The symptoms that are common to all types of interstitial lung disease are shortness
of breath and non-productive cough.
Give this one a try later!
This statement is true. The symptoms that are common to all types of
interstitial lung disease are shortness of breath and non-productive cough.
,All asthma symptoms tend to occur at night or in the early morning hours. This is a key
feature in the diagnosis of asthma. Night and early morning symptoms may be a
concern. The inability to sleep impacts the individual's quality of life as symptoms of
chest tightness, shortness of breath, coughing and wheezing interrupts sleep. More
importantly, worsening of nighttime symptoms that could indicate that further
management of the asthma is needed. Although the reasons for the worsening of
asthma symptoms at night in some individuals is not clearly understood, there are
some factors to be considered. First, there may be environmental triggers in the
mattress such as dust mites and pet dander that trigger a reaction.
Another potential cause may relate to gastric reflux that may aggravate asthma
symptoms at night. Sleeping position may also be factor, especially the reclining
position that compresses the airways decreasing lung volumes. Post-nasal drip and
coughing also contribute to airway irritation. Bronchospasms may occur as a result of
airway cooling during the night.
Physiologically, cortisol levels are higher during the day, but decrease during the
night. Decreased cortisol levels results in an increase in histamine levels that lead to
increased mucus production and inflammation. There is also decreased levels of
epinephrine and increased vagal tone that contributes to nighttime asthma symptoms.
Give this one a try later!
Asthma Characteristics
Asthma is a complex obstructive disease. The wide range of environmental
triggers for the condition, the variety of inflammatory chemicals released
during an exacerbation, and the large number of genes that may play a
role in the susceptibility and development of asthma underscores that no
two patients may experience the exact same disease progression nor
respond the same way to treatment.
The typical presentation during the onset of an attack is chest tightness,
expiratory wheezing, dyspnea, non-productive cough, prolonged
expiration, tachycardia, and tachypnea. In more severe attacks, the patient
will use the accessory muscles to breath. Status asthmaticus may result if
bronchospasm is not reversed with treatment. In this case, hypoxemia
worsens, expiratory flow rates further decrease and ventilation decreases
resulting in acidosis. The absence of breath sounds and a PaCO2 greater
, than 70 mmHg are signs of impending death.
The types of asthma are staged as either intermittent or persistent.
Persistent is divided into mild, moderate and severe. Staging considers the
frequency of day and nighttime symptoms, the impact on activity level, the
frequency of severe exacerbations and the FEV1 and FEV1/FEV results.
These are summarized in the following table.
-Triggered by a variety of non-allergic factors (chemicals, airborne irritants, infections,
exercise, stress, anxiety, GERD, obesity)
-No elevation in IgE
-More common in adults less than 40 years of age
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Intrinsic
Step 2
Preferred: Low-dose ICS + LABA or medium-dose ICS
Alternative: Cromolyn, LTRA, nedocromil or theophylline
Step 3
Preferred: Low-dose ICS + LABA or medium-dose ICS
Alternative: Low-dose ICS + LTRA, theophylline or zileuton
Step 4
Preferred: Medium-dose ICS + LABA
Alternative: Medium-dose ICS + LTRA, theophylline or zileuton
Step 5
Preferred: High-dose ICS + LABA
Consider: Omalizumab for patients with allergies
Step 6
, Preferred: High-dose ICS + LABA + OCS
Consider: Omalizumab for patients with allergies
Give this one a try later!
Asthma Severity: Persistent Asthma
Steps 2-4 consider subcutaneous allergen immunotherapy for patients with
allergic asthma
In order to classify the respiratory issue as either obstructive, restrictive or normal.,
the NP starts by looking at the FEV1/FVC ratio.
Obstructive pattern: If the FEV1/FVC ratio is "less than 70%" or less than the lower limit
of normal for the patient. FEV1 also falls to a greater degree than the FVC.
Restrictive pattern: If the FEV1/FVC ratio is "greater than 70%" or greater than the
lower limit of normal, then the spirometry test is either normal, or a restrictive
respiratory abnormality is present.
To make this distinction, the NP must look at the TLC. In restrictive disorders, the
percent predicted of TLC is <80%, where 80-120% represents a normal range.
Give this one a try later!
Step 1 - Determine the pattern
Obstructive disorders are characterized by obstruction to airflow during expiration.
This can be related to conditions that increase mucus production leading to mucus
plugs as in the case of chronic bronchitis or the loss of surface area of the lung that
decreases areas of gas exchange as a result in inflammatory processes that destroys
the lung's elastic resulting in decreased recoil.
