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Questions and Answers
What is a primary effect of emphysema on the lungs?
What is a primary effect of emphysema on the lungs?
Which statement best describes chronic bronchitis?
Which statement best describes chronic bronchitis?
What is the consequence of increased work of breathing in COPD patients?
What is the consequence of increased work of breathing in COPD patients?
How does chronic inflammation in bronchitis affect the bronchial airways?
How does chronic inflammation in bronchitis affect the bronchial airways?
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What physiological condition results in 'air hunger' in COPD patients?
What physiological condition results in 'air hunger' in COPD patients?
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Which of the following is NOT a direct effect of chronic bronchitis?
Which of the following is NOT a direct effect of chronic bronchitis?
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Which process describes the main consequence of long-term irritant exposure in the context of COPD?
Which process describes the main consequence of long-term irritant exposure in the context of COPD?
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What is a significant outcome of increased mucus in chronic bronchitis?
What is a significant outcome of increased mucus in chronic bronchitis?
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What primarily activates mast cells in the immediate reaction phase of asthma?
What primarily activates mast cells in the immediate reaction phase of asthma?
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Which of the following is a consequence of the late reaction in asthma?
Which of the following is a consequence of the late reaction in asthma?
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Which of the following triggers does NOT typically contribute to asthma episodes?
Which of the following triggers does NOT typically contribute to asthma episodes?
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What symptom is commonly associated with an acute asthma attack?
What symptom is commonly associated with an acute asthma attack?
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Which test is considered diagnostic for asthma?
Which test is considered diagnostic for asthma?
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Which of the following findings would be expected in pulmonary function tests for asthma?
Which of the following findings would be expected in pulmonary function tests for asthma?
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Which factor is NOT considered a risk factor for developing asthma?
Which factor is NOT considered a risk factor for developing asthma?
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What role do eosinophils play in the late reaction of asthma?
What role do eosinophils play in the late reaction of asthma?
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Which of the following measures can help reduce mold in a living environment?
Which of the following measures can help reduce mold in a living environment?
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Which of the following is a primary cause for decreased production of red blood cells?
Which of the following is a primary cause for decreased production of red blood cells?
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What is a recommended action to manage indoor dander levels?
What is a recommended action to manage indoor dander levels?
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Which of the following is NOT a suggested intervention for asthma prevention?
Which of the following is NOT a suggested intervention for asthma prevention?
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Which factor contributes to increased destruction of red blood cells?
Which factor contributes to increased destruction of red blood cells?
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What is the goal for managing humidity indoors for asthma sufferers?
What is the goal for managing humidity indoors for asthma sufferers?
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What action should be taken if asthma symptoms do not respond to treatment?
What action should be taken if asthma symptoms do not respond to treatment?
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Which of the following is typically a direct result of anemia?
Which of the following is typically a direct result of anemia?
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What is the primary goal of maintaining gas exchange in clients with COPD?
What is the primary goal of maintaining gas exchange in clients with COPD?
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Which statement indicates a client with COPD might need further management of their condition?
Which statement indicates a client with COPD might need further management of their condition?
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Which aspect of COPD care management focuses on helping the client learn techniques to manage their symptoms?
Which aspect of COPD care management focuses on helping the client learn techniques to manage their symptoms?
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In a client with COPD, which of the following findings would most likely indicate an increase in respiratory distress?
In a client with COPD, which of the following findings would most likely indicate an increase in respiratory distress?
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What is a critical nursing intervention for a client with a chest tube after pneumonectomy?
What is a critical nursing intervention for a client with a chest tube after pneumonectomy?
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Which action should the nurse prioritize after receiving a peak expiratory flow reading in the red zone from a client with asthma?
Which action should the nurse prioritize after receiving a peak expiratory flow reading in the red zone from a client with asthma?
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Which health promotion behavior is most crucial for a client with COPD who smokes?
Which health promotion behavior is most crucial for a client with COPD who smokes?
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What outcome is most indicative of successful self-management education for a client with COPD?
