Wheezing Assessment Quiz
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Questions and Answers

What components are included in a cultural assessment of patients?

  • Response to illness and dietary preferences
  • All psychological evaluations
  • Cultural norms and world views (correct)
  • Personal backgrounds and medical history

    • Which of the following symptoms indicates persistent asthma?

  • Symptoms only at night
  • Daily use of inhaled short-acting medications (correct)
  • Symptoms present two times a month
  • Daily symptoms occurring less than once a week

    • What is a major predisposing factor for asthma development?

  • Exposure to cold weather
  • Chronic exposure to airway irritants or allergens (correct)
  • Genetic predisposition only
  • Lack of physical exercise

    • How can airway obstruction occur in patients with asthma?

    <p>Via inflammation and airway hyperresponsiveness</p> Signup and view all the answers

    Which of the following best describes an acute respiratory distress syndrome (ARDS)?

    <p>It is characterized by rapid onset of severe respiratory failure</p> Signup and view all the answers

    What defines 'mild' asthma according to the National Asthma and Prevention Program?

    <p>FEV1 or PEF between 60% and 80% of predicted</p> Signup and view all the answers

    What is the effect of allergens and airway irritants on asthma?

    <p>They can cause airway inflammation and exacerbate symptoms</p> Signup and view all the answers

    What lung function measure is used to assess asthma severity?

    <p>FEV1 or predicted FEV1</p> Signup and view all the answers

    Which sign is indicative of a severe asthma episode as indicated by elevated pulsus paradoxus?

    <p>Systolic blood pressure during expiration exceeds that in inspiration by more than 10 mmHg</p> Signup and view all the answers

    What does a peak flow meter primarily measure during an asthma assessment?

    <p>The volume of airflow during forced expiration</p> Signup and view all the answers

    What oxygenation method is preferred for patients with COVID-19 and acute hypoxemic respiratory failure who do not respond to conventional oxygen therapy?

    <p>High-flow nasal cannula oxygenation</p> Signup and view all the answers

    What is the ideal tidal volume for lung protective ventilation strategy in patients with COVID-19 infection and ARDS?

    <p>6-8 mL/kg</p> Signup and view all the answers

    During an asthma attack, which of the following changes is most likely to occur in arterial carbon dioxide levels over time?

    <p>PaCO2 increases later in the episode</p> Signup and view all the answers

    A patient demonstrates wheezing and restlessness. Which additional finding suggests hypoxemia?

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

    Which therapy is indicated for COVID-19 patients with refractory ARDS?

    <p>VA ECMO</p> Signup and view all the answers

    A peak flow reading in the yellow zone indicates what range of airflow?

    <p>60% to 80%</p> Signup and view all the answers

    What is the primary purpose of Sustained Low-Efficiency Dialysis (SLED)?

    <p>For patients with acute kidney injury (AKI)</p> Signup and view all the answers

    Which symptom is characteristic of an asthma episode that may indicate imminent respiratory failure?

    <p>Hypercapnea accompanied by increased retractions</p> Signup and view all the answers

    What should be assessed to check for signs of shock in a patient?

    <p>BP and heart rate</p> Signup and view all the answers

    Which of the following is a method for assessing the level of consciousness?

    <p>Pupillary response</p> Signup and view all the answers

    In assessing a patient with asthma, which of the following findings would likely require immediate medical intervention?

    <p>Inspiratory stridor</p> Signup and view all the answers

    What physiological change might be observed with hypoxemia in a patient during an acute asthma exacerbation?

    <p>Decreased arterial oxygen level (PaO2)</p> Signup and view all the answers

    Which exposure history is crucial for assessing potential COVID-19 transmission?

    <p>Contact with confirmed cases within 1 meter for more than 15 minutes</p> Signup and view all the answers

    Which vaccine is used to prevent symptomatic SARS-CoV-2 infection in adults?

    <p>BNT162b2 (Pfizer/BioNTech)</p> Signup and view all the answers

    What is indicated when non-invasive ventilation management fails to support oxygenation?

    <p>Mechanical ventilation</p> Signup and view all the answers

    Which arterial blood gas (ABG) finding is considered a hallmark of ARDS?

    <p>PaO2 &lt; 38 C</p> Signup and view all the answers

    Which pulmonary function test result would most likely indicate ARDS?

    <p>Reduced vital capacity</p> Signup and view all the answers

    What is a common finding in stage III ARDS regarding heart rate?

    <p>Heart rate &gt; 90 BPM</p> Signup and view all the answers

    What condition does not commonly present with the presence of air bronchograms?

