Asthma for Certified Emergency Nursing (CEN)

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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)
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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

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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:

  • Cardiac Disorders
  • Cardiovascular
  • Emergency Care of the Cardiac Patient
  • Circulatory System
  • Nervous System
  • Skeletal System
  • Shock
  • Shock
  • Disorders of the Posterior Pituitary Gland
  • Endocrine
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Hematology
  • Gastrointestinal
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Newborn Complications
  • Lower GI Disorders
  • Multisystem
  • Neurological
  • Central Nervous System Disorders – Brain
  • Renal
  • Respiratory
  • Urinary System
  • Respiratory System
  • Noninfectious Respiratory Disorder
  • Test Taking Strategies
  • Note Taking
  • Basics of NCLEX
  • Prefixes
  • Suffixes
  • Medication Administration
  • Gastrointestinal Disorders
  • Respiratory Disorders
  • Pregnancy Risks
  • Labor Complications
  • Hematologic Disorders
  • Fundamentals of Emergency Nursing
  • Factors Influencing Community Health
  • Delegation
  • Perioperative Nursing Roles
  • EENT Disorders
  • Basics of Chemistry
  • Immunological Disorders
  • Vascular Disorders
  • Studying
  • Integumentary Disorders
  • Musculoskeletal Trauma
  • Sexually Transmitted Infections
  • Newborn Care
  • Microbiology
  • Proteins
  • Oncology Disorders

Study Plan Lessons

02.18 Cardiovascular Practice Questions for CCRN Review
01.01 CCRN Test Overview for CCRN Review
02.01 Hypertensive Crisis for CCRN Review
02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.05 Calculating PAWP on PEEP for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.07 Reading “A, C, V Waves” & PAWP Waveforms for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.03 Hypoglycemia for CCRN Review
03.04 DKA vs HHNK for CCRN Review
03.05 Endocrine Practice Questions for CCRN Review
04.01 Hematology for CCRN Review
04.02 Hematology Review Questions for CCRN Review
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
05.03 Jaundice for CCRN Review
05.04 Ruptured Spleen for CCRN Review
05.05 GI Practice Questions for CCRN Review
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
06.02 Poisoning for CCRN Review
06.03 Multi-System CCRN Important Points for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
07.02 Neuro Anatomy for CCRN Review
07.03 Uncal Herniation for CCRN Review
07.05 Supratentorial Herniation: Cushings Triad for CCRN Review
07.04 Supratentorial Herniation and Glasgow Coma Scale for CCRN Review
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
07.07 Cerebral Perfusion Pressure for CCRN Review
07.08 Basilar Skull Fracture for CCRN Review
07.09 Meningitis for CCRN Review
07.10 Neurologic Review questions for CCRN Review
08.01 Psychological Review for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.02 Acute Tubular Necrosis for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.04 Continuous Renal Replacement Therapy for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
09.06 Renal Practice Questions for CCRN Review
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
10.02 Breath Sounds for CCRN Review
10.03 Acute Respiratory Failure for CCRN Review
10.04 Pulmonary Question Review for CCRN Review
12 Points to Answering Pharmacology Questions
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
5 Rules for Powerpoint
5 Things You Never Knew About The NCLEX – Live Tutoring Archive
54 Common Medication Prefixes and Suffixes
6 Rights of Medication Administration
9 Easy Steps to Passing Every Nursing School Test | With Jon Haws, BSN, RN, Founder of NURSING.com
Abdomen (Abdominal) Assessment
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placenta for Certified Emergency Nursing (CEN)
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Absolute Words
Abuse
Abuse and Neglect for Certified Emergency Nursing (CEN)
Access to Care
Accountability and Assistance for Personal Limitations for Certified Perioperative Nurse (CNOR)
ACE (angiotensin-converting enzyme) Inhibitors
Acetaminophen (Tylenol) Nursing Considerations
Acids & Bases (acid base balance)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Asthma Concept Map
Asthma for Certified Emergency Nursing (CEN)
Asthma management Nursing Mnemonic (ASTHMA)
At Risk for Gout Nursing Mnemonic (MALE)
Atenolol (Tenormin) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AVPU Mnemonic (The AVPU Scale)
Avoiding Alarm Fatigue
Avulsions and Degloving Injuries for Certified Emergency Nursing (CEN)
Azithromycin (Zithromax) Nursing Considerations
Babies by Term
Backwards and Forwards
Bacteria
Bariatric Surgeries
Betamethasone and Dexamethasone
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Biochemistry Course Introduction
Biopsy
Bisacodyl (Dulcolax) Nursing Considerations
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations