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AG > AG2-PE/ARDS/ARF > Flashcards

AG2-PE/ARDS/ARF Flashcards

1
Q

Best diagnostic tests for PE?

A

Angiogram (CTA) or Spiral CT

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2
Q

What kind of chest pain is specific to PE?

A

Sharp stabbing pain with tachycardia and dyspnea

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3
Q

After calling a rapid response what should we anticipate happen?

A

Administration of TPA for massive PE or Lovenox for small PE

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4
Q

Who should not be given TPA?

A

Anyone with hemorrhaging, trauma, or post surgery

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5
Q

Causes of ARDS r/t direct injury to the lung tissue?

A

Aspiration, chest trauma, PNA, near drowning, and COVID 19

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6
Q

Causes of ARDS r/t indirect injury to lung tissue?

A

Severe trauma, blood transfusions, drug overdose, pancreatitis, cardiopulmonary bypass

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7
Q

Mild ARDS P/F ratio?

A

200-300

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8
Q

Moderate ARDS P/F ratio?

A

100-200

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9
Q

Severe ARDS P/F ratio?

A

<100

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10
Q

When is the ARDS protocol initiated?

A

When P/F ration is around 300

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11
Q

What is ARF?

A

When the respiratory system fails in one or both of its gas exchange functions: oxygenation and carbon dioxide elimination. As a result the pt will experience hypoxemia or hypercapnia.

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12
Q

What is the most common form of respiratory failure?

A 
Hypoxemic normocapnia (oxygenation failure)
PaO2< Or equal to 60mm Hg on 60% oxygen, PaCO2 is normal
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13
Q

What acute diseases can cause oxygenation failure?

A

Pulmonary edema and PNA

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14
Q

What is ventilator failure?

A

Hypoxemic hypercapnia; PaO2< or equal to 60 mmHg on 60% oxygen, PaCO2 > 50mmHg and pH < 7.35

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15
Q

Causes of ventilator failure?

A

Drug overdose, asthma, and COPD

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16
Q

4 causes of hypoxemia?

A

V/Q mismatch, alveolar hypoventilation, diffuse limitation, and shunting

17
Q

What is a V/Q mismatch?

A

When ventilation exceeds perfusion or perfusion exceeds ventilation

18
Q

What is shunting?

A

When the blood returns to the left side of the heart without participating gas exchange in the lungs first.

19
Q

What neuromuscular diseases may result in msl weakness or paralysis?

A

Guillain-Barre, muscular dystrophy, myasthenia gravis, MS

20
Q

What are early signs of ARF?

A

Dyspnea, tachypnea, or intercostal retractions noted during inspiration

21
Q

Symptoms of acidosis?

A

Chest pain and cardiac dysrhythmias because as acidosis increases and PaO2 decreases the myocardium becomes dysfunctional. Cerebral and kidney damage may occur if the hypoxemia is severe and prolonged.

22
Q

What is an indicator of severe worsening ARF?

A

Paradoxical diaphragmatic movements

23
Q

What is an indicator of moderate ARF?

A

Accessory msl use

24
Q

ARDS is characterized by?

A

Severe dyspnea, hypoxemia refractory to supplemental oxygen, reduced lung compliance, and diffuse pulmonary infiltrates.

25
Q

Common risk factors for ARDS development? Direct and indirect

A

Direct lung injury: Sepsis, aspiration of gastric contents , viral or bacterial PNA

Indirect lung injury: sepsis, severe massive trauma

26
Q

What sx will the patient exhibit in the 1st phase of ARDS?

A

Tachypnea, dyspnea, cough, restlessness, confusion

27
Q

What s/sx may be present in the 2nd phase of ARDS?

A

Tachycardia, diaphoresis, cyanosis, decreased mentation, pallor, hypoxemia despite O2, hypercapnia

28
Q

What signs may be present in the 3rd phase of ARDS?

A

White out x ray, pleural effusions, severe hypoxemia and hypercapnia, metabolic acidosis

29
Q

Possible complications in the 4th phase of ARDS?

A

MODS (kidneys, liver, and heart are most commonly affected)

30
Q

Possible complications of ARDS?

A

Infection, respiratory, cardiovascular, GI, hematologist, ET tube, and CNS psychological complications.

31
Q

What is hemodynamic monitoring?

A

When an arterial catheter is inserted for continuous monitoring of blood pressure and sampling of blood for determination of ABG values

32
Q

How does dopamine and dobutamine help with ARDS tx?

A

It supports cardiac output and function

AG (30 decks)

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