NURS 590 Exam 2 Study Guide + Practice
Questions With Solution
Try to differentiate COPD from Asthma - ANSWER asthma is reversible, copd
is not
COPD sx: sob, chronic cough, sputum, wheezing/chest tightness, risk factors:
host factors, exposure to particles: tobacco, pollution, occupation, disease
related
key indicators for considering copd - ANSWER dyspnea that progresses over
time, is persistent, and characteristically worse with exercise
chronic cough: may be intermittent, un productive, with recurrent wheeze
chronic sputum production: any pattern of chronic sputum production is
suspicious for copd
modified mrc dyspnea scale - ANSWER grade 0: i only get breathless with
strenuous exercise
grade 1: i only get breathless when hurrying on the level, walking up a hill
grade 2: i walk slower than people of the same age on the level bc of
breathlessness, or i have to stop to catch my breath when walking at my own
pace on the level
grade 3: stop for breath after walking 100 m or few minutes on level
grade 4: too breathless when leaving house, dressing or undressing
COPD meds - ANSWER Beta 2 agonists- Bronchodilators • Short-acting Beta
Agonists (SABA)• Albuterol• Long-Acting Beta Agonists (LABA)•
,Formoterol/Salmeterol• Muscarinic Antagonists
(Antimuscarinic/Anticholinergic)-decrease secretions• Long-Acting
Muscarinic Agonists (LAMA)• Tiotropium• Methylxanthines• Theophylline•
Anti-inflammatory (usually in combination LABA)• Inhaled corticosteroids•
Oral corticosteroids• PDE4 (Pharphodiesterase-4) Inhibitors• Roflumilast•
Antibiotics• Azithromycin/Erythromycin• Mucolytics and Antitoxin agents•
Carbocysteine and N-acetylcystine • Immunoregulator drugs
GOLD guidelines for copd 2022 - ANSWER spirometrically confirmed
diagnosis--> assessment airflow limitation-->assessment of symptoms risks/
factors
GOLD 1 FEV1 >=80
GOLD 2 FEV1 50-79
GOLD 3 30-49
GOLD 4 <30
>= 2 or >= 1 leading to hospital admission
0 or 1 (not leading to hospital admisison)
CAT assessment - ANSWER assessment of copd sx
initial pharmacological tx: all should have a SABA for relief - ANSWER
exacerbation risk: more exacerbations- >= 2 moderate exacerbations or >= 1
leading to hospitalization- apply the drugs to the clinical sx Group c- LAMA,
group d: LAMA or LAMA + LABA (CAT .20) or ICS + LABA (eos >= 300)
Few exacerbations: 0 or 1 moderate exacerbations not leading to hospital
admission
, group a: a bronchodilator SABA/ LABA, group B LABA or LAMA.
assess symptoms: mMRC 0-1, CAt ,10. fewer daily symptoms
mMRC .= 2, CAT >= 10 more daily symptoms
exacerbations: discrete episodes characterized by acute worsening of
symptoms (increased dyspnea, sputum volume, purulence) beyond usual
day-to-day variation and requiring intervention
commonly used maintenance medications in COPD- SABA and LABA -
ANSWER short acting:
salbutamol (albuterol)= onset of action 5 min
MDI & DPI inhaler- pill, syrup, ER tablet, pill, nebulizer, injection, duration of
action: 4-6 hrs, 12 hrs (ER)
long acting:
formoterol DPI inhaler- onset of action <= 12 min duration of action 12 hrs
salmeterol:MDI % DPi inhaler, - onset of action <20 min duration of action 12
hrs
COPD muscarinic antagonist- anticholintergics, LAMA - ANSWER ipratropium
broicde- inhaler type MDI, nebulizer, duration of action 6-8 hrs
tiotropium inhaler DPI, SMI, MDI, duratio of action 24 hrs
location/action: exocrine glands and smooth muscle, reverses increase in
secretions, smooth muscle contraction
Tiffany is a 25 year old presenting to the clinic for complaints of a headache.
