Med-Surg (Collaborative Care -

Asthma

what is the disorder where there are allergens/irritant triggers that stimulate mast cells to degranulate causing swelling, spams, and secretions

IgE

asthma is related to what antibody?

Atopy

what means a genetic pre-disposition to have an IgE mediated allergic response

Has asthma, recurring nasal polyps, sensitivity to ASA/NSAIDs

what does the asthma triad consist of?

Wheezing, cough, dyspnea, chest tightness

what are the four S&S's of an asthma attack

Peak expiratory flow rate

what is the thing that measures the volume and rate that air can be forcefully breathed out of the lungs

Green

with a peak flow meter what indicates that there is a good flow rate

yellow

with a peak flow meter, which indicates a worse flow rate

alkalosis

what does a yellow peak flow meter indicate

Red

what color indicates the worst flow rate?

Acidosis

what does a red peak flow meter indicate

STAT meds

if a patient has a red flow meter what needs to happen

Pulmonary function test

what is the test that gives measurements of the volume or degrees of obstruction?

6 hours

how long should one avoid bronchodilators before taking a PFT

Long-acting inhaled corticosteroids

what is the gold standard treatment for asthma?

Beclomethasone, budesonide, fluticasone, mometasone

what are the four long-acting inhaled corticosteroids

rinse the mouth

what must occur right after using long-acting inhaled corticosteroids

IV corticosteroids

what is the drug that is can be very helpful in an acute asthma attack

Albuterol, Levalbuterol

what is the DOC for asthma attacks

Salmeterol, formoterol

what are the two long-acting inhaled B2 adrenergic agonists

Ipratropium

what is the short-acting inhaled anticholinergics that can be given during an asthma attack

tiotropium

what is the long-acting inhaled anticholinergics

Inhaled anticholingerics

what are the drugs that treat asthma that prevent bronchoconstriction

Montelukast, Zileuton

what are the two leukotriene modifiers

Methylxanthines

what is the asthma drug that is an anti-inflammatory bronchodilator

Monoclonal antibodies

what is the drug that attempts to decrease the circulating IgE decreasing inflammation

Anti-interleukin-5

what is the drug that that is typically added on as an add on therapy for patients receiving other asthma meds that is known for hypersensitivity reactions

Oxygen, SABA, Inhaled anticholinergic, Systemic Corticosteroids

What are the four Emergency treatments for an asthma attack

Smoking

what is the #1 cause of COPD

Alpha 1-Antitrypsin deficiency

what is the genetic disorder that is autosomal recessive and is a serum protein that is produced by the liver but protects the lungs

bullae

what are air pockets in the lungs called?

emphysema

what is permanent distention of the alveoli called?

smoking

what is the #1 cause of emphysema

Cough, sputum/hemoptysis, Dyspnea, wheezing, weight loss, barrel chest, Hypoxemia, Hypercapnia

what are the eight clinical manifestations of COPD

Hypoxemia

what are low oxygen levels in the blood called

PaO2 <60%

what is the value that one must have to be considered to have Hypoxemia

>45

what is the value that indicates hypercapnia

COPD exacerbation

what is the complication that is a sudden worsening of the baseline d/t bacterial and viral infections

Cor pulmonale

what is described as right ventricular hypertrophy d/t lung disease

FEV1/FVC ratio

what is the test that confirms the presence of airflow obstructions

forced vital capacity

measures amount of air forcibly exhaled form lungs after taking the deepest breath possible

FEV1

how much air is forcibly exhaled in one second

≥80%

what value indicates mild COPD

50-80%

what value indicates moderate COPD

30-50%

what value indicates severe COPD

<30%

what value indicates very severe COPD

flattened diaphragm

for a patient with COPD what does a CXR look for?

Smoking cessation

what is the single most effective and cost-effective intervention for COPD

Short-acting or long-acting B2 agonists

what are the two drugs that should be given if there were fewer than 2 exacerbations and no hospitalizatoins

Roflumilast

what is the phosphodiesterase inhibitor that is a PO med given to decrease exacerbations

>60

what should we keep the PaO2 levels at?

>90

what should we keep the SaO2 levels at?

Huff coughing

what is the airway clearance technique where you are breathing from the diaphragm then forcefully exhaling as if fogging up a mirror

PEP device

what is the device that creates vibrations when breathing into the device to break up the mucus

Lung volume reduction surgery

what is the surgical procedure that is done to remove diseased tissue so that the remaining lung tissue can perform better

Bullectomy

what is the surgery that is a removal of bullae

Smoking

what is the leading cause of preventable illness and death in the US

Bupropion, Varenicline, Clonidine

what are the three nicotine replacement medications?

Thoracentesis

what is a needle aspiration of air or fluid from the pleural space

VS, hemostasis, puncture site, CXR

what are the four things that are assessed after a thoracentesis

Pleural Chest tube

what is the type of chest tube that is a single tube that is inserted into a intercostal space that allows the lungs to reexpand

Mediastinal chest tube

what is the chest tube that is a Y tube that drains blood and fluid from around the heart

CABG

what is the most common time for a patient to have a mediastinal chest tube

anterior, superior

if there is an air chest tube where is it placed anatomically

posterior, inferior

if there is a fluid/blood chest tube where is it placed anitomically

Flutter valve

what is the one way valve that will open when the intrathoracic pressure is greater than the atmospheric pressure

Ocean

what is a wet suction three-chamber system called?

Sahara, Oasis

what is a dry suction three-chamber system called?

air leak

if there is continuous bubbling in the water seal chamber, what does this indicate?

intermittent bubbling, tidaling

what are the two normal things to see in a water-seal chamber