oxygen are given
immediately to reverse the condition.
a destructive problem of lung elastic tissue that reduces its ability to recoil after
stretching, leading to hyperinflation of the lung
Emphysema
a collection of lower airway disorders that interfere with airflow and gas exchange
.
COPD
Answers | The following are asthma symptoms that may
present themselves SATA:
The following are asthma symptoms that may present themselves SATA:
A. Crackles heard bilaterally on lung bases on auscultation
B. Daytime symptoms of wheezing, dyspnea, coughing present more than twice
weekly
C. Waking from night sleep with symptoms of wheezing, dyspnea, coughing
D. Dyspnea on exertion with activity
E. Reliever (rescue) drug needed more than twice weekly
F. Activity limited or stopped by symptoms more than twice weekly
B, C, E, F
During an acute asthma exacerbation, wheezing can be heard on ______
exhalation
The following conditions may cause patients to have a barrel chest or increased
anteroposterior (AP) diameter of the chest SATA:
A. Bronchitis
B. COPD
C. Asthma
D. Pneumonia
E. Cystic Fibrosis
B, C
Which tests can be used to assess for asthma? Select all that apply.
1) Blood gas
2) Basic Metabolic Panel
3) Prothrombin Time
4) Immunoglobulin E level
5) Pulmonary Function Test
6) Eosinophil level
1, 4, 5, 6
The most accurate tests for measuring airflow in asthma are _____
pulmonary function tests (PFTs)
Provide patient teaching on how to properly manage asthma
Avoid potential environmental asthma such as smoke, dust, mold, weather changes,
etc.
Avoid drugs that may trigger asthma such as aspirin, NSAIDs, and beta blockers
avoid food that has been prepared with MSG or metabisulfate
For exercise, use the reliever inhaler 30 min before workout to reduce bronchospasm
Wash all bedding with hot water to destroy dust mites
Get adequate rest and sleep
For the patient with hx of asthma, seek immediate emergency care if you
experience:
Gray or blue fingertips or lips
Difficulty breathing, walking, or talking
,Retractions of the neck, chest, or ribs
Nasal flaring
Failure of drugs to control worsening symptoms
Primarily used as a fast-acting reliever (rescue) drug; Induces rapid
bronchodilation through relaxing beta 2 receptors in lungs; Given to improve
bronchospasm within 5-15 min; can control symptoms for up to 6 hours
Short acting Beta Agonists (SABA)
Examples of short acting beta agonist medications
Levalbuterol (Xenopex)
Albuterol
Patient education for SABA drugs
Carry drug on you at all times to reduce a chance of life-threatening
bronchoconstriction.
Patient needs to monitor heart rate because excessive use of albuterol causes
tachycardia
When taking this drug with any other inhaled drugs, teach patient to use them at least 5
minutes before the other inhaled drugs
Use the correct technique for MDI or DPR to ensure the drug reaches the site of action
Causes bronchodilation through relaxing bronchiolar smooth muscle by binding
to and activating pulmonary beta2 receptors. Given for bronchospasms but onset
slow with long duration (within 15-30mins; helps control symptoms for approx. 12
hrs). Primary use is prevention of an asthma attack
Long acting Beta 2 Agonists (LABA)
Examples of long acting beta 2 receptors
Salmeterol (inhaled drug); Indacaterol (COPD only) (inhaled drug); Formoterol
Arformoterol (COPD only)
Patient education for LABA drugs
Do not use these drugs as reliever drugs because they have a slow onset of action and
do not relieve acute symptoms.
Teach patient the correct technique for using the MDI or DPI to ensure that the drug
reaches the site of action
Should never be prescribed as the only drug therapy for asthma and are not to be used
during an acute asthma attack or bronchospasm.
Use daily even when no asthma symptoms are present
Disrupt production pathways of inflammatory mediators. The main purpose is to
prevent an asthma attack caused by inflammation or allergies (controller drug).
Corticosteroids
Examples of corticosteroids
Fluticasone (MDI inhaled drug); Beclomethasone (MDI inhaled drug); Budesonide (MDI
inhaled drug)
Patient education for Corticosteroid drugs (inhaler and PO)
Use the drug daily, even when no symptoms are present, because maximum
effectiveness requires continued use for 48-72 hours and depends on regular use.
Do not use these drugs as reliever drugs because they have a slow onset of action and
do not relieve acute symptoms.
Use MDI to ensure the drug reaches the site of action.
, Teach patient to avoid anyone who has an upper respiratory infection because the drug
reduces all protective inflammatory responses, increasing the risk for infection
Teach patient to take drug with food to help reduce the side effect of GI ulceration.
Teach patient not to suddenly stop taking the drug for any reason because the drug
suppresses adrenal production of corticosteroids, which are essential for life.
Teach patient to avoid activities that lead to injury because blood vessels become more
fragile, leading to bruising and petechiae.
Why is it important for patients taking corticosteroids to practice good oral care ?
use good mouth care and check mouth daily for lesions or drainage because these
drugs reduce local immunity and increase the risk for local infections, especially
Candida albicans (yeast)
Blocks the leukotriene receptor, preventing the inflammatory mediator from
stimulating inflammation. Purpose is to prevent asthma attack triggered by
inflammation or allergens.
Leukotriene Modifiers
Patient education for Montelukast drugs
use the drug daily, even when no symptoms are present, because maximum
effectiveness requires continued use for 48-72 hours and depends on regular use.
Do not decrease the dose of or stop taking any other asthma drugs unless instructed by
the health care professional because this drug is for long-term asthma control and does
not replace other drugs, especially corticosteroids and reliever (rescue) drugs.
Risk factors of COPD
Cigarette smoking, environmental factors, genetics, asthma, Alpha 1 -antitrypsin
deficiency, hx of asthma
Normal ABGs
pH: 7.35 - 7.45
PaCO2: 35 - 45
HCO3: 22 - 26
PaO2: 80 - 100
T/F: Ensure that no open flames (e.g., smoking, fireplaces, burning candles) or
other combustion hazards are in rooms where oxygen is in use.
True
a severe, life-threatening acute episode of airway obstruction that intensifies
once it begins and often does not respond to usual therapy; If the condition is not
reversed, the patient may develop pneumothorax and cardiac or respiratory
arrest.
Status Asthmaticus
Intervention for status asthmaticus
IV fluids, potent systemic bronchodilators, steroids, epinephrine, and oxygen are given
immediately to reverse the condition.
a destructive problem of lung elastic tissue that reduces its ability to recoil after
stretching, leading to hyperinflation of the lung
Emphysema
a collection of lower airway disorders that interfere with airflow and gas exchange
.
COPD
