Asthma for Certified Emergency Nursing (CEN)
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Included In This Lesson
Study Tools For Asthma for Certified Emergency Nursing (CEN)
Asthma Medications (Cheatsheet)
Asthma Pathochart (Cheatsheet)
Asthma management (Mnemonic)
Asthma Implementation and Education (Picmonic)
Asthma Assessment (Picmonic)
Outline
Asthma
Definition/Etiology:
- Chronic reactive airway disease with airway hyperreactivity, inflammation, and reversible airflow obstruction
- Can be life-threatening. Status asthmaticus is a severe, refractory asthma attack
Common Triggers:
- Allergy induced
- Environment, (pollution, smoke, cold/dry air, seasonal changes)
- Medications (ASA, NSAIDs, beta blockers)
- Food additives, sulfites, tetrazine
- Illness – URI, GERD
- Exercise
- Menses
Pathophysiology:
Very complex – involves airway inflammation, constriction/obstruction, overresponsive bronchi
Clinical Presentation:
- Chest tightness, cough, increased work of breathing
Wheezing (expiration=early; inhalation=late)- may be audible without stethoscope
Assessment:
- Crackles on auscultation
- Prolonged expiratory time
- Lower lobe breath sounds diminished
Signs of hypoxia – impending respiratory failure
- Silent chest
- Restlessness, somnolence, decreased respiratory effort, bradycardia, periodic apnea
Collaborative Management:
- Peak expiratory flow rate (PEFR)
- sit upright with legs dangling
- Inhale fully, seal circumference of the mouthpiece and exhale fully
- Note position of flow meter
- Repeat 3 times and base treatment decisions on best of the readings
Findings:
- 70–90% of predicted value or personal best, use inhalers
- Less than 70% of predicted value or personal best: seek medical attention
- 40–69% of predicted value or personal best: moderate exacerbation
- Less than 40% of predicted value or personal best: severe exacerbation
Meds:
- Short-acting beta agonists – relax smooth muscles, bronchodilation
- Anticholinergics – inhibits contraction of bronchial smooth muscle, limits mucus
- Corticosteroids – anti-inflammatory, limits mucus
- Magnesium sulfate – inhibits smooth muscle contraction, decreases histamine
Medications Delivery:
- Metered dose inhaler (MDI)
- use of spacer recommended; increases delivery from 15-85%
- Dry power inhaler
- Nebulizer
Evaluation | Patient Monitoring | Education:
- Avoid known allergens/triggers
- Use hypoallergenic bedding, wash in hot water
- Air purifiers, carpet removal
- Keep cats and dogs outside of the house
- Remain inside with air conditioning during the early morning and midday
- Take medication as directed, pretreat before exercise
- Smoking cessation
Linchpins: (Key Points)
If you treat late, you may have to intubate
- Position of comfort
- Progression prevention and airway management
- Severity of exacerbation determines clinical presentation and aggression of treatment
- Medication administration
- Trigger management
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
- Egging, D. (2017). Respiratory Emergencies and Thoracic Trauma. In CEN Online Review. Emergency Nurses Association.
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Concepts Covered:
- Shock
- Shock
- Immunological Disorders
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Integumentary Disorders
- Neurological Trauma
- Musculoskeletal Trauma
- Liver & Gallbladder Disorders
- Intraoperative Nursing
- Neurological Emergencies
- Oncology Disorders
- Emergency Care of the Neurological Patient
- Postoperative Nursing
- Disorders of the Thyroid & Parathyroid Glands
- Central Nervous System Disorders – Brain
- Noninfectious Respiratory Disorder
- Respiratory Emergencies
- Hematologic Disorders
- Vascular Disorders
- Respiratory System
- Infectious Respiratory Disorder
- Urinary Disorders
- Urinary System
- Musculoskeletal Disorders
- Acute & Chronic Renal Disorders
- Emergency Care of the Trauma Patient
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Cognitive Disorders
- Medication Administration
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Disorders of Pancreas
- Newborn Complications
- Communication
- Lower GI Disorders
Study Plan Lessons
Sepsis Concept Map
Shock
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Concept Map
Stroke for Certified Emergency Nursing (CEN)
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Surgical Incisions & Drain Sites
Surgical Prep
Surgical Counts for Certified Perioperative Nurse (CNOR)
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Tension and Cluster Headaches
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
Thoracentesis
Thrombocytopenia
Thrombolytics
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Vancomycin (Vancocin) Nursing Considerations
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Wound Infections for Certified Emergency Nursing (CEN)
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)
Wound Dressing Maintenance for Certified Perioperative Nurse (CNOR)
Wound Classification for Certified Perioperative Nurse (CNOR)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
02.14 Shock Stages for CCRN Review
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
ACE (angiotensin-converting enzyme) Inhibitors
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Adjunct Neuro Assessments
Admissions, Discharges, and Transfers
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Advance Directives
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Airway Suctioning
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Alteplase (tPA, Activase) Nursing Considerations
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Amputation
Amputation Concept Map
Anemia for Progressive Care Certified Nurse (PCCN)
Anesthetic Agents
Anesthetic Agents
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Anti-Infective – Antitubercular
Anti-Platelet Aggregate
Anticonvulsants
Antidiabetic Agents
Antimetabolites
Antineoplastics
Antinuclear Antibody Lab Values
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
ASA (Aspirin) Nursing Considerations
Aspiration for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Asthma for Certified Emergency Nursing (CEN)
At Risk for Gout Nursing Mnemonic (MALE)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
Azithromycin (Zithromax) Nursing Considerations
Barriers to Health Assessment
Blood Flow Through The Heart
Blunt Chest Trauma
Bowel Obstruction Concept Map