Regardless of the cause of the obstruction, there is an increased work of breathing
of breath and non-productive cough.
Give this one a try later!
This statement is true. The symptoms that are common to all types of
interstitial lung disease are shortness of breath and non-productive cough.
,All asthma symptoms tend to occur at night or in the early morning hours. This is a key
feature in the diagnosis of asthma. Night and early morning symptoms may be a
concern. The inability to sleep impacts the individual's quality of life as symptoms of
chest tightness, shortness of breath, coughing and wheezing interrupts sleep. More
importantly, worsening of nighttime symptoms that could indicate that further
management of the asthma is needed. Although the reasons for the worsening of
asthma symptoms at night in some individuals is not clearly understood, there are
some factors to be considered. First, there may be environmental triggers in the
mattress such as dust mites and pet dander that trigger a reaction.
Another potential cause may relate to gastric reflux that may aggravate asthma
symptoms at night. Sleeping position may also be factor, especially the reclining
position that compresses the airways decreasing lung volumes. Post-nasal drip and
coughing also contribute to airway irritation. Bronchospasms may occur as a result of
airway cooling during the night.
Physiologically, cortisol levels are higher during the day, but decrease during the
night. Decreased cortisol levels results in an increase in histamine levels that lead to
increased mucus production and inflammation. There is also decreased levels of
epinephrine and increased vagal tone that contributes to nighttime asthma symptoms.
Give this one a try later!
Asthma Characteristics
Asthma is a complex obstructive disease. The wide range of environmental
triggers for the condition, the variety of inflammatory chemicals released
during an exacerbation, and the large number of genes that may play a
role in the susceptibility and development of asthma underscores that no
two patients may experience the exact same disease progression nor
respond the same way to treatment.
The typical presentation during the onset of an attack is chest tightness,
expiratory wheezing, dyspnea, non-productive cough, prolonged
expiration, tachycardia, and tachypnea. In more severe attacks, the patient
will use the accessory muscles to breath. Status asthmaticus may result if
bronchospasm is not reversed with treatment. In this case, hypoxemia
worsens, expiratory flow rates further decrease and ventilation decreases
resulting in acidosis. The absence of breath sounds and a PaCO2 greater
, than 70 mmHg are signs of impending death.
The types of asthma are staged as either intermittent or persistent.
Persistent is divided into mild, moderate and severe. Staging considers the
frequency of day and nighttime symptoms, the impact on activity level, the
frequency of severe exacerbations and the FEV1 and FEV1/FEV results.
These are summarized in the following table.
-Triggered by a variety of non-allergic factors (chemicals, airborne irritants, infections,
exercise, stress, anxiety, GERD, obesity)
-No elevation in IgE
-More common in adults less than 40 years of age
Give this one a try later!
Intrinsic
Step 2
Preferred: Low-dose ICS + LABA or medium-dose ICS
Alternative: Cromolyn, LTRA, nedocromil or theophylline
Step 3
Preferred: Low-dose ICS + LABA or medium-dose ICS
Alternative: Low-dose ICS + LTRA, theophylline or zileuton
Step 4
Preferred: Medium-dose ICS + LABA
Alternative: Medium-dose ICS + LTRA, theophylline or zileuton
Step 5
Preferred: High-dose ICS + LABA
Consider: Omalizumab for patients with allergies
Step 6
, Preferred: High-dose ICS + LABA + OCS
Consider: Omalizumab for patients with allergies
Give this one a try later!
Asthma Severity: Persistent Asthma
Steps 2-4 consider subcutaneous allergen immunotherapy for patients with
allergic asthma
In order to classify the respiratory issue as either obstructive, restrictive or normal.,
the NP starts by looking at the FEV1/FVC ratio.
Obstructive pattern: If the FEV1/FVC ratio is "less than 70%" or less than the lower limit
of normal for the patient. FEV1 also falls to a greater degree than the FVC.
Restrictive pattern: If the FEV1/FVC ratio is "greater than 70%" or greater than the
lower limit of normal, then the spirometry test is either normal, or a restrictive
respiratory abnormality is present.
To make this distinction, the NP must look at the TLC. In restrictive disorders, the
percent predicted of TLC is <80%, where 80-120% represents a normal range.
Give this one a try later!
Step 1 - Determine the pattern
Obstructive disorders are characterized by obstruction to airflow during expiration.
This can be related to conditions that increase mucus production leading to mucus
plugs as in the case of chronic bronchitis or the loss of surface area of the lung that
decreases areas of gas exchange as a result in inflammatory processes that destroys
the lung's elastic resulting in decreased recoil.
Regardless of the cause of the obstruction, there is an increased work of breathing
