Student Learning Guide for Obstructive Pulmonary Diseases
1. Identify the triggers of asthma.
2. Describe the pathophysiology of asthma.
3. What are the manifestations of asthma?
4. Is the amount of wheezing an indicator of the severity of the attack?
5. What is status asthmaticus and what are the manifestations that differ from those of an asthma
attack?
6. Explain why each of the following laboratory test would be abnormal for a client with asthma.
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7. Complete the following table:
Category/Names
Anti-inflammatory
 Systemic
o Solu-cortif
o SoluMedrol
o Prednisone
 Inhaled
o Beclovent
o Azmacort
o Flovent
o Pulmacort
Action
Suppresses
inflammation
Mast Cell Stabilizers
 Cromolyn (Intal)
 Tilade
Anticholinergics
 Short acting:
Atrovent
 Long acting:
Spiriva
Inhibit IgE mediated
release of
inflammatory
mediators from mast
cells and suppress
eosinophils
Blocks the bronchoconstricting influence
of the
parasymphathetic
nervous system.
Combivent is a combo of
anticholinergic and β2
Leukotriene Modifiers:
tablets
 Blockers
o Accolate
o Singular
 Inhibitor
o Zyflo
β2 Adrenergic Agonists
Short Acting:
 Alupent
 Proventil
Blocks the synthesis or
action of leukotrienes
from mast cells and
eosinophils.
Leukotrienes are
potent
bronchoconstrictors
Prevent release of
inflammatory
mediators from mast
cells
Side Effects
Systemic
Nursing Considerations
Systemic
Inhaled
Inhaled:
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 Ventolin
 Maxair
 Brethine
Long Acting:
 Serevent
 Foradil
Immediate Acting
 Adrenalin
Methylxanthines:
 theophylline
Unknown, but causes
bronchodilation
8. Describe the correct way to use metered dose and dry powder inhalers.
9. Why is it necessary for the client with asthma to use both the β2 Adrenergic Agonists inhaler and the
long-term therapy of inhaled corticosteriods or cromolyn?
10. Why are the OTC products that contain epinephrine and ephedrine dangerous?
11. List the teaching points for an asthmatic client to prevent asthma attacks.
12. Describe the red flags for a client during an acute asthma attack.
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13. Describe the care of a client during an asthma attack.
14. Why is a peak flow meter used for clients with asthma and what do the zones mean?
15. What is COPD and what two diseases comprise COPD?
16. Identify the etiological causes of COPD.
17. Describe the pathophysiology of COPD.
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18. What are the manifestations of COPD?
19. What is cor pulmonale and why does it occur in clients with COPD?
20. What is the treatment of clients with COPD exacerbations?
21. Why do clients with COPD have an increased incidence of peptic ulcer and GERD?
22. Why are COPD clients prone to depression and anxiety?
23. Why is smoking cessation important and what is the relationship between smoking cessation and
COPD?
24. Match the nursing diagnosis to the manifestation which would support that nursing diagnosis.
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A = Impaired gas exchange
B = Ineffective breathing pattern
C = Ineffective airway clearance
_____ Adventitious lung sounds
_____ SpO2
_____ shallow respirations
_____ copious sputum
_____ wheezing
_____ cyanosis
_____ hypoxemia
_____ restlessness
_____ tachypnea
_____ respiratory acidosis
_____ hypoventilation
_____ retraction
_____ low peak air flow
_____ hyperventilation
_____ decreased vital capacity
_____ inspiratory-expiratory ratio of 1:3
_____ orthopnea
25. For each of the above manifestations establish an outcome criteria addressing that specific manifestation, under
the correct nursing diagnoses.
Impaired gas exchange:
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Ineffective breathing pattern
Ineffective airway clearance
26. Oxygen should be administered to the client to keep the PaO2 between ________ mm Hg.
Consequently, many clients with end stage COPD require high ________ and high _____
concentrations for survival.
27. The major benefit of long term oxygen therapy for the client with COPD is __________ rates and the
improved prognosis comes from _______________________ of the disease.
28. What is pursed lip breathing and why is it used for clients with COPD?
29. What is huff coughing and why is it used for clients with COPD?
30. What should the client with COPD be taught about nutrition?
31. Why should clients with COPD attend pulmonary rehabilitation?
32. Why is exercise training important for clients with COPD?
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