Acute Pulmonary Embolism and Status Asthmaticus

Which condition can occur if status asthmaticus is not reversed in a timely manner? Chronic obstructive pulmonary disease (COPD) Frequent, uncontrolled asthma Acute lung failure (ALF) Frequent, controlled asthma

Acute lung failure (ALF) As a result of severely constricted airways, adequate gas exchange cannot take place, causing tissue damage from ALF.

Which electrolyte may be beneficial in the reversal of status asthmaticus? Sodium Magnesium Potassium Calcium

Magnesium Magnesium has a bronchodilator effect sometimes noted in patients with status asthmaticus who are otherwise not responsive to conventional treatments.

Which description best outlines the reason behind regular peak flowmeter use? Allows patients a better understanding of their current condition Tells patients how sick they are Alerts patients to when they are starting to have an asthma attack Prevents future asthma attacks

Allows patients a better understanding of their current condition The peak flowmeter, when properly used, gives a data point of wellness or illness in an objective manner. Trended data is best and allows patients to seek professional guidance well in advance of exacerbations as well as to gauge the effectiveness of therapies.

Which description best defines status asthmaticus? An individual with a diagnosis of asthma The status of an individual with asthma who has achieved complete remission The formal name for the condition of partially reversible airway obstruction An exacerbation of asthma that does not respond to conventional interventions

An exacerbation of asthma that does not respond to conventional interventions Status asthmaticus is a severe asthma attack that fails to respond to conventional therapy.

Which intervention would the nurse be prepared to complete for the patient with a pulmonary embolism (PE)? Filter placement Compression device placement Platelet administration Clot dissolution

Clot dissolution Either administration of a thrombolytic medication or assisting in the mechanical removal of a clot are possible interventions for which the nurse should be prepared.

Which blood test is suggestive of a pulmonary embolism (PE)? D-dimer Arterial blood gas (ABG) C-reactive protein (CRP) Ventilation-perfusion (V/Q) scan

D-dimer The D-dimer provides a general indication of a patient's clotting probability. It would be elevated in a patient with a PE, and a normal D-dimer would rule out this diagnosis.

Which condition is the greatest contributing factor to thrombus formation?Endothelial injury Smoking Hormone therapy Immobility

Endothelial injury Endothelial injury appears to be the most common factor in the formation of blood clots. It can occur as a result of several conditions commonly associated with embolic injuries.

Which class of medication might the nurse expect to administer in the care of the patient with a pulmonary embolism (PE)? Select all that apply. One, some, or all responses may be correct. Fibrinolytic Anticoagulant Bronchodilator Sedative Inotrope Analgesic

Fibrinolytic Fibrinolytics promote the dissolution of the clot, thus restoring circulation. Anticoagulant Anticoagulants are administered to prevent secondary clot formation. Bronchodilator Bronchodilators counteract airway constriction brought on by the interrupted circulation to the alveoli. Sedative Sedatives help the patient tolerate treatments such as mechanical ventilation, thus reducing oxygen demand. Inotrope Inotropic medications offset the circulatory compromises caused by the PE by making cardiac output optimal. Analgesic Pain control reduces anxiety and oxygen demand, thus promoting recovery.

Which educational subject can best help the asthma patient control the condition? Metered-dose inhaler (MDI) technique Medication purpose and regimen Flowmeter use and reading Symptoms of status asthmaticus

Flowmeter use and reading Regular use of a peak flowmeter and understanding of the data will help the patient with early recognition of exacerbation and promote therapy compliance.

Which component is part of an asthma attack? Select all that apply. One, some, or all responses may be correct. Inflammation Aspiration Hyperresponsiveness Bronchospasm Trigger

Inflammation Inflammation ensues from the irritant and the resulting responses and further constricts the airways, contributing to an asthma attack. Hyperresponsiveness A response to a trigger that is too robust begins the cycle of an asthma attack. Bronchospasm The contraction of the lumen of the airways is part of the hyperresponse to the irritating trigger. Trigger Exposure to an irritant such as animal dander or smoke triggers an asthma attack.

Which action is thought to be the benefit of leukotriene inhibitors? Bronchoconstriction prevention Inflammation prevention Irritant control Positive inotropic effect

Inflammation prevention By inhibiting the actions of leukotrienes, the inflammatory response is reduced, thus limiting one component of asthma

Which component begins the process of an asthma attack? Inflammation Bronchospasm Mucous Irritant

Irritant The initiating factor to an asthma attack is the irritant trigger. Exposure to such things as strong perfume or cologne, smoke, or animal dander can begin the process.

Which nursing intervention decreases the incidence of a pulmonary embolism? Patient ambulation Fluid restriction Vitamin K administration Bed rest

Patient ambulation Walking is highly effective in the prevention of deep vein thrombosis formation of the lower extremities.

From which area of the body are emboli most likely to travel to the lungs? Arm Right heart Pelvis Left heart

Pelvis Most clots originate from the pelvic and deep veins.

Which patient condition is most suggestive of status asthmaticus? Tachypnea Tachycardia Hypoxemia Pulsus paradoxus

Pulsus paradoxus Pulsus paradoxus of greater than 25 mm Hg is a later sign, making it more suggestive of the condition.

Which sign of a pulmonary embolism (PE) is the most common? Apprehension Respiratory rate >20 Cough S waves on electrocardiogram (ECG)

Respiratory rate >20 Elevated rates of breathing and heartbeat are the most common presenting signs of a PE.

Which educational topic for patients and families is appropriate for prevention of future blood clots? Symptoms of a pulmonary embolism (PE) Risk factor modification Signs of a deep vein thrombosis (DVT) Bleeding prevention

Risk factor modification Reducing or eliminating risk factors is a preventive measure that should be taught and reinforced to patients and families.

Which subject is appropriate for discharge education for the patient with a pulmonary embolism (PE)? Select all that apply. One, some, or all responses may be correct. Risk factor modification Deep vein thrombosis (DVT) prevention Signs of DVT Symptoms of excessive anticoagulation Pathophysiology

Risk factor modification Smoking cessation and non-hormone-based birth control methods are modifiable behaviors that can be made by the patient at risk for another PE. Deep vein thrombosis (DVT) prevention Prevention of DVT is paramount to the prevention of PE, as most clots form in the lower extremities; lifestyle changes can reduce the risk. Signs of DVT Knowing the indicators of DVT formation will alert the patient to seek care before embolization of the thrombus occurs. Symptoms of excessive anticoagulation Anticoagulation therapy is not without serious risk. The patient will be able to seek care for being too anticoagulated when aware of the signs and symptoms. Pathophysiology Having an understanding of what occurs helps to reinforce treatment. Knowing the how makes the why more sustainable.