NUR 330: Exam 1 (Resp) UPDATED ACTUAL Questions and
CORRECT Answers
For asthma pts: exposure to allergens/ irritants trigger an bronchoconstriction, hyperresponsiveness (increase HR and anxiety), and edema
inflammatory response leading to... of the airways
If asthma is left untreated what could result in the lungs? hypertrophy
What are early signs of an asthma attack? wheezing on expiration, sharp pain and chest tightness
Is lack of wheezing a good or bad sign for patients Wheezing is a "good" sign as it indicates some air exchange, if there was no sound
experiencing an asthma attack? (silent chest) that indicates no air exchanges meaning bronchioles are fully
closed/ mucus clogged the airways
What does hyperventilation and air trapping lead to? hypoxemia and decreased PaCO2 --> pH to increase (respiratory alkalosis)
- becomes respiratory acidosis as the patients tired= sign of respiratory failure
What is a tension pneumothorax? air accumulates in the space between the lung and chest wall, shifting the heart
and other structures to the opporite side
-MED EMERGENCY
Clinical manifestations of tension pneumothorax severe SOB, rapid and shallow breathing, tachycardia, tracheal deviation to the
good side, decreased or absent breath sounds on affected side, neck vein
distention, cyanosis, and diaphoresis
What is Status asthmaticus? extreme acute asthma attack that does not improve with regular bronchodilators
or corticosteroids
s/sx: hypoxia, hypercapnia, acute resp failire, chest tightness, short shallow breath,
wheeze or no air movement, cough, sweating, difficulty talking
, What can occur if Status asthmaticus is not recognized? hypotension, bradycardia, and respiratory or cardiac arrest
What IV medication is administered as emergency IV magnesium sulfate
treatment for Status asthmaticus?
Why are Status asthmaticus patient's sedated? to control hyper responsiveness/ anxiety
What is the normal peak expiratory flow rate? When Normal= 80-100%
should you do to the hospital/ call HCP? If < 50% Call HCP/ Go to hospital
What OTC medication should asthma patients avoid and NSAIDs and ASA, as they cause spasms
why?
what does a spirometry measure? lung volume and capacities
What are some expected side effects of bronchodilator tremors, HA, tachycardia, and nausea
use?
What are some signs of a severe asthma attack? frightened, tachycardia, tachypnea, accessory muscle use, tripod position,
wheezing,
What are some collaborative care actions in the hospital - Supplemental O2 and oximetry
for severe asthma attack patients? - Monitor PEFR, ABGs, VS
- Bronchodilators and IV/PO corticosteroids
Short-acting beta agonists (SABA) Example: albuterol
Example: Action: used to treat acute attacks, causes bronchodilation to open airways
Action: Side Effect: tachycardia and tremors
Side Effects
Long acting beta agonists (LABA) Example: salmeterol (COPD) and formoterol (ASTHMA)
Example: Action: achieve and maintain control of asthma on a daily basis , causes
Action: bronchodilation
Side Effects Side Effects: tremors, HA
Corticosteroids Example: fluticasone and budesonide (inhaled) and prednisone (PO/IV)
Example: Action: anti-inflammatory , reduce bronchial hyper-responsiveness, and decrease
Action: mucus production
Side Effects Side Effects: 6 "S"s (high sugar, soggy bones, sex drive decreased, sad, sick, and
salt and water retention)
Why should patients wash their mouth after inhaled To reduce the risk of thrush
corticosteroid use?
Methylxanthine Example: aminophylline (IV) and theophylline (PO)
Example: Action: bronchodilation to alleviate early attacks but has little effect on bronchial
Action: hyperreponsivenes
Side Effects: Side Effects: HA, tachycardia, and dysrhythmia
theophylline has a narrow therapeutic range (10-20 mcg/ml)
CORRECT Answers
For asthma pts: exposure to allergens/ irritants trigger an bronchoconstriction, hyperresponsiveness (increase HR and anxiety), and edema
inflammatory response leading to... of the airways
If asthma is left untreated what could result in the lungs? hypertrophy
What are early signs of an asthma attack? wheezing on expiration, sharp pain and chest tightness
Is lack of wheezing a good or bad sign for patients Wheezing is a "good" sign as it indicates some air exchange, if there was no sound
experiencing an asthma attack? (silent chest) that indicates no air exchanges meaning bronchioles are fully
closed/ mucus clogged the airways
What does hyperventilation and air trapping lead to? hypoxemia and decreased PaCO2 --> pH to increase (respiratory alkalosis)
- becomes respiratory acidosis as the patients tired= sign of respiratory failure
What is a tension pneumothorax? air accumulates in the space between the lung and chest wall, shifting the heart
and other structures to the opporite side
-MED EMERGENCY
Clinical manifestations of tension pneumothorax severe SOB, rapid and shallow breathing, tachycardia, tracheal deviation to the
good side, decreased or absent breath sounds on affected side, neck vein
distention, cyanosis, and diaphoresis
What is Status asthmaticus? extreme acute asthma attack that does not improve with regular bronchodilators
or corticosteroids
s/sx: hypoxia, hypercapnia, acute resp failire, chest tightness, short shallow breath,
wheeze or no air movement, cough, sweating, difficulty talking
, What can occur if Status asthmaticus is not recognized? hypotension, bradycardia, and respiratory or cardiac arrest
What IV medication is administered as emergency IV magnesium sulfate
treatment for Status asthmaticus?
Why are Status asthmaticus patient's sedated? to control hyper responsiveness/ anxiety
What is the normal peak expiratory flow rate? When Normal= 80-100%
should you do to the hospital/ call HCP? If < 50% Call HCP/ Go to hospital
What OTC medication should asthma patients avoid and NSAIDs and ASA, as they cause spasms
why?
what does a spirometry measure? lung volume and capacities
What are some expected side effects of bronchodilator tremors, HA, tachycardia, and nausea
use?
What are some signs of a severe asthma attack? frightened, tachycardia, tachypnea, accessory muscle use, tripod position,
wheezing,
What are some collaborative care actions in the hospital - Supplemental O2 and oximetry
for severe asthma attack patients? - Monitor PEFR, ABGs, VS
- Bronchodilators and IV/PO corticosteroids
Short-acting beta agonists (SABA) Example: albuterol
Example: Action: used to treat acute attacks, causes bronchodilation to open airways
Action: Side Effect: tachycardia and tremors
Side Effects
Long acting beta agonists (LABA) Example: salmeterol (COPD) and formoterol (ASTHMA)
Example: Action: achieve and maintain control of asthma on a daily basis , causes
Action: bronchodilation
Side Effects Side Effects: tremors, HA
Corticosteroids Example: fluticasone and budesonide (inhaled) and prednisone (PO/IV)
Example: Action: anti-inflammatory , reduce bronchial hyper-responsiveness, and decrease
Action: mucus production
Side Effects Side Effects: 6 "S"s (high sugar, soggy bones, sex drive decreased, sad, sick, and
salt and water retention)
Why should patients wash their mouth after inhaled To reduce the risk of thrush
corticosteroid use?
Methylxanthine Example: aminophylline (IV) and theophylline (PO)
Example: Action: bronchodilation to alleviate early attacks but has little effect on bronchial
Action: hyperreponsivenes
Side Effects: Side Effects: HA, tachycardia, and dysrhythmia
theophylline has a narrow therapeutic range (10-20 mcg/ml)
