Comprehensive Asthma, Medication, and Coagulation Therapy Review

What type of disease is asthma?

A chronic inflammatory but reversible airway disease.

What part of the airway is mainly affected in asthma?

The bronchioles.

Why is breathing difficult during asthma?

Airways become clogged and inflamed.

What does wheezing indicate in asthma?

Airway obstruction.

Why is absence of wheezing dangerous in asthma?

It may indicate severe airway closure (life-threatening).

What medication is first-line for acute asthma attack?

Albuterol (SABA beta-2 agonist).

Why are long-acting bronchodilators not used in acute asthma?

They are not effective for immediate relief.

What emergency medication may be given for severe breathing problems?

Epinephrine.

What class of medication treats airway inflammation in asthma?

Inhaled corticosteroids.

Why are corticosteroids used in asthma?

To reduce airway inflammation.

What infection signs should patients on steroids report?

Sore throat, fever, chills.

What inhaler device is commonly used?

Metered-dose inhaler (MDI).

What breathing technique should patients use with inhalers?

Hold breath for 10 seconds after inhalation.

What should patients do before using nasal medications?

Blow nostrils gently to clear passages.

What is diphenhydramine (Benadryl)?

First-generation H1 antihistamine.

What common effect does first-generation antihistamine cause?

Drowsiness.

What safety teaching is required with antihistamines?

Avoid driving or operating machinery.

What side effect occurs with antihistamines?

Dry mouth.

How can dry mouth be treated?

Water, sugarless gum, hard/sour candy.

When should antihistamines NOT be given for dry mouth relief?

If patient cannot have water.

What is guaifenesin used for?

Thins thick mucus to help coughing.

What type of cough is guaifenesin used for?

Dry cough with thick secretions.

What is pseudoephedrine used for?

Allergy relief and nasal congestion.

What cardiac effect can pseudoephedrine cause?

Increased heart rate.

When is pseudoephedrine contraindicated?

In tachycardia patients.

Does pseudoephedrine cause drowsiness?

No.

Why is pseudoephedrine kept behind the pharmacy counter?

Risk of abuse in young people.

Why should alcohol be avoided with antihistamines?

Increased sedative effects.

What is codeine classified as?

Antitussive.

What effects does codeine cause?

Sedation and constipation.

What safety teaching is required with codeine?

Avoid driving and machinery.

What is acetylcysteine (Mucomyst)?

Mucolytic that breaks up secretions.

What teaching is required after acetylcysteine?

Rinse mouth due to foul smell.

What overdose antidote role does acetylcysteine have?

Antidote for acetaminophen toxicity.

What is activated charcoal used for?

Drug overdose treatment.

What additional uses does diphenhydramine have?

Itching and chemotherapy reactions.

When should diphenhydramine be taken?

At bedtime due to sedation.

What drug class is theophylline?

Methylxanthine bronchodilator.

What is unique about theophylline therapeutic range?

Very narrow (high toxicity risk).

What toxic effects can occur with theophylline?

Seizures and dysrhythmias.

What must be monitored during theophylline therapy?

Blood drug levels.

What medication treats theophylline-induced dysrhythmias?

Lidocaine.

What medication treats theophylline-induced seizures?

Benzodiazepines (e.g., lorazepam).

Why should caffeine be avoided with theophylline?

Increases CNS stimulation → seizure/dysrhythmia risk.

Why are beta-blockers risky in asthma?

Beta-2 blockade causes bronchoconstriction.

Example of a beta-blocker to avoid in asthma?

Propranolol.

Examples of anticoagulants?

Heparin, warfarin, aspirin, LMWH.

What conditions is heparin used for?

DVT, PE, evolving stroke, dialysis.

Does heparin dissolve clots?

No — prevents formation and extension.

What lab monitors heparin therapy?

aPTT every 4 hours.

What major complications occur with heparin?

Bleeding and thrombocytopenia.

What is normal platelet count?

~150,000.

What condition occurs with low platelets on heparin?

Heparin-induced thrombocytopenia.

What should nurse do if platelets drop?

Hold dose and notify provider.

What drug can replace heparin in thrombocytopenia?

Argatroban.

Why is heparin high-alert medication?

Requires double-nurse verification.

What solution is heparin mixed with?

Normal saline only.

What is the antidote for heparin?

Protamine sulfate.

Examples of LMWH?

Enoxaparin (Lovenox), Dalteparin.

What are LMWH indications?

Prevent DVT post-op, treat PE complications.

What administration method is used?

Subcutaneous injection.

What special syringe instruction is required?

Do NOT expel air bubble.

What clotting factor does LMWH inhibit?

Factor Xa.

Can LMWH be combined with warfarin?

Yes.

What is warfarin mechanism?

Vitamin K inhibitor.

What patients commonly need warfarin?

Prosthetic valve and atrial fibrillation.

What labs monitor warfarin?

INR and PT.

What INR level indicates bleeding risk?

Around 5.2.

What is warfarin antidote?

Vitamin K.

Why is heparin given with warfarin initially?

Warfarin takes longer to become therapeutic.

When is heparin stopped?

Once INR is therapeutic.

What herbal supplements should be avoided?

Ginkgo, garlic, ginger.

Why avoid glucosamine with warfarin?

Increased bleeding risk.

What is clopidogrel (Plavix)?

Antiplatelet drug.

What teaching is required before surgery on clopidogrel?

Stop 5 days prior.

What does aspirin do?

Prevents platelet aggregation.

What is TPA?

Thrombolytic 'clot buster.'

What conditions require TPA?

Massive ischemic stroke or MI.

Why must brain scan be done first?

To rule out hemorrhagic stroke.

What is TPA major risk?

Massive bleeding.

What time window is required for TPA?

Within 3 hours.

What monitoring is required?

Continuous bleeding and neuro status.

What is TPA antidote?

Aminocaproic acid.

What fall precaution teaching is required?

Prevent injury → risk brain bleed.

What hygiene teaching is required?

Use soft toothbrush, avoid razors.

What stool finding is concerning?

Bloody stool or melena.

Why are iron supplements given?

Iron deficiency anemia.

What stool color is normal with iron?

Black or green.

What dental teaching is needed?

Use straw to prevent staining.

What improves iron absorption?

Vitamin C (orange juice).

What GI effect occurs with iron?

Constipation.

What test is required before transfusion?

Type and screen.

How long can blood hang?

Max 4 hours.

What solution is blood infused with?

Normal saline.

What tubing is used?

Y tubing.

How often monitor vitals initially?

Every 15 minutes.

Signs of transfusion reaction?

Rash, chills, fever, back pain.

What action if reaction occurs?

Stop transfusion immediately.

Which vaccine is required for hospital workers?

Hepatitis B.

Who should get shingles vaccine?

Those who had chickenpox (age 50+).