Asthma

Question 1

chronic inflammatory disease of the lungs characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and coughing

Answer 1

asthma

Question 2

what are some common triggers for an acute asthma attack?

Answer 2

• exposure to allergens
• respiratory tract infections
• exercise
• inhaled irritants
• emotional upset

Question 3

NOTE

Answer 3

in asthma the airways are in a constant state of inflammation, even when symptom free (these periods are known as subacute or quiet)

Question 4

when an asthma sufferer is exposed to a trigger what are the three things that occur that make breathing more difficult?

Answer 4

• bronchoconstriction
• airway edema
• impaired clearance of secretions

Question 5

what physiological results occur when an asthma attack is underway?

Answer 5

• airway narrowing limits the airflow
• increases work it takes to breathe
• trapped air mixes with inhaled air -> impairs gas exchange

Question 6

what is the acute or early response of an asthma attack?

Answer 6

bronchospasms and parasympathetic response

Question 7

what occurs in the late-phase of an asthma attack?

Answer 7

inflammatory cells (basophils, eosinphils) :

• damage airway epithelium
• produce mucosal edema
• impair mucociliary clearance
• produce/prolong bronchoconstriction

Question 8

when does the late-phase of an asthma attack occur?

Answer 8

4-12 hours later

Question 9

what can an untreated asthma attack lead to?

Answer 9

• limited expiratory air flow (CO2 isn’t getting out)
• hypoxemia
• hyperventilation

Question 10

what acid base imbalance can occur with an untreated asthma attack?

Answer 10

because of hyperventilation (blowing off excess CO2) the CO2 levels will drop causing respiratory alkalosis

Question 11

an exaggerated bronchoconstrictor response

Answer 11

hyperresponsiveness

Question 12

• a severe, prolonged form of asthma that is difficult to treat
• can result in respiratory failure

Answer 12

status asthmaticus

Question 13

the effort or force needed to move oxygen through the trachea to the lungs

Answer 13

airway resistance

Question 14

what is the primary method of breathing for children under 6 years, and why?

Answer 14

due to immature intercostal muscles, children are diaphragmatic breathers before age 6

Question 15

sunken areas seen between the ribs during inspiration

Answer 15

retractions

Question 16

why is oxygen consumption higher in children than in adults?

Answer 16

greater metabolic rate

Question 17

children have a greater metabolic rate than adults, what effect does this have on breathing?

Answer 17

high oxygen consumption

Question 18

what are the clinical manifestations of asthma?

Answer 18

• coughing
• wheezing
• shortness of breath
• chest tightness
• tachypnea
• tachycardia
• anxiety/apprehension

Question 19

NOTE

locations of airway obstructions

Answer 19

nasopharyngeal – sonorous snoring
larynx/upper trachea – inspiratory stridor
mid-lower trachea/central bronchus – exp. stridor, croupy or low pitched cough
larynx or subglottic space – insp&exp stridor
obstructed vocal chords – hoarse/weak voice

Question 20

what does PEFR stand for?

Answer 20

Peak Expiratory Flow Reading

Question 21

• a method of objective measure of lung function
• allows clients to monitor symptoms and communicate severity to others
• personal norms established over period of time so that deviation can be read later

Answer 21

PERF (Peak Expiratory Flow Reading)

Question 22

what does MDI stand for?

Answer 22

metered dose inhaler

Question 23

what does DPI stand for?

Answer 23

dry powder inhaler

Question 24

asthma meds:

• relaxes the smooth muscles of the airways
• inhalation of nebulized medication is preferred
• can be anticholinergic, methylxylines or adrenergic stimulants
• often administered with anti-inflammatory agent (corticosteroids)

Answer 24

bronchodilators

Question 25

asthma meds: - affects sympathetic receptors in the respiratory tract - administered by MDI or DPI - treatment of choice for acute bronchial asthma - oral forms have slow onset, but can be used prophylactically

Answer 25

adrenergic stimulants (adrenergic agonists)

Question 26

asthma meds: - central nervous system stimulants (chemically related to caffeine) - -produce bronchodilation through relaxation of bronchial smooth muscles - used primarily to prevent nocturnal asthma attacks in adults - potential toxic side effects

Answer 26

methyxanthines

Question 27

asthma meds: - potent bronchodilator - blocks muscarinic receptors of parasympathetic nervous system - produces smooth muscle relaxation and bronchodilation by blocking receptors

Answer 27

anticholenergics

Question 28

asthma meds: - anti-inflammatory - prevents and treats acute episodes of asthma - allows reduced dosages of other drugs - decreases the synthesis and release of inflammatory mediators, reduce inflammatory cell activation/infiltration, and decrease airway edema - decrease mucous production in the airways - increase number and receptivity of beta2 receptors

Answer 28

corticosteroids

Question 29

asthma meds: - inhibits inflammatory cells in the airway, blocking early and late responses to inhaled antigens - prevent bronchoconstriction in response to inhaling cold air - act by stabilizing the cytoplasmic membrane of mast cells, preventing the cells from releasing inflammatory mediators - used only for prevention, not for acute attacks

Answer 29

mast cell stabilizers

Question 30

asthma meds: - interfere with inflammatory process in the airways by suppressing the effects of leukotrines (inflammatory mediators) - blocking leukotrine synthesis or receptors improves airflow, decreases symptoms and reduces the need for short acting bronchodilators - used as maintenance therapy in adults and children over 12 as alternative to corticosteroid therapy - not used for acute attacks

Answer 30

leukotrine modifiers

Question 31

-a system of treating asthma where the severity of the asthma is assessed and then the prescriber increases or decreases the amount of medication until it suits the individual

Answer 31

step-wise approach

Question 32

what are some examples of complimentary therapies used to treat asthma?

Answer 32

- nutritional/dietary therapies (elimination diet) - herbal therapies - biofeedback - yoga - breathing techniques - acupuncture - massage - homeopathy