Shared Flashcard Set

Details

Asthma
N/A
35
Medical
Graduate
06/24/2012

Additional Medical Flashcards

 


 

Cards

Term
Normal respiratory rates
Definition
  • newborn = 40-60
  • infant = 20-40
  • child = 20-30
  • adolescent = 14-20

Factors = sleeping/awake, anger/fear/hydration, fever, meds

Term
normal heart rates
Definition
  • newborn = 80-180, 140
  • infant = 75-160, 130
  • toddler = 60-110, 103
  • child = 60-110, 95
  • adolescent = 50-90, 85
Term
conditions requiring rapid assessment and potential intervention
Definition
  1. RR > 60 or slow irregular respirations in acutely ill child
  2. HR in child <5yo that is >180 or <80
  3. HR in child >5yo that is >160 or <60
  4. increased work of breathing---> retractions, grunting, nasal flaring
  5. cyanosis
  6. irritability (toxic/fussy but consolable) vs. lethargy
Term
chronic cough top differential
Definition
  1. post nasal drip
  2. GERD
  3. asthma
Term
grunting
Definition
  • premature glottic closure accompanying late expiratory contraction of the diaphragm
  • increases airway pressure
  • Seen in: pneumonia, atelectasis, edema
Term
retractions
Definition
  1. suprasternal
  2. intercostal
  3. abdominal breathing
  4. subcostal
  5. substernal
Term
severe respiratory distress
Definition
  • wheezing
  • tachypnea
Term
stridor
Definition
  • high pitched INSPIRATORY sound
  • UPPER airway obstruction
  • made worse if upset or crying
  • Seen in: croup, FB, allergic reaction, laryngomalacia, hemangioma, etc.
  • epiglottitis not common today because of immunizations
Term
wheezing
Definition
  • high-pitched EXPIRATORY sound, may also be inspiratory
  • LOWER airway obstruction
  • Seen in: asthma, bronchiolitis, edema, FB
  • prolonged expiratory phase of respiration
Term
How to estimate obstructed air movement
Definition
  1. expiration far greater than inspiratiion
  2. inabiity to speak (count to 10, say alphabet)
  3. decreased ability to blow (ask pt. to keep piece of paper up)
  4. PEFR (peak expiratory flow rate)
Term
peak flow meter
Definition
  • measures RATE, not volume
  • different than PFT, but convenient and quick
Term
PEFR
Definition
  • admit if PEFR <50% after initial treatment
  • do  not discharge until PEFR is about 75-80% of predicted for age, sex, or size
Term
non-rebreathing mask
Definition
  • 10-15 L/min
  • 60-80% oxygen
  • actually PARTIAL non-rebreathing mask because missing one valve
Term
nasal cannula
Definition
  • 1-6 L/min (usually 2L)
  • 24-40% oxygen
  • SE: nosebleeds, dries nose, uncomfortable
  • do not use in young children or at 6L (ears hurt because so much air blowing)
Term
simple face mask
Definition
  • 6-10 L/min
  • 40-60% oxygen
Term
blow by
Definition
  • usually infants
  • & oxygen unpredictable
  • usually only used if slightly hypoxic

 

Term
mild intermittent asthma
Definition
  • symptoms less than or equal to 2 times a week
  • nighttime sx less than or equal to 2 times a month
  • using less than 2 cannisters per year
  • FEV1 or peak flows greater than or equal to 80% & peak flow variability less than or equal to 20%
  1. no daily meds for long term control
  2. quick relief- short acting beta agonists- albuterol MDI 2 puffs BID prn wheezing
  3. education on environmental controls,  role and use of medications, self-management
Term
mild persistent asthma
Definition
  • symptoms greater than 2 times a week
  • nighttime sx greater than 2 times a month
  • FEV1 or peak flows greater than or equal to 80% predicted
  • peak flow variability 20-30%
  1. long-term control- once daily inhaled LOW dose CS (Flovent or Pulmicort) OR leukotriene inhibitors (Singulair) which is only an alternative
  2. quick relief-albuterol
  3. education
Term
moderate persistent asthma
Definition
  • daily sx, daily use on short-acting bronchodilators, exacerbations affect daily activity level, exacerbations greater than or equal to 2 times a week-may last days
  • nighttime sx greater than 1 time per week
  • FEV1 or peak flows between 60-80% predicted
  • peak flow variability greater than 30%
  1. long-term control- LOW-MEDIUM dose CS, long-acting bronchodilator (ADVAIR= 2 drugs), leukotriene inhibitors, cromolyn
  2. quick relief- albuterol
  3. education
Term
severe persistent asthma
Definition
  • continual sx, limited physical activity, frequent exacerbations
  • frequent nighttime sx
  • FEV1 or peak flows less than or equal to 60% predicted
  • peak flow variability greater than 30%
  1. long-term control- HIGH dose inhaled CS, long acting bronchodilator, ORAL CS needed like PREDNISONE, maybe theophylline
  2. quick relief- albuterol MDI or nebulizer maybe QID treatments
  3. education
Term
common quick relief agents- inhaled beta 2 agonists
Definition
  • albuterol (Proventil, Ventolin, Proair)
  • levalbuterol (Xopenex)
  • pirbuterol (Maxair)

nebulized, metered dose inhaler, autohaler

Term
long term control agents
Definition

inhaled anti-inflammatory= cromolyn (intal), nedocromil (tilade)

  • not useful in acute exacerbations
  • slow onset of action
  • MAST CELL STABILIZERS
  • hardly ever used today
Term
long term control agents- inhaled corticosteroids
Definition
  • flunisolide (aerobid) - bad taste
  • beclomethasone (Qvar)
  • fluticasone (flovent)
  • mometasone (asmanex)
  • budesonide (pulmicort)
Term
long-term control agents- leukotriene inhibitors
Definition
  • montelukast (singulair)
  • zafirlukast (accolate)

ORAL AGENTS, not steroid, chewable

Term
leukotrienes
Definition

potent biochemical mediators that contribute to airway obstruction by:

  1. contracting smooth muscle
  2. increasing vascular permeability and mucus secretion
  3. attracting inflammatory cells
Term
long-acting beta agonists
Definition
  • salmeterol (in advair)
  • formoterol (in symbicort and dulera)

up to 12 hours relief, not effective for acute sx, mixed with a STEROID

Term
long-term control agents- phosphodiesterase inhibitors
Definition
  • theophylline (slo-bid)

MOA:

  1. bronchodilatory
  2. diaphragmatic contractility
  3. anti-inflammatory
  4. mucociliary clearance

usually only prescribed by pulmonologist

Term
asthma
Definition
  • chronic disease characterized by airway obstruction that is at least partially reversible, airway hyperresponsiveness to a variety of external stimuli, and chronic inflammation of the airway
  • 80% of sx begin before age 5
Term
atopy
Definition
  1. asthma
  2. allergic rhinitis
  3. eczema
Term
98.6F
Definition
37C
Term
100.4F
Definition
38C
Term
102.2F
Definition
39C
Term
104.1F
Definition
40C
Term
albuterol SE
Definition
  • increase HR
  • N/V
  • jittery
Term
steroids
Definition
pick 3, 5, or 7 days (no tapering unless longer than one month d/t HPA axis suppression)
Supporting users have an ad free experience!