The whole respiratory batch, compressed into mnemonics and worked questions
This is the last page of the respiratory batch and the one to open the night before an exam. It does three things: it puts every drug on one map, it collects every mnemonic in the batch in one place, and it works through the classic exam questions option by option — including why each wrong answer is wrong, because that is where the marks actually are. Every other page in the batch is linked from here.
📄 Simple Nursing original — opens in Drive →
Four pictures that hold the entire batch. If you can redraw these, you know the material.
Every drug in this batch is on this tree. Before you answer any respiratory drug question, find the drug on the tree — the trunk it belongs to already tells you whether it rescues or prevents.
| Page | What it covers | The one line to remember |
|---|---|---|
| NG-102 Beta-2 agonists | Albuterol, salmeterol, formoterol · inhaler technique · the order rule | SABA rescues · LABA never does |
| NG-143 Anticholinergics + methylxanthines | Ipratropium, tiotropium, theophylline, aminophylline | Very dry body · toxic over 20 mcg/mL |
| NG-097 Allergy & cough | Antihistamines, decongestants, antitussives, expectorants | Match the drug to what the symptom is doing |
| NG-083 BiPAP & intubation | CPAP vs BiPAP, intubation, tube confirmation, vent alarms, VAP | CPAP = 1 pressure · BiPAP = 2 |
| NG-100 Anti-inflammatory agents | Inhaled and systemic steroids, montelukast, cromolyn | Preventers — they never rescue |
| NG-006 Hypoxia & O₂ devices | Nasal cannula → non-rebreather → high flow, FiO₂ and flow rates | Flat bag = more gas |
| NG-004 Anatomy of the lungs | The airway tree, the alveolus, breath sounds, lobes | Right lung 3 lobes · left lung 2 |
This wheel is the single highest-value thing on the page for an exam with an unfamiliar drug name in it. You do not need to have met the drug — you need to have met the ending.
The chain works in one direction and it is reliable:
The order is by speed, not by importance. All three are given — the steroid is given early precisely because it is slow.
Three panels, one rule, and at least three different exam questions built out of it.
Collected in one place. Say them out loud — that is what makes them stick.
A — Albuterol first (minutes)
I — Ipratropium second (15–30 minutes)
M — Methylprednisolone (hours — so give it early)
Oxygen, upright positioning and continuous monitoring run alongside all three.
T — Tachycardia and palpitations
T — Tremor (fine, both hands)
T — Tossing and turning (insomnia, jitteriness)
All three are expected, not allergic. Report chest pain or a rate that keeps climbing.
Salmeterol = Slow acting. NOT a rescue inhaler. Scheduled twice daily. Never used alone in asthma — it needs a Steroid alongside it.
Beta-2 agonist · "-buterol" · for Brutal asthma attacks.
And the receptor number tells you the organ: beta-TWO = TWO lungs, beta-ONE = ONE heart.
Every anticholinergic — ipratropium, tiotropium, diphenhydramine, and the rest.
Blurred vision and dilated pupils · urinary retention · dry mouth and throat · constipation. Plus can't sweat, which is the overheating risk.
Glaucoma (closed-angle) · Gotta-go problems (urinary retention, BPH) · a Gut that has stopped (obstruction, ileus).
Short version from the source: "we never give these to someone who is already dry."
T — Toxic over 20 mcg/mL (commonly cited; ranges vary by lab) —
expect frequent blood draws.
T — Tachycardia and dysrhythmias — report before the next dose.
T — Tonic-clonic seizures — the emergency stage.
Cimetidine and Ciprofloxacin slow the liver, so the level rises.
Add the third C — Caffeine — which stacks on top of the drug's own effects. And remember the reverse: quitting smoking can push a stable patient into the toxic range.
Once daily · maintenance only · never a rescue drug · and the capsule is inhaled, never swallowed.
A metered-dose inhaler is a suspension. Unshaken, the first puffs can be mostly propellant.
And its opposite: a dry-powder inhaler is never shaken, and you breathe in fast and deep rather than slow.
First-generation antihistamines (diphenhydramine, chlorpheniramine, hydroxyzine) cross into the brain → sedation plus every anticholinergic effect.
Second generation (loratadine, cetirizine, fexofenadine) mostly stay out. Cetirizine is the drowsiest of the second-generation group.
Dry, hacking, brings nothing up → antitussive (dextromethorphan, codeine).
Wet, rattly, brings mucus up → expectorant (guaifenesin) plus fluids.
Never suppress a productive cough — trapped secretions become pneumonia.
High CO₂ (PaCO₂ > 45) — hypercapnic respiratory failure, classically a COPD exacerbation — is the BiPAP patient.
And count the letters: Continuous = ONE pressure. Bi = TWO.
High-pressure ventilator alarm = something is in the WAY — secretions, biting, kinks, water, bronchospasm, pneumothorax.
Low-pressure alarm = something is MISSING — a disconnection, a cuff leak, a tube that has moved.
Wave — waveform capnography, the most reliable bedside check.
Listen — bilateral breath sounds and over the epigastrium.
Film — chest X-ray for the depth.
Auscultation alone is NOT confirmation.
Bronchodilators = Beta-2 · Anticholinergic · Methylxanthine. "BAM — the airway is open."
Anti-inflammatories = Steroid · Leukotriene inhibitor · Mast-cell stabilizer. "SLiM the swelling down."
Two grids that answer whole categories of question before you even read the options.
"Which prescription should the nurse question?" is one of the most common respiratory item types there is — and it is almost always one of the red cells on this grid.
An ARB such as losartan in a client with diabetes is appropriate — it is commonly used specifically because it is kidney-protective in diabetes.
It appears in this question set purely as the "safe" option to make sure you are not just flagging everything.
Do this before you look at the options. Most wrong answers on these items are not knowledge failures — they are reading failures.
These stems ask for the WRONG statement:
The exact same four options, written as "which statement indicates understanding?", would have a completely different answer.
"Which is the priority / first action?" — assessment first unless the stem describes an immediate life threat. Airway beats everything.
"Select all that apply." — judge each option as a separate true/false question. Do not look for a pattern, and do not assume there must be exactly three.
These are the source infographic's own items — every option explained, not just the key.
A client is receiving discharge instructions for an inhaled corticosteroid metered-dose inhaler. Which teaching should the nurse include?
Which statement by the client requires further teaching?
Which of the following prescriptions should the nurse question? Select all that apply.
What patient teaching should be included with new prescriptions of albuterol, ibuprofen, tiotropium and beclomethasone? Select all that apply.
Which medication prescribed for asthma causes tachycardia and dysrhythmias?
This is the question the source labels "most commonly missed". It is missed because the tachycardia in the stem looks like a reason to withhold albuterol.
A client with severe asthma has a heart rate over 120, a respiratory rate over 30, an SpO₂ under 90% on room air, and a peak expiratory flow under 40% of predicted. Which medications would you anticipate? Select all that apply.
Notify the provider. Do not keep dosing and hoping — this is an escalation point. Also assess for a silent chest, rising drowsiness, and inability to speak a sentence.
Respiratory rate falling (for example 34 → 24), SpO₂ at least 90%, wheeze quieter, accessory-muscle use easing, sentences getting longer.
Hypercapnic — PaCO₂ over 45, classically a COPD exacerbation. Two pressures move air, and moving air is what clears CO₂. HyperCAP → BiPAP.
Waveform capnography at the bedside, supported by bilateral breath sounds and confirmed for depth by chest X-ray. Auscultation alone is not confirmation.