    <p>Pulmonary edema</p> Signup and view all the answers

    Which laboratory finding is indicative of an inflammatory response in ARDS?

    <p>WBC &gt; 12,000 cells/mm3</p> Signup and view all the answers

    What does normal pulmonary artery pressure in ARDS help to distinguish?

    <p>ARDS from cardiogenic pulmonary edema</p> Signup and view all the answers

    What characterizes the appearance of the lungs in ARDS?

    <p>Presence of exudate</p> Signup and view all the answers

    What is the primary therapeutic action of short-acting inhaled beta2-adrenergic agonists (SABAs)?

    <p>Relax smooth muscle in the airways</p> Signup and view all the answers

    What happens to wheezing as obstruction worsens in a patient experiencing a severe asthma attack?

    <p>Wheezing disappears entirely</p> Signup and view all the answers

    What is the first objective indication of status asthmaticus?

    <p>Increasing PaCO2 levels</p> Signup and view all the answers

    Which medication class is recognized as the most potent and effective anti-inflammatory treatment?

    <p>Systemic corticosteroids</p> Signup and view all the answers

    What is a hallmark characteristic of ARDS related to oxygen therapy?

    <p>Refractory hypoxaemia</p> Signup and view all the answers

    Which device is commonly used for the nebulization of medications during an asthma attack?

    <p>Nebulizer mask</p> Signup and view all the answers

    What role does supplemental oxygen play during an acute asthma attack?

    <p>It enhances oxygen delivery to tissues</p> Signup and view all the answers

    Which method of oxygen delivery may be used during an acute asthma attack?

    <p>Endotracheal tube</p> Signup and view all the answers

    Study Notes

    Generalized Wheezing and Assessment Findings

    • Symptoms include tachycardia, retractions, restlessness, and anxiety.
    • Respiratory signs encompass inspiratory stridor, expiratory wheezing, hypoxemia, hypercapnia, and cough with sputum production.
    • Expiratory prolongation and cyanosis indicate severe respiratory distress.
    • Elevated pulsus paradoxus: systolic blood pressure during expiration exceeds inspiration by over 10 mmHg.

    Diagnostic Studies

    Laboratory Assessments

    • Arterial oxygen level (PaO2) may decrease during asthma attacks, while early arterial carbon dioxide level (PaCO2) may be low; late stages show an increase in PaCO2.

    Peak Flow Monitoring

    • Peak flow meters measure airflow during forced expiration.
    • Color-coded zones for peak flow results:
      • Green Zone: 80%-100% of personal best.
      • Yellow Zone: 60%-80%.
      • Red Zone: less than 60%, requiring immediate action.

    Status Asthmaticus

    • Episodes can lead to respiratory failure and potential complications like pneumothorax.
    • Increasing PaCO2 indicates worsening condition, a primary concern in status asthmaticus.

    Medical Management

    • Close monitoring of the patient and therapy responses is crucial.
    • Treatment typically involves:
      • Short-acting beta2-adrenergic agonists (e.g., albuterol).
      • Systemic corticosteroids prescribed for severe cases.
    • Supplemental oxygen is usually administered during acute attacks.

    Respiratory Distress Syndrome and ARDS

    • Refractory hypoxemia is a key feature of ARDS, where hypoxemia persists despite oxygen administration.
    • ABG tests show hypoxemic conditions with decreased PaO2.
    • Pulmonary function tests reveal reduced lung compliance and vital capacity.

    Mechanical Ventilation Strategies

    • Indicated if non-invasive ventilation (NIV) fails to support oxygenation or ventilation.
    • Ventilation strategies include lung protective ventilation (tidal volume: 4-8 mL/kg).
    • Continuous renal replacement therapy (CRRT) or sustained low-efficiency dialysis (SLED) for patients with acute kidney injury.

    Vaccination for SARS-CoV-2

    • Vaccines such as BNT162b2 (Pfizer/BioNTech) are recommended to prevent symptomatic COVID-19 infection.
    • Assess exposure to COVID-19 cases within defined timeframes to evaluate risk.

    Cultural Sensitivity in Patient Assessment

    • Cultural beliefs and norms play a significant role in patients' responses to illnesses and should be considered in healthcare delivery.

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    Description

    Test your knowledge on generalized wheezing and its associated symptoms. This quiz covers additional assessment findings such as tachycardia, retractions, restlessness, and anxiety. Perfect for those studying respiratory conditions or nursing assessments.

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