NUR 917 Module 3 Test With
Complete Solution
What are differentials for persistent cough other than asthma? - ANSWER
lung cancer, TB, LSHF, cystic fibrosis, interstitial lung disease, bronchiectasis,
idiopathic cough, chronic allergic rhinitis, post nasal drip syndrome, upper
airway cough syndrome, GERD, medications (ACEIs)
What are the criteria for making a diagnosis of asthma? - ANSWER symptoms
and spirometry
-episodic wheeze, SOB, cough and/or chest tightness
-variable expiratory airflow limitation
What are some pertinent (+) for asthma? - ANSWER variable airflow
obstruction, symptoms vary day by day, s/s worse at night or early morning,
allergy/rhinitis/eczema also present, family hx asthma, childhood
presentation often
Intermittent asthma is also referred to as exercise induced bronchospasm
and often treated with SABA and adequate warm-up prior to exercise. Why
should this be closely monitored and addressed at least annually? - ANSWER
-Effectiveness can vary over time, so need to assess the need for treatment
and effectiveness of regimen
-Make sure they are taking the correct dose, using their inhaler correctly,
how often they are using it
What is the criteria for assessing asthma control? - ANSWER no night time
,waking, interference with normal activity, reliever medication needed 2+
times/week, or daytime asthma symptoms 2+ times/week
When is asthma considered well controlled? - ANSWER absence of these
components in the last 4 weeks:
-no night time waking
-interference with normal activity
-reliever medication needed 2+ times/week
-daytime asthma symptoms 2+ times/week
When is asthma considered not controlled? - ANSWER 3 or 4 of these
components in the last 4 weeks:
-no night time waking
-interference with normal activity
-reliever medication needed 2+ times/week
-daytime asthma symptoms 2+ times/week
What is the goal of asthma therapy? - ANSWER To achieve good symptom
control, maintain normal activity levels & to minimize future risk of
asthma-related mortality, exacerbation, persistent airflow limitation and
side-effects of treatment
*The pts own goals for their asthma and its treatment should also be
identified
What is single maintenance and reliever therapy (SMART)? - ANSWER using
the same medication as maintenance (daily) and reliever (PRN)
,What medications are under the SMART inhaler use? - ANSWER ICS with
formoterol
-budesonide-formoterol (Symbicort)
-beclometasone-formoterol (Fostair or Luforbec)
What is step-up therapy and when is this instituted? - ANSWER -stepwise
method of treating symptoms of asthma and is individualized for each
person
-utilized at time of diagnosis to get s/s under control or during temporary
loss of acceptable control (illness/exacerbation)
What is step 1 of asthma management? - ANSWER controller:
1. PRN low dose ICS-formoterol
2. low dose ICS with SABA use
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is step 2 of asthma management? - ANSWER controller:
1. daily low dose ICS or PRN low-dose ICS-formoterol
2. LTRA or low-dose ICS with SABA use
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
, What is step 3 of asthma management? - ANSWER controller:
1. low dose ICS-LABA
2. medium dose ICS or low-dose ICS-LTRA
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is step 4 of asthma management? - ANSWER controller:
1. medium-dose ICS-LABA
2. high-dose ICS, add on LTRA, or add on tioptropium
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is step 5 of asthma management? - ANSWER controller:
1. high-dose ICS-LABA
*refer for phenotypic assessment/add on therapy
2. add low-dose OCS but consider SE
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is the difference in asthma diagnosis for children 5 and under? -
Complete Solution
What are differentials for persistent cough other than asthma? - ANSWER
lung cancer, TB, LSHF, cystic fibrosis, interstitial lung disease, bronchiectasis,
idiopathic cough, chronic allergic rhinitis, post nasal drip syndrome, upper
airway cough syndrome, GERD, medications (ACEIs)
What are the criteria for making a diagnosis of asthma? - ANSWER symptoms
and spirometry
-episodic wheeze, SOB, cough and/or chest tightness
-variable expiratory airflow limitation
What are some pertinent (+) for asthma? - ANSWER variable airflow
obstruction, symptoms vary day by day, s/s worse at night or early morning,
allergy/rhinitis/eczema also present, family hx asthma, childhood
presentation often
Intermittent asthma is also referred to as exercise induced bronchospasm
and often treated with SABA and adequate warm-up prior to exercise. Why
should this be closely monitored and addressed at least annually? - ANSWER
-Effectiveness can vary over time, so need to assess the need for treatment
and effectiveness of regimen
-Make sure they are taking the correct dose, using their inhaler correctly,
how often they are using it
What is the criteria for assessing asthma control? - ANSWER no night time
,waking, interference with normal activity, reliever medication needed 2+
times/week, or daytime asthma symptoms 2+ times/week
When is asthma considered well controlled? - ANSWER absence of these
components in the last 4 weeks:
-no night time waking
-interference with normal activity
-reliever medication needed 2+ times/week
-daytime asthma symptoms 2+ times/week
When is asthma considered not controlled? - ANSWER 3 or 4 of these
components in the last 4 weeks:
-no night time waking
-interference with normal activity
-reliever medication needed 2+ times/week
-daytime asthma symptoms 2+ times/week
What is the goal of asthma therapy? - ANSWER To achieve good symptom
control, maintain normal activity levels & to minimize future risk of
asthma-related mortality, exacerbation, persistent airflow limitation and
side-effects of treatment
*The pts own goals for their asthma and its treatment should also be
identified
What is single maintenance and reliever therapy (SMART)? - ANSWER using
the same medication as maintenance (daily) and reliever (PRN)
,What medications are under the SMART inhaler use? - ANSWER ICS with
formoterol
-budesonide-formoterol (Symbicort)
-beclometasone-formoterol (Fostair or Luforbec)
What is step-up therapy and when is this instituted? - ANSWER -stepwise
method of treating symptoms of asthma and is individualized for each
person
-utilized at time of diagnosis to get s/s under control or during temporary
loss of acceptable control (illness/exacerbation)
What is step 1 of asthma management? - ANSWER controller:
1. PRN low dose ICS-formoterol
2. low dose ICS with SABA use
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is step 2 of asthma management? - ANSWER controller:
1. daily low dose ICS or PRN low-dose ICS-formoterol
2. LTRA or low-dose ICS with SABA use
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
, What is step 3 of asthma management? - ANSWER controller:
1. low dose ICS-LABA
2. medium dose ICS or low-dose ICS-LTRA
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is step 4 of asthma management? - ANSWER controller:
1. medium-dose ICS-LABA
2. high-dose ICS, add on LTRA, or add on tioptropium
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is step 5 of asthma management? - ANSWER controller:
1. high-dose ICS-LABA
*refer for phenotypic assessment/add on therapy
2. add low-dose OCS but consider SE
reliever:
1. PRN low-dose ICS-formoterol
2. PRN SABA (not preferred)
What is the difference in asthma diagnosis for children 5 and under? -