What outcome is most indicative of successful self-management education for a client with COPD?
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Which medication is classified as a long-acting beta 2 adrenergic agent?
Which medication is classified as a long-acting beta 2 adrenergic agent?
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What is the primary action of leukotriene inhibitors like Montelukast?
What is the primary action of leukotriene inhibitors like Montelukast?
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Which of the following symptoms indicates the need for emergency treatment in asthma?
Which of the following symptoms indicates the need for emergency treatment in asthma?
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What is a characteristic of status asthmaticus?
What is a characteristic of status asthmaticus?
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Which combination medication includes budesonide and formoterol?
Which combination medication includes budesonide and formoterol?
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What environmental modification can help minimize asthma triggers?
What environmental modification can help minimize asthma triggers?
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Which medication requires monitoring for toxicity due to its potential side effects?
Which medication requires monitoring for toxicity due to its potential side effects?
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What is the recommended frequency for administering Omalizumab for allergic type asthma?
What is the recommended frequency for administering Omalizumab for allergic type asthma?
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What is the primary aim for maintaining oxygen saturation levels in COPD patients?
What is the primary aim for maintaining oxygen saturation levels in COPD patients?
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Which of the following is a key component in managing dyspnea for COPD patients?
Which of the following is a key component in managing dyspnea for COPD patients?
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Which complication of COPD is related directly to the cardiovascular system?
Which complication of COPD is related directly to the cardiovascular system?
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What lifestyle change is strongly advised for individuals suffering from chronic bronchitis?
What lifestyle change is strongly advised for individuals suffering from chronic bronchitis?
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What is a significant risk associated with high CO2 levels in COPD patients?
What is a significant risk associated with high CO2 levels in COPD patients?
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Which method is commonly used to gauge treatment response in patients with COPD?
Which method is commonly used to gauge treatment response in patients with COPD?
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Which factor is NOT associated with the prevention of weight loss in COPD patients?
Which factor is NOT associated with the prevention of weight loss in COPD patients?
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Which psychosocial intervention can be beneficial for COPD patients experiencing anxiety?
Which psychosocial intervention can be beneficial for COPD patients experiencing anxiety?
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What is a characteristic feature of status asthmaticus?
What is a characteristic feature of status asthmaticus?
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Which of the following medications combines an inhaled corticosteroid with a long-acting beta agonist?
Which of the following medications combines an inhaled corticosteroid with a long-acting beta agonist?
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What is the recommended monitoring for Theophylline therapy?
What is the recommended monitoring for Theophylline therapy?
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Which environmental modification is suggested for reducing asthma triggers?
Which environmental modification is suggested for reducing asthma triggers?
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Which drug is classified as an anti-IgE antibody medication?
Which drug is classified as an anti-IgE antibody medication?
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What symptom indicates a potential emergency situation in an asthma attack?
What symptom indicates a potential emergency situation in an asthma attack?
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Which treatment is generally included in the management of status asthmaticus?
Which treatment is generally included in the management of status asthmaticus?
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Which of the following describes the use of leukotriene inhibitors in asthma treatment?
Which of the following describes the use of leukotriene inhibitors in asthma treatment?
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What is the most crucial goal for clients with COPD regarding their weight management?
What is the most crucial goal for clients with COPD regarding their weight management?
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Which of the following self-management strategies is most effective for a client with COPD to improve gas exchange?
Which of the following self-management strategies is most effective for a client with COPD to improve gas exchange?
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Which nursing intervention is most appropriate for a client with COPD who presents with signs of increased dyspnea?
Which nursing intervention is most appropriate for a client with COPD who presents with signs of increased dyspnea?
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Which of the following activities is NOT beneficial for clients with COPD to prevent serious respiratory infections?
Which of the following activities is NOT beneficial for clients with COPD to prevent serious respiratory infections?
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In the context of COPD care coordination, which of the following is NOT typically included as part of a home care management plan?
In the context of COPD care coordination, which of the following is NOT typically included as part of a home care management plan?
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Which symptom is most indicative of a potential exacerbation in a client with COPD?
