Chp. 37 test review
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Questions and Answers

What is Chronic Obstructive Pulmonary Disease?

  • A disease that affects the airways of the lungs (correct)
  • Recurrent and reversible shortness of breath
  • Inflammation of the bronchial mucosa
  • Production of viscous mucus
  • What causes the airways of the lungs to become narrow in COPD?

  • Bronchospasms
  • Inflammation of the bronchial mucosa and production of viscous mucus
  • Edema of the bronchial mucosa
  • All of the above (correct)
  • What type of inhaler is used as a rescue inhaler for acute episodes of COPD?

  • Long-acting beta agonist inhaler
  • Combination inhaler
  • Short-acting beta inhaler (correct)
  • Steroid inhaler
  • What is the most commonly used short-acting beta-2 specific bronchodilating beta agonist?

    <p>Albuterol</p> Signup and view all the answers

    Why should SABAs not be used too frequently?

    <p>They increase systemic effects</p> Signup and view all the answers

    What is the purpose of LABAs in COPD treatment?

    <p>To provide maintenance therapy for COPD</p> Signup and view all the answers

    Which of the following LABAs should never be given more than twice daily or exceeded the maximum daily dose?

    <p>Salmeterol</p> Signup and view all the answers

    What is the main difference between SABAs and LABAs?

    <p>SABAs are used for acute episodes, while LABAs are used for maintenance</p> Signup and view all the answers

    Why are SABAs used in patient education for rapid/onset of respiratory episode?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT a characteristic of COPD?

    <p>Reversible airflow limitation</p> Signup and view all the answers

    What is the combination of vilanterol and fluticasone known as?

    <p>Breo Ellipta</p> Signup and view all the answers

    What type of receptors do non-selective adrenergics stimulate?

    <p>Alpha, beta-1, and beta-2 receptors</p> Signup and view all the answers

    What is the indication for using beta-2 agonists?

    <p>Relief of bronchospasm in asthma and COPD patients</p> Signup and view all the answers

    What is a contraindication for using beta-2 agonists?

    <p>Uncontrolled hypertension</p> Signup and view all the answers

    What is a common adverse effect of albuterol?

    <p>All of the above</p> Signup and view all the answers

    How often should salmeterol be taken?

    <p>Twice daily</p> Signup and view all the answers

    What is the mechanism of action of anticholinergics?

    <p>Inhibition of ACh receptors</p> Signup and view all the answers

    What is the indication for using ipratropium?

    <p>Prevention of bronchospasms associated with chronic bronchitis or emphysema</p> Signup and view all the answers

    What is a common adverse effect of ipratropium?

    <p>Dry mouth or throat</p> Signup and view all the answers

    What is the only xanthine derivative used as a bronchodilator?

    <p>Theophylline</p> Signup and view all the answers

    What is the therapeutic blood level range for the medication Aminophylline?

    <p>10-20mcg/ml</p> Signup and view all the answers

    Which of the following is a contraindication for Leukotriene Receptor Antagonist (LRTAs)?

    <p>Allergy to povidone</p> Signup and view all the answers

    What is the primary effect of Aminophylline on the cardiovascular system?

    <p>Cardiac stimulation and increased heart rate</p> Signup and view all the answers

    Which of the following is an indication for Aminophylline?

    <p>Mild or Moderate cases of acute asthma</p> Signup and view all the answers

    What is the primary mechanism of action of Leukotriene Receptor Antagonist (LRTAs)?

    <p>Non-bronchodilating</p> Signup and view all the answers

    Which of the following is a side effect of Aminophylline?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Why is it recommended to avoid caffeine when taking Aminophylline?

    <p>Because caffeine increases the metabolism of Aminophylline</p> Signup and view all the answers

    Which of the following is an approved indication for Montelukast?

    <p>Allergic rhinitis</p> Signup and view all the answers

    What is the effect of Aminophylline on the kidneys?

    <p>Diuretic effect</p> Signup and view all the answers

    When can improvement be seen with the use of Leukotriene Receptor Antagonist (LRTAs)?

    <p>Within 1 week</p> Signup and view all the answers

    What is the primary use of inhaled corticosteroids in the treatment of asthma?

    <p>To control the inflammatory responses that are believed to be the cause of bronchospastic disorders</p> Signup and view all the answers

    What is a common side effect of inhaled corticosteroids?

    <p>Pharyngeal irritation</p> Signup and view all the answers

    Why are systemic corticosteroids generally used to treat acute exacerbations or severe asthma?

    <p>Because they are more effective in treating acute exacerbations or severe asthma</p> Signup and view all the answers

    What is a nursing implication for patients taking beta-adrenergic agonist therapy?

    <p>All of the above</p> Signup and view all the answers

    What is a contraindication for the use of inhaled corticosteroids?

    <p>Patients whose sputum test positive for Candida organisms</p> Signup and view all the answers

    What is a nursing implication for patients taking xanthine derivatives?

    <p>All of the above</p> Signup and view all the answers

    What is the mechanism of action of inhaled corticosteroids?

