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Exam (elaborations)

Pnp 301 Final Exam Respiratory Disorders

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PNP 301 FINAL EXAM RESPIRATORY DISORDERS

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PNP 301 FINAL EXAM: RESPIRATORY DISORDERS

Asthma is a disease that involves - Answers - - periodic episodes of severe, reversible
bronchial obstruction in its with: hypersensitive or hyperresponsive airways

Frequent repeated attacks of acute asthma may lead to... - Answers - Irreversible lung
damage and development of chronic asthma (C.O.L.D
(chronic obstructive lung disease))

Asthma is classified into two types - Answers - Extrinsic and Intrinsic asthma

Extrinsic asthma - Answers - is more common in childhood, and causes bronchioles
constriction as a result of an outside substance like dust.

-hypersensitivity

- family hx of allergic conditions ex. Allergic rhinitis, eczema

Intrinsic asthma - Answers - is more common in adults where no specific cause for the
bronchioles constriction can be identified

-hyperresponsiveness

-resp infections
-stress
-exposure to cold
-exercise
-drugs ex. Aspirin
- inhaling irritants ex. Cigarette smoke

Can patients have a combination of intrinsic and extrinsic asthma? - Answers - yes,
many pts do

Asthma can be classified in 2 different ways: acute or chronic - Answers - Acute: single
episode
Chronic: long-term condition

Case of asthma on a clinical scale rating - Answers - mild and intermittent to severe
and persistent

All types of asthma exhibit the same path changes r/t inflammation during an acute
attack. The bronchi & bronchioles respond to the stimuli with 3 changes... - Answers -
1. Inflammation
2. Contraction of sm (bronchoconstriction)

,3. Increased secretion of thick mucus in the airway

These 3 changes can... - Answers - can cause partial or total obstruction of airways

-interferes w/ airflow and o2 supply

In patients with extrinsic asthma, the antigen reacts with immunoglobulin E and
release.... Which causes... - Answers - - histamine
-kinins
-prostaglandins
-other chemical mediators

CAUSES INFLAMMATION, BRONCHOSPASM, EDEMA, INCREASED MUCUS
SECRETION

AND BRONCHOCONSTRICTION

What do leukotrienes do? (chemical mediators) - Answers - cause prolonged
inflammation, bronchoconstriction, and epithet damage

Partial obstruction of the small bronchi and bronchioles results in... - Answers - air
trapping and hyperinflation of the lungs

Total obstruction of the airway results when... - Answers - mucus plugs completely
block the flow of air in the already narrowed passage.


- this leads to atelectasis or nonaeration of tissue distal to the obstruction

Both partial and total airway obstruction lead to - Answers - marked hypoxia

Status asthmaticus - Answers - a severe, life-threatening asthma attack that can put
the patient at risk for developing respiratory failure.
- r/t inadequate medical treatment

- MEDICAL EMERGENCY
- does not respond to usual therapy
- may be fatal because of severe hypoxia and acidosis ----> cardiac arrhythmias or CNS
depression

Etiology of asthma - Answers - - family hx of hay fever, eczema
- viral upper resp infections precipitate attacks

Contributing factors: sedentary lifestyles, kids staying indoors resulting in increased
exposure to allergens amid poor ventilation, increased air pollution

, How do you know when a pt is undergoing respiratory failure? - Answers - - decreased
responsiveness
- cyanosis

Signs and symptoms of an acute asthma attack - Answers - - cough
- dyspnea
- chest tightness w/ agitation
- wheezing
- rapid, laboured breathing
- thick and tenacious or sticky mucus coughed up
- tachycardia
- pulsus paradoxus
- hypoxia
- respiratory alkalosis d/t hyperventilation
- respiratory acidosis d/t air trapping

- severe respiratory distress, - hypoventilation ---> to increasing hypoxemia &
respiratory acidosis

- respiratory failure indicated by decreasing responsiveness, cyanosis and ABG
measurements: pao2 < 50 mm Hg or a paco2 >50 mm Hg

Treatment of asthma - Answers - - skin tests to determine stimuli to be avoided
- avoid triggers ex. Dust, smoke, aspirin
- good ventilation
- swimming, walking
- prophylactic meds
- controlled breathing techniques
- bronchodilator


Minimizing the number and severity of acute attacks to prevent permanent lung
damage, reduce risk of infection, prevent development of COLD

Asthma Diagnostic Tests - Answers - - History and physical exams
- Spirometry
- abgs
- Allergy skin testing
- lung function test

These things may occur in the progression of asthma - Answers - - respiratory
alkalosis
- respiratory acidosis
- severe respiratory distress
- respiratory failure

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