Asthma

Question 1

What type of disorder is asthma?

Answer 1

A chronic inflammatory airway disorder.

Question 2

What airway characteristic is present in asthma?

Answer 2

Airway hyper-responsiveness.

Question 3

What airway change occurs in asthma?

Answer 3

Airway edema.

Question 4

What secretion change occurs in asthma?

Answer 4

Mucus production.

Question 5

What does asthma result in regarding airway obstruction?

Answer 5

Airway obstruction that might be partially or completely reversed.

Question 6

What may contribute to asthma symptoms?

Answer 6

Allergens or triggers.

Question 7

What respiratory rate change may occur in asthma?

Answer 7

Tachypnea.

Question 8

What breathing change may occur in asthma?

Answer 8

Increased work of breathing.

Question 9

What respiratory symptoms are common in asthma?

Answer 9

Cough and wheeze.

Question 10

What is the core of asthma management?

Answer 10

Control or prevention of inflammation.

Question 11

What should be avoided in asthma management?

Answer 11

Asthma triggers.

Question 12

How are medications adjusted in the step-wise approach?

Answer 12

Increasing medications as the child’s condition worsens.

Question 13

What occurs as the child’s condition improves?

Answer 13

Backing off medications.

Question 14

What are short-acting bronchodilators used for?

Answer 14

Acute treatment of bronchoconstriction.

Question 15

What are long-acting forms used for?

Answer 15

To prevent bronchospasm.

Question 16

What is the first step when using a metered-dose inhaler?

Answer 16

Shake the inhaler and take off the cap.

Question 17

What should be attached to the inhaler?

Answer 17

The spacer or holding chamber.

Question 18

What should the patient do before inhaling medication?

Answer 18

Breathe out completely.

Question 19

How should the spacer or mask be positioned?

Answer 19

Put the spacer mouthpiece in the mouth or place the mask over the child’s nose and mouth ensuring a good seal.

Question 20

How should the medication be inhaled?

Answer 20

Compress the inhaler and inhale slowly and deeply.

Question 21

How long should the breath be held after inhalation?

Answer 21

Hold the breath for a count of 10.

Question 22

How long should be waited before a second inhalation if prescribed?

Answer 22

One full minute.

Question 23

What should be included for all children at each step of asthma management?

Answer 23

Child education, environmental control, and management of comorbidities.

Question 24

When should referral to an asthma specialist be considered?

Answer 24

At step 3.

Question 25

What type of asthma is Step 1?

Answer 25

Intermittent asthma.

Question 26

What medication is preferred in Step 1?

Answer 26

Short-acting beta-2 agonist PRN.

Question 27

What is preferred in Step 2?

Answer 27

Low-dose inhaled corticosteroid.

Question 28

What are alternatives in Step 2?

Answer 28

Cromolyn or leukotriene modifier.

Question 29

What is preferred in Step 3?

Answer 29

Medium-dose inhaled corticosteroid (all ages) OR low-dose inhaled corticosteroid and leukotriene modifier or long-acting beta-2 agonist (children older than 4 years).

Question 30

What is preferred in Step 4?

Answer 30

Medium-dose inhaled corticosteroids and long-acting beta-2 agonist (can use leukotriene modifier in children younger than 4 years).

Question 31

What is preferred in Step 5?

Answer 31

High-dose inhaled corticosteroids and long-acting beta-2 agonist (or leukotriene modifier or theophylline).

Question 32

What is preferred in Step 6?

Answer 32

High-dose inhaled corticosteroids, long-acting beta-2 agonist, and oral systemic corticosteroids.

Question 33

How can trauma be minimized when providing nebulizer treatment to a young child?

Answer 33

Use play, make-believe about the mask, and distraction techniques such as reading a book.

Question 34

What effect does making activities into games have?

Answer 34

Helps minimize trauma when providing necessary care to young children.

Question 35

What is the goal of asthma management regarding breathing?

Answer 35

Restore a clear airway and effective breathing pattern.

Question 36

What is another goal of asthma management?

Answer 36

Promote adequate oxygenation and ventilation (gas exchange).

Question 37

What is the hallmark of airway obstruction in asthma?

Answer 37

Wheezing.

Question 38

What other breath sound may be present?

Answer 38

Coarseness.

Question 39

What may happen to breath sounds in asthma?

Answer 39

Breath sounds might be diminished.

Question 40

What can a quiet chest in an asthmatic child indicate?

Answer 40

An ominous sign.

Question 41

What may occur with severe airway obstruction?

Answer 41

Air movement can be so poor that wheezes might not be heard on auscultation.

Question 42

What may percussion reveal?

Answer 42

Hyperresonance.

Question 43

Why is asthma education important?

Answer 43

It is a critical component for ensuring optimal health in children with asthma.

Question 44

What must children learn regarding asthma?

Answer 44

To master their disease.

Question 45

What does the use of PEFR help determine?

Answer 45

Daily control for those with more severe asthma.

Question 46

When is a child’s “personal best” determined?

Answer 46

Collaboratively with the primary provider or nurse practitioner during a symptom-free period.

Question 47

What does PEFR track?

Answer 47

Airway narrowing day-to-day and falls before symptoms worsen.

Question 48

What does PEFR help guide?

Answer 48

Action plans and treatment changes.

Question 49

What should asthma management plans provide based on PEFR?

Answer 49

Specific instructions.

Question 50

Why is it important to educate children and families about the meter?

Answer 50

So they know how to appropriately use it.

Question 51

What developmental ability do school-age children have regarding asthma management?

Answer 51

Cognitive ability to begin taking responsibility for asthma management with continued parental involvement.

Question 52

What effect does this developmental process have?

Answer 52

Increases the child’s feeling of control over the illness.

Question 53

What is the first step when using a peak flow meter?

Answer 53

Slide the arrow down to “zero.”

Question 54

What position should be used when using a peak flow meter?

Answer 54

Stand up straight.

Question 55

What breathing step is performed before blowing into the meter?

Answer 55

Take a deep breath and close the lips tightly around the mouthpiece.

Question 56

How should air be expelled into the peak flow meter?

Answer 56

Blow out hard and fast.

Question 57

What should be done after blowing into the meter?

Answer 57

Note the number the arrow moves to.

Question 58

How many times should the test be repeated?

Answer 58

Three times, recording the highest reading.

Question 59

How should daily readings be recorded?

Answer 59

Keep a record and measure peak flow at the same time each day.

Question 60

What is an asthma action plan?

Answer 60

A written, individualized plan that tells families, schools, and caregivers what to do every day and during flare-ups using Green/Yellow/Red zones based on symptoms and PEFR.

Question 61

What does the asthma action plan provide based on PEFR?

Answer 61

Specific instructions.

Question 62

Where should the asthma action plan also be kept?

Answer 62

On file at school.

Question 63

What should be available at all times for children with asthma?

Answer 63

Relief medication.

Question 64

Can children with asthma participate in PE or athletics?

Answer 64

Yes, but they need to be allowed to use medicine before activity.

Question 65

What may be needed before vigorous exercise or activity?

Answer 65

A longer warm-up period.