    <p>Stabilizing membranes of cells that release harmful bronchoconstricting substances</p> Signup and view all the answers

    What is a nursing implication for patients taking LRTAs?

    <p>Ensure that the drug is being used for chronic management of asthma, not acute asthma</p> Signup and view all the answers

    What is a common combination therapy for asthma treatment?

    <p>Inhaled corticosteroids and beta-adrenergic agonist bronchodilators</p> Signup and view all the answers

    What is a nursing implication for patients taking inhaled corticosteroids?

    <p>Teach patients to gargle and rinse the mouth with lukewarm water after use to prevent oral fungal infections</p> Signup and view all the answers

    Study Notes

    Chronic Obstructive Pulmonary Disease (COPD)

    • COPD occurs when the airways of the lungs become narrow, leading to recurrent and reversible shortness of breath
    • Narrowing of airways is caused by bronchospasms, inflammation of the bronchial mucosa, edema of the bronchial mucosa, and production of viscous mucus

    Beta-Adrenergic Agonists

    • Used to treat bronchospasm related to asthma, bronchitis, and other pulmonary diseases
    • Three types: nonselective adrenergics, nonselective beta-adrenergics, and selective beta-2 drugs
    • Examples: epinephrine, metproterenol, and albuterol
    • Indications: relief of bronchospasm, treatment and prevention of acute attacks
    • Contraindications: known drug allergy, uncontrolled hypertension, cardiac dysrhythmias, and high risk of stroke
    • Adverse effects: insomnia, restlessness, anorexia, vascular headache, hyperglycemia, tremor, and cardiac stimulation

    Short-Acting Beta-2 Agonists (SABAs)

    • Used as rescue inhalers for acute episodes
    • Examples: albuterol (Ventolin, ProAir), levalbuterol (Xopenex), and terbutaline (Brethine)
    • Patient education: used for rapid onset of respiratory episode, must not be used too frequently

    Long-Acting Beta-2 Agonists (LABAs)

    • Used as maintenance medications
    • Examples: arformoterol (Brovana), formoterol (Foradil, Perforomist), and salmeterol (Serevent)
    • Patient education: used for chronic management of asthma, not for acute asthma treatment

    Anticholinergics

    • MOA: bind to ACh receptors, preventing ACh binding, resulting in prevention of bronchoconstriction and airway dilation
    • Examples: ipratropium (Atrovent), tiotropium (Spiriva), and aclidinium (Tudorza)
    • Indications: prevention of bronchospasms associated with chronic bronchitis or emphysema
    • Adverse effects: dry mouth or throat, nasal congestion, heart palpitations, gastrointestinal distress, headache, coughing, and anxiety

    Xanthine Derivatives

    • Only theophylline is used as a bronchodilator
    • Decreases cAMP levels, causes smooth muscle relaxation, bronchodilation, and increased airflow
    • Also known as Aminophylline, given IV for treatment of patients with status asthmaticus
    • Therapeutic blood level range: 10-20mcg/ml, now most clinicians advise levels between 5 and 15 mcg/ml
    • Drug effects: cardiac stimulation, increased force of contraction, and increased heart rate
    • Patient education: avoid caffeine, teach patients to take medications exactly as prescribed, and report adverse effects

    Leukotriene Receptor Antagonists (LRTAs)

    • Nonbronchodilating
    • Newer class of asthma medications
    • Examples: montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo)
    • Indications: prophylaxis and long-term treatment and prevention of asthma in adults and children 12 years of age and older
    • Contraindications: known drug allergy, previous adverse drug reaction, and allergy to inactive ingredients
    • Patient education: approved for treatment of allergic rhinitis, improvement seen in about 1 week, and report adverse effects

    Corticosteroids

    • Naturally occurring or synthetic drugs used for their anti-inflammatory effects
    • MOA: stabilize membranes of cells that release harmful bronchoconstricting substances, increase responsiveness of bronchial smooth muscle to beta-adrenergic stimulation
    • Indications: primarily used to treat bronchospastic disorders, persistent asthma, and often used concurrently with beta-adrenergic agonist
    • Adverse effects: pharyngeal irritation, coughing, dry mouth, oral fungal infections, and systemic effects
    • Patient education: teach patients to take medications exactly as prescribed, report adverse effects, and monitor for therapeutic effects

    Nursing Implications

    • Encourage patients to take measures to prevent, relieve, or decrease symptoms of COPD
    • Perform a thorough assessment before beginning therapy, including skin color, baseline vitals, respirations, respiratory assessment, and pulse oximetry
    • Teach patients to take bronchodilators exactly as prescribed, report adverse effects, and monitor for therapeutic effects
    • Ensure patients know how to use inhalers and MDIs, and provide a demonstration to ensure successful administration

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    Description

    This quiz covers the definition, symptoms, and treatment of Chronic Obstructive Pulmonary Disease (COPD), a lung condition characterized by recurring and reversible shortness of breath. Learn about the causes, such as bronchospasms, inflammation, and mucus production, and the role of rescue inhalers like albuterol.

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