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NURS 590 Exam 2 study guide + practice
questions Questions and Correct
Answers the Latest Update
try to differentiate COPD from Asthma
✓ 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
✓ 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
✓ 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
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✓ 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
✓ 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
✓ assessment of copd sx
initial pharmacological tx: all should have a SABA for relief
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✓ 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
✓ 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
✓ 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
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NURS 590 Exam 2 study guide + practice
questions Questions and Correct
Answers the Latest Update
try to differentiate COPD from Asthma
✓ 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
✓ 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
✓ 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
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✓ 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
✓ 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
✓ assessment of copd sx
initial pharmacological tx: all should have a SABA for relief
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✓ 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
✓ 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
✓ 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
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