The nurse practitioner diagnoses her with a tension headache. Which of the
Questions With Solution
Try to differentiate COPD from Asthma - ANSWER asthma is reversible, copd
is not
COPD sx: sob, chronic cough, sputum, wheezing/chest tightness, risk factors:
host factors, exposure to particles: tobacco, pollution, occupation, disease
related
key indicators for considering copd - ANSWER dyspnea that progresses over
time, is persistent, and characteristically worse with exercise
chronic cough: may be intermittent, un productive, with recurrent wheeze
chronic sputum production: any pattern of chronic sputum production is
suspicious for copd
modified mrc dyspnea scale - ANSWER grade 0: i only get breathless with
strenuous exercise
grade 1: i only get breathless when hurrying on the level, walking up a hill
grade 2: i walk slower than people of the same age on the level bc of
breathlessness, or i have to stop to catch my breath when walking at my own
pace on the level
grade 3: stop for breath after walking 100 m or few minutes on level
grade 4: too breathless when leaving house, dressing or undressing
COPD meds - ANSWER Beta 2 agonists- Bronchodilators • Short-acting Beta
Agonists (SABA)• Albuterol• Long-Acting Beta Agonists (LABA)•
,Formoterol/Salmeterol• Muscarinic Antagonists
(Antimuscarinic/Anticholinergic)-decrease secretions• Long-Acting
Muscarinic Agonists (LAMA)• Tiotropium• Methylxanthines• Theophylline•
Anti-inflammatory (usually in combination LABA)• Inhaled corticosteroids•
Oral corticosteroids• PDE4 (Pharphodiesterase-4) Inhibitors• Roflumilast•
Antibiotics• Azithromycin/Erythromycin• Mucolytics and Antitoxin agents•
Carbocysteine and N-acetylcystine • Immunoregulator drugs
GOLD guidelines for copd 2022 - ANSWER spirometrically confirmed
diagnosis--> assessment airflow limitation-->assessment of symptoms risks/
factors
GOLD 1 FEV1 >=80
GOLD 2 FEV1 50-79
GOLD 3 30-49
GOLD 4 <30
>= 2 or >= 1 leading to hospital admission
0 or 1 (not leading to hospital admisison)
CAT assessment - ANSWER assessment of copd sx
initial pharmacological tx: all should have a SABA for relief - ANSWER
exacerbation risk: more exacerbations- >= 2 moderate exacerbations or >= 1
leading to hospitalization- apply the drugs to the clinical sx Group c- LAMA,
group d: LAMA or LAMA + LABA (CAT .20) or ICS + LABA (eos >= 300)
Few exacerbations: 0 or 1 moderate exacerbations not leading to hospital
admission
, group a: a bronchodilator SABA/ LABA, group B LABA or LAMA.
assess symptoms: mMRC 0-1, CAt ,10. fewer daily symptoms
mMRC .= 2, CAT >= 10 more daily symptoms
exacerbations: discrete episodes characterized by acute worsening of
symptoms (increased dyspnea, sputum volume, purulence) beyond usual
day-to-day variation and requiring intervention
commonly used maintenance medications in COPD- SABA and LABA -
ANSWER short acting:
salbutamol (albuterol)= onset of action 5 min
MDI & DPI inhaler- pill, syrup, ER tablet, pill, nebulizer, injection, duration of
action: 4-6 hrs, 12 hrs (ER)
long acting:
formoterol DPI inhaler- onset of action <= 12 min duration of action 12 hrs
salmeterol:MDI % DPi inhaler, - onset of action <20 min duration of action 12
hrs
COPD muscarinic antagonist- anticholintergics, LAMA - ANSWER ipratropium
broicde- inhaler type MDI, nebulizer, duration of action 6-8 hrs
tiotropium inhaler DPI, SMI, MDI, duratio of action 24 hrs
location/action: exocrine glands and smooth muscle, reverses increase in
secretions, smooth muscle contraction
Tiffany is a 25 year old presenting to the clinic for complaints of a headache.
The nurse practitioner diagnoses her with a tension headache. Which of the
