PN2 Exam #2 Study Guide
ASTHMA
• Characterized by exacerbations of acute airway inflammation
• Airway obstruction occurs d/t bronchoconstriction, mucous, or inflammation when exposed
to trigger
Clinical Manifestations:
• High pitched, wheezing lung sounds
• Cough
• SOB
• Chest tightness
• Worsens at night or when triggers are present
Medications:
• Short Acting= Albuterol, Proventil, Ventoli
• Long Acting= Serevent
• Corticosteroids= Serevent, Advair
Education:
• Avoid triggers
• Stop/avoid smoking
• Teach which inhaler is rescue
Exacerbation Interventions:
• Give short-acting beta agonist
• IV corticosteroids depending on severity
• O2 via nasal cannula
• High-fowler’s position
• Calm atmosphere
Questions:
If a pt. is having an asthma attack how would you expect it to affect their VS?
• At first RR increased then decreased as attack progresses
• Tachycardia >120
• Decreased BP
If you give a pt. Albuterol, what type of side effects would you expect to see?
• Increased HR
• Tremors
What are rescue medications for Asthma?
• Short-acting beta agonists (Albuterol)
EPITAXIS
• Nose bleed – d/t trauma, allergies, drug use
• Most frequent ED complaint
Interventions & Treatment:
• Anterior portion of nose = apply direct pressure for 5-10 while leaning forward
• Apply silver nitrate
• Apply lidocaine/ep with cotton pledge for 5-10 minutes
• Nasal packing for 2-5 days
• Educate on prevention – Vaseline, humidifiers
COPD
, • Chronic obstructive pulmonary disease – emphysema & chronic bronchitis
• Causes= air pollution, occupation, smoking
Primary Symptoms:
• Cough
• Sputum production
• DOE – Dyspnea On Exertion
Clinical Manifestations:
• Wheezes or crackles heard in lungs
• Prolonged expiratory phase
• Distant heart sounds
• Orthopneic position
• Barrel chest
• Use of accessory muscles
• Weight loss (dyspnea with eating)
• Late phase= clubbing to nails, right-sided HF, chronic cyanosis
Medications:
• Avoid frequent use of cough suppressants (antitussives) because coughing is a
protective mechanism
• Limit narcotic use d/t respiratory depression can worsen hypercapnia
• Beta-Adrenergic Agonists: Albuterol, formoterol
• Anticholinergics: Atrovent, Spiriva
• Corticosteroids: short course only
• Methylxanthines: Theophylline (limited)
Interventions & Education:
• Pursed lipped breathing
• Controlled coughing
• Controlled O2 therapy (1-2 L)
• Low sodium diet
• Diaphragmic breathing
• Conserve energy
• Small frequent meals
• Increase fluids
• BiPAP
RAYNAUD’S DISEASE
• Bilateral vasospasms; peripheral artery occlusive disease triggered by cold & stress
Clinical Manifestations:
• Pain & cyanosis followed by redness and pain (when warmed up)
• Pain is intermittent, extremities are numb & cold & may have swelling/ulcerations
Education:
• Stop smoking
• Exercise
• Control stress
• Avoid extreme temperatures
ASTHMA
• Characterized by exacerbations of acute airway inflammation
• Airway obstruction occurs d/t bronchoconstriction, mucous, or inflammation when exposed
to trigger
Clinical Manifestations:
• High pitched, wheezing lung sounds
• Cough
• SOB
• Chest tightness
• Worsens at night or when triggers are present
Medications:
• Short Acting= Albuterol, Proventil, Ventoli
• Long Acting= Serevent
• Corticosteroids= Serevent, Advair
Education:
• Avoid triggers
• Stop/avoid smoking
• Teach which inhaler is rescue
Exacerbation Interventions:
• Give short-acting beta agonist
• IV corticosteroids depending on severity
• O2 via nasal cannula
• High-fowler’s position
• Calm atmosphere
Questions:
If a pt. is having an asthma attack how would you expect it to affect their VS?
• At first RR increased then decreased as attack progresses
• Tachycardia >120
• Decreased BP
If you give a pt. Albuterol, what type of side effects would you expect to see?
• Increased HR
• Tremors
What are rescue medications for Asthma?
• Short-acting beta agonists (Albuterol)
EPITAXIS
• Nose bleed – d/t trauma, allergies, drug use
• Most frequent ED complaint
Interventions & Treatment:
• Anterior portion of nose = apply direct pressure for 5-10 while leaning forward
• Apply silver nitrate
• Apply lidocaine/ep with cotton pledge for 5-10 minutes
• Nasal packing for 2-5 days
• Educate on prevention – Vaseline, humidifiers
COPD
, • Chronic obstructive pulmonary disease – emphysema & chronic bronchitis
• Causes= air pollution, occupation, smoking
Primary Symptoms:
• Cough
• Sputum production
• DOE – Dyspnea On Exertion
Clinical Manifestations:
• Wheezes or crackles heard in lungs
• Prolonged expiratory phase
• Distant heart sounds
• Orthopneic position
• Barrel chest
• Use of accessory muscles
• Weight loss (dyspnea with eating)
• Late phase= clubbing to nails, right-sided HF, chronic cyanosis
Medications:
• Avoid frequent use of cough suppressants (antitussives) because coughing is a
protective mechanism
• Limit narcotic use d/t respiratory depression can worsen hypercapnia
• Beta-Adrenergic Agonists: Albuterol, formoterol
• Anticholinergics: Atrovent, Spiriva
• Corticosteroids: short course only
• Methylxanthines: Theophylline (limited)
Interventions & Education:
• Pursed lipped breathing
• Controlled coughing
• Controlled O2 therapy (1-2 L)
• Low sodium diet
• Diaphragmic breathing
• Conserve energy
• Small frequent meals
• Increase fluids
• BiPAP
RAYNAUD’S DISEASE
• Bilateral vasospasms; peripheral artery occlusive disease triggered by cold & stress
Clinical Manifestations:
• Pain & cyanosis followed by redness and pain (when warmed up)
• Pain is intermittent, extremities are numb & cold & may have swelling/ulcerations
Education:
• Stop smoking
• Exercise
• Control stress
• Avoid extreme temperatures