Which symptom is most indicative of a potential exacerbation in a client with COPD?
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Which intervention is key to facilitating effective breathing patterns in clients with COPD?
Which intervention is key to facilitating effective breathing patterns in clients with COPD?
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Which statement by a client with COPD indicates a need for further education regarding their condition management?
Which statement by a client with COPD indicates a need for further education regarding their condition management?
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What is the primary consequence of emphysema's impact on lung tissue?
What is the primary consequence of emphysema's impact on lung tissue?
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What pathological change occurs in the bronchi due to chronic bronchitis?
What pathological change occurs in the bronchi due to chronic bronchitis?
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Which symptom is primarily associated with air trapping in emphysema?
Which symptom is primarily associated with air trapping in emphysema?
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What is a primary mechanism through which irritants lead to chronic bronchitis?
What is a primary mechanism through which irritants lead to chronic bronchitis?
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What physiological change occurs in patients with COPD that is primarily responsible for CO2 retention?
What physiological change occurs in patients with COPD that is primarily responsible for CO2 retention?
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What most directly contributes to the sensation of 'air hunger' experienced by COPD patients?
What most directly contributes to the sensation of 'air hunger' experienced by COPD patients?
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What distinguishes a severe persistent asthma classification from other types?
What distinguishes a severe persistent asthma classification from other types?
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What role does excessive mucus play in chronic bronchitis?
What role does excessive mucus play in chronic bronchitis?
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Which medication class can be used in combination with a SABA for acute asthma management?
Which medication class can be used in combination with a SABA for acute asthma management?
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Which of the following best describes the inflammation process related to chronic exposure to cigarette smoke in COPD?
Which of the following best describes the inflammation process related to chronic exposure to cigarette smoke in COPD?
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Which assessment finding indicates that asthma is poorly controlled?
Which assessment finding indicates that asthma is poorly controlled?
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What is the primary goal of asthma therapeutic management?
What is the primary goal of asthma therapeutic management?
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What patient education topic is essential for managing asthma effectively?
What patient education topic is essential for managing asthma effectively?
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Which lab finding is commonly associated with asthma exacerbation?
Which lab finding is commonly associated with asthma exacerbation?
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How many nighttime awakenings due to asthma symptoms classify as poorly controlled?
How many nighttime awakenings due to asthma symptoms classify as poorly controlled?
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Which of the following is not considered a rescue medication for asthma?
Which of the following is not considered a rescue medication for asthma?
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Study Notes
COPD Overview
- COPD affects approximately 15 million individuals in the U.S. and 900,000 in Canada.
- It is the 4th leading cause of morbidity and mortality in the U.S.
- Defined as a collection of lower airway disorders that interfere with airflow and gas exchange.
Types of COPD
-
Chronic Bronchitis:
- Inflammation of bronchi and bronchioles due to irritants, primarily cigarette smoke.
- Results in increased mucus production and chronic infection risks.
-
Emphysema:
- Deterioration of lung elastic tissue compromises recoil ability.
- Leads to lung hyperinflation, air trapping, increased work of breathing, and sensation of "air hunger."
- Causes respiratory acidosis due to decreased gas exchange.
Pathophysiology
- Inflammation from irritants leads to vasodilation, mucosal edema, and bronchospasm.
- Chronic inflammation thickens bronchial walls and increases mucus-secreting glands, which block smaller airways.
Management and Care Coordination
- Home care may include oxygen therapy and self-management education focusing on drug therapy and breathing techniques.
- Key goals:
- Maintain gas exchange at chronic baseline levels.
- Achieve an effective breathing pattern and maintain a patent airway.
- Manage body weight within 10% of ideal weight while reducing anxiety and increasing acceptable activity levels.
Evaluation and Interventions
- Regular assessment of dyspnea and changes in vital signs required.
- Monitoring includes understanding patient's responses to medications and interventions.
Asthma Overview
- Involves immediate and late reactions with airway narrowing triggered by allergens and non-allergic stimuli.
