NR 601 Midterm Exam Study Guide: Questions & Answers: Updated A+ Guide

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What are the 3 primary physiological changes of aging? (Ans- 1. Reduced physiological reserve of most body systems, esp. cardiac, resp, renal. 2. Reduced homeostatic mechanisms that fail to adj ... ust regulatory systems (i.e. temp control, fluid/lyte balance, etc.). 3. Impaired immunological function (infection risk is greater, autoimmune dz's more prevalent) What is the preferred amount of exercise for elderly? (Ans- 30min/day 5 days/wk of moderate exercise. If trying to lose wt: 60min/day. What are PFTs? (Ans- Group of tests that provide quantifiable measurement of lung function, used to dx resp abnormalities or assess progression/resolution of lung dz. What is FEV1? (Ans- Forced Expiratory Volume in 1 second (80-120%) What is FVC? (Ans- Forced Vital Capacity (80-120%) What is normal FEV1/FVC ratio? (Ans- <0.7 (70%) What is GOLD 1 criteria? (Ans- Mild FEV1 >/= 80% predicted What is GOLD 2 criteria? (Ans- Moderate FEV1 50-79% predicted What is GOLD 3 criteria? (Ans- Severe FEV1 30-49% predicted What is GOLD 4 criteria? (Ans- Very severe FEV1 <30% predicted What are the signal symptoms of COPD? (Ans- Dyspnea Chronic cough w/sputum Decreased activity tolerance Wheezing What are characteristics of COPD? (Ans- Common, preventable, treatable. Characterized by persistent airflow limitation. Usually progressive, associated with enhanced chronic inflammatory response in airways and lungs to noxious particles/gases Airway fibrosis, luminal plugs, airway inflammation, increased airway resistance, small airway dz. Decreased elastic recoil of alveoli. What are risk factors for COPD? (Ans- Smoking (increasing w/number of pack years) Second hand smoke Environmental pollution (endotoxins, coal dust, mineral dust) What is seen on phys exam in COPD? (Ans- May be normal in early states As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance), accessory muscle use, pursed lip breathing, increased expiratory phase, neck vein distention. How is COPD diagnosed? (Ans- Spirometry is gold standard (pre and post bronchodilator). Irreversible airflow limitation is hallmark. How is COPD treated? (Ans- Bronchodilators: beta agonists (long/short), anticholinergics (long/short), or combo. What is the MOA of beta agonists? (Ans- Stimulates beta-2-adrenergic receptors, increasing cyclic AMP, resulting in relaxing airways. What is the MOA of anticholinergics? (Ans- Block the effect of acetylcholine on muscarinic type 3 receptors, resulting in bronchodilation. Why are long-acting beta agonists prescribed for COPD? (Ans- They are for moderate airflow limitation. They relieve symptoms, increase exercise tolerance, reduce number of exacerbations, improve QOL. What are some non pulmonary diagnoses that result in COPD-type symptoms? (Ans- CHF Hyperventilation syndrome Panic attacks Vocal cord dysfunction Obstructive sleep apnea Aspergillosis Chronic fatigue syndrome What are signal symptoms of asthma? (Ans- Wheezing Shortness of breath Cough (esp at night) Chest tightness What is chronic bronchitis? (Ans- Daily chronic cough w/increased sputum for at least 3 consecutive months in at least 2 consecutive years. Usually worse on wakening. May or may not be associated with COPD. What is emphysema? (Ans- Characterized by obstruction to airflow caused by abnormal airspace enlargement distal to terminal bronchioles. Chronic inflammation/remodeling, trapping air, hindering effective O2/CO2 exchange (all due to inflammatory mediators infiltrating airways). What are signal symptoms of ischemic heart dz? (Ans- Chest pain Chest tightness [Show More]

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