ASTHMA Characterized by exacerbations of acute airway inflammation Airway obstruction occurs d/t bronchoconstriction, mucous, or inflammation when exposed to trigger Clinical Manifestation... s: High pitched, wheezing lung sounds Cough SOB Chest tightness Worsens at night or when triggers are present Medications: Short Acting= Albuterol, Proventil, Ventoli Long Acting= Serevent Corticosteroids= Serevent, Advair Education: Avoid triggers Stop/avoid smoking Teach which inhaler is rescue Exacerbation Interventions: Give short-acting beta agonist IV corticosteroids depending on severity O2 via nasal cannula High-fowler’s position Calm atmosphere Questions: If a pt. is having an asthma attack how would you expect it to affect their VS? At first RR increased then decreased as attack progresses Tachycardia >120 Decreased BP If you give a pt. Albuterol, what type of side effects would you expect to see? Increased HR Tremors What are rescue medications for Asthma? Short-acting beta agonists (Albuterol) EPITAXIS Nose bleed – d/t trauma, allergies, drug use Most frequent ED complaint Interventions & Treatment: Anterior portion of nose = apply direct pressure for 5-10 while leaning forward Apply silver nitrate Apply lidocaine/ep with cotton pledge for 5-10 minutes Nasal packing for 2-5 days Educate on prevention – Vaseline, humidifiers COPD Chronic obstructive pulmonary disease – emphysema & chronic bronchitis Causes= air pollution, occupation, smoking Primary Symptoms: Cough Sputum production DOE – Dyspnea On Exertion Clinical Manifestations: Wheezes or crackles heard in lungs Prolonged expiratory phase Distant heart sounds Orthopneic position Barrel chest Use of accessory muscles Weight loss (dyspnea with eating) Late phase= clubbing to nails, right-sided HF, chronic cyanosis Medications: Avoid frequent use of cough suppressants (antitussives) because coughing is a protective mechanism Limit narcotic use d/t respiratory depression can worsen hypercapnia Beta-Adrenergic Agonists: Albuterol, formoterol Anticholinergics: Atrovent, Spiriva Corticosteroids: short course only Methylxanthines: Theophylline (limited) Interventions & Education: Pursed lipped breathing Controlled coughing Controlled O2 therapy (1-2 L) Low sodium diet Diaphragmic breathing Conserve energy Small frequent meals Increase fluids BiPAP RAYNAUD’S DISEASE Bilateral vasospasms; peripheral artery occlusive disease triggered by cold & stress Clinical Manifestations: Pain & cyanosis followed by redness and pain (when warmed up) Pain is intermittent, extremities are numb & cold & may have swelling/ulcerations Education: Stop smoking Exercise Control stress Avoid extreme temperatures ALLERGIC RHINITIS Prevention: Remove carpet Keep pets out of house or out of bedrooms Wash linens in hot water Avoid heat & humidity Avoid feather pillows Avoid cigarette smoke Medications: Fexofenadine (Allergra) = non-drowsy Pseudoephedrine (Sudafed) = non-drowsy Diphenhydramine (Benadryl) = drowsy CYSTIC FIBROS [Show More]
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