- Symptoms include bronchoconstriction, inflammation, and mucous production.
Asthma Assessment
- Assessing patient history includes previous wheezing episodes, allergies, triggers, and family history.
- Vital signs, lung sounds, and accessory muscle use are critical indicators during assessment.
Diagnostics for Asthma
- Lab assessments include pulse oximetry, ABGs, and peak flow measurements.
- Pulmonary function tests identify decreased forced vital capacity (FVC) and forced expiratory volume (FEV1).
Asthma Management
- Long-term control therapy involves daily anti-inflammatory agents and combination medications.
- Rescue medications for emergencies, including bronchodilators, are also vital.
Emergency Signs for Asthma
- Need for immediate intervention when experiencing worsened wheezing, ineffective bronchodilator response, or difficulty in breathing/talking.
- Signs may lead to status asthmaticus, necessitating IV fluids, bronchodilators, and potential intubation.
Environmental Modifications
- Keeping indoor environments allergen-free through measures like frequent cleaning and using air filters.
- Reducing exposure to known triggers such as dust, pollen, and smoke maintains airway health.
Education and Prevention
- Emphasizes collaboration with healthcare providers, understanding triggers, and maintaining regular check-ins for asthma management.
COPD Overview
- Affects 15 million individuals in the U.S. and 900,000 in Canada.
- Fourth leading cause of morbidity and mortality in the U.S.
- Chronic Obstructive Pulmonary Disease (COPD) comprises chronic bronchitis and emphysema, impairing airflow and gas exchange.
Emphysema
- Involves damage to lung elastic tissue, affecting its ability to recoil after stretching, leading to lung hyperinflation.
- Results in air trapping, increased work of breathing, and sensations of "air hunger."
- Decreased gas exchange results in CO2 retention and respiratory acidosis.
Chronic Bronchitis
- Characterized by inflammation of the bronchi and bronchioles due to irritants like cigarette smoke.
- Causes thickening of bronchial walls, increased mucus production, and airway obstruction.
- Increased mucus activity leads to chronic infections.
Risk Factors for COPD
- Major risk factor: cigarette smoking.
- Additional risks include alpha-1 antitrypsin deficiency and history of asthma.
Complications of COPD
- Potential complications include hypoxemia, respiratory infections, cardiac failure (cor pulmonale), dysrhythmias, and respiratory failure.
Assessment and Recognition of Cues
- Monitor history: smoking, breathing problems, activity level, and weight.
- General appearance, respiratory signs, and cardiac changes serve as cues.
- Laboratory assessment includes ABGs to monitor oxygen levels and CO2 retention; aim for O2 saturation of 88-92%.
Management Strategies
- Emphasize smoking cessation as critical for health improvement.
- Focus on maintaining gas exchange at baseline, effective breathing patterns, and weight management within 10% of ideal.
- Recommend small meals, high-calorie food, and relaxation techniques for anxiety and nutrition support.
Health Promotion and Maintenance
- Embrace self-management education, including drug therapy, breathing techniques, and awareness of triggers.
- Encourage home care management and connections with healthcare resources.
Evaluation of Outcomes
- Aim for reduced anxiety, increased acceptable activity levels, and prevention of respiratory infections.
Asthma Overview
- Includes assessment of symptoms, with classifications ranging from intermittent to severe persistent.
- Regular use of rescue drugs and daily preventive medications is essential.
Therapeutic Management of Asthma
- Focus on improving airflow and gas exchange through early recognition, avoidance of triggers, and consistent medication use.
- Rescue drugs include SABAs for acute attacks and corticosteroids for short-term management.
Signs and Symptoms for Emergency Treatment
- Worsening wheeze, lack of improvement post-bronchodilator use, and difficulty in breathing indicate a need for urgent action.
- Status asthmaticus represents a life-threatening situation requiring immediate intervention and potential intubation.
Environmental Modifications
- Recommendations include washing sheets regularly, using air filters, and managing household humidity.
- Avoiding allergenic materials like wool and ensuring proper cleaning techniques can help minimize asthma triggers.
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