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Exam 3 Intro Pharm Airway > Airway > Flashcards

Airway Flashcards

1
Q

What occurs in the exchange of oxygen and carbon dioxide between the organism and the environment?

A

Respiration

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2
Q

___ is the exchange of air into and out of the lungs.

A

Ventilation

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3
Q

What is intrapulmonic pressure?

A

Pressure of gas in the alveoli

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4
Q

What is the normal amount of intrapulmonic pressure?

A

Around 760mmHg

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5
Q

What type of pressure is found in the plural space?

A

Intrathoracic

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6
Q

What is the normal amount of intrathoracic pressure?

A

It is normally less than intrapulmonic pressure

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7
Q

What is compliance?

A

The ease with which the lungs and thorax expand during pressure changes

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8
Q

What is the normal tidal volume for an adult?

A

500-600mL

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9
Q

Of normal tidal volume, ______mL never make it to alveoli.

A

150

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10
Q

What is the total lung capacity?

A

Sum of vital capacity and residual volume

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11
Q

What is residual volume?

A

Gas that remains in the respiratory system after forceful expiratory activity

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12
Q

What is normal residual volume of an adult?

A

1100mL

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13
Q

What process is involved in how oxygen and carbon dioxide are exchanged in the tissues and alveoli?

A

Diffusion

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14
Q

________results from destroying or collapsing of alveolar wall.

A

Atelectasis

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15
Q

What is ficks principal?

A

Amount of oxygen the lungs deliver to the blood related to the amount of oxygen the body consumes

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16
Q

What is the term given to decreased oxygen at the tissue level?

A

Hypoxia

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17
Q

What is the term given for a decreased oxygen state at the arterial blood level?

A

Hypoxemia

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18
Q

Where is the phrenic nerve located?

A

C4

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19
Q

What are the two mechanisms responsible for basic respiratory rhythm?

A

Vagal reflex and pneumotaxic center

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20
Q

Where is the vagal reflex located?

A

Bronchi, bronchioles, and lungs

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21
Q

Where is the pneumotaxic center located?

A

Pons

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22
Q

When is the pneumotaxic center active?

A

Only in active breathing

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23
Q

The ______ says to stop breathing and the ____ say inhale.

A

Medulla and pons

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24
Q

Chemoreceptors do not work well in what type of patient?

A

Shock patients

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25
Q

What three parameters are evaluated when assessing airway adequacy?

A

Rate, regularity, effort

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26
Q

What is considered normal respiratory range for an adult?

A

12-20 per minute

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27
Q

What is considered normal respiratory range for a child?

A

15-30 per minute

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28
Q

What is the normal respiratory rate of an infant?

A

25-50 per minute

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29
Q

What is a sign?

A

Something you can see and/or touch

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30
Q

What causes snoring?

A

Tongue has fallen back and is blocking the airway

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31
Q

What causes gurgling?

A

Fluid in the airway

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32
Q

What causes wheezing?

A

REversible narrowing of the lower airway

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33
Q

What causes stridor?

A

Partial upper airway obstruction. High pitched sound heard on inhalation.

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34
Q

What causes rales?

A

Fine cracking bubbles in alveoli

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35
Q

What causes rhonchi?

A

Fluid in the brochioles

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36
Q

Cheyne-Stokes respiration’s are seen in patients with?

A

Head injury and medulla

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37
Q

Which respirations are described as fast to slow and deep to shallow and period of apnea?

A

Cheyne-Stokes

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38
Q

What are Kussmaul respirations?

A

Fast and depp respiration’s

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39
Q

What are some causes for an increase in respiratory rate?

A

Acidosis, anxiety, aspirin poisoning, pain, pons damage

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40
Q

What are some causes for a decrease in respiratory rate?

A

Alkalosis, narcotic, obesity

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41
Q

A nasal cannula 1-6 LPM contains what percent of oxygen?

A

24-44%

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42
Q

A ventruri mask 4-8 LPM contains what percent of oxygen?

A

24-50%

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43
Q

A simple face mask 6-10 LPM contains what percent of oxygen?

A

35-60%

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44
Q

What are two complications of positive pressure breathing in a non-intubated patient?

A

Gastric inflation and rupture of lung tissue

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45
Q

Inspiratory pressures in adults average _______ to ________.

A

20-30

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46
Q

What is the most likely cardiac dysrhythmia to occur during endotracheal suctioning?

A

Bradycardia

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47
Q

What is the typical ET size is recommended for men?

A

7-8

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48
Q

What typical ET size is recommended for women?

A

6-7

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49
Q

What typical ET size is recommended for toddlers?

A

Age divided by 4 plus 4
or
16 plus age divided by 4

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50
Q

Which intubation tool traps the epiglottis and lifts?

A

Straight blade

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51
Q

Which intubation tool enters the vallecula and lifts?

A

Curved blade

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52
Q

Which intubation tool gives shape and support to ET tube?

A

Stylet

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53
Q

The distance between the teeth and the carina is?

A

27 cm

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54
Q

What is the #1 cause of airway obstruction?

A

Tongue

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55
Q

What is the formula for minute volume?

A

Tidal volume x respiratory rate

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56
Q

Typical tidal volume is ____ cc.

A

500

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57
Q

Alveolar volume is found by?

A

Subtracting 150 from tidal volume

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58
Q

What is the acceptable pulse ox range for a COPD patient?

A

90-92%

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59
Q

What is the result of CO2 retention?

A

Hypoxic Drive

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60
Q

At what range in CO2 does a COPD patient “flip” to the hypoxic drive?

A

When the CO2 levels rise from normal (35 to 45%) to greater than 60%.

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61
Q

At what range in O2 does a COPD patient “flip” to the hypoxic drive?

A

When the O2 levels drop from normal (80 to 100%) to less than 60%.

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62
Q

___________ allowed users to sleep by keeping the airways open

A

CPAP

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63
Q

What is the major problem with CPAP?

A

The person had to exhale against the extra pressure

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64
Q

What is BiPAP?

A

Air is delivered through a mask can be set at one pressure for inhaling and
another for exhaling

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65
Q

Which types of patients benefit the most with the use of BiPAP?

A

Patients with congestive heart failure and lung disorders as well as Sufferers of atelectasis

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66
Q

What is Atelectasis?

A

When all or part of a lung collapses, and

results in the loss of the ability of air sacs at the furthest reaches of the lungs to expand

67
Q

Inspiratory pressures in adults average?

A

20 to 30 cm H2O

68
Q

What is the most likely cardiac dysrhythmia to occur during endotracheal suctioning and
how can it be avoided?

A

Bradycardia

69
Q

How many ml of air do you put in the cuff of the ET tube?

A

10mL

70
Q

What are the primary methods for confirming tube placement?

A

Chest rise, visualization, tube condensation, color improves, lung sounds

71
Q

What are the secondary methods for confirming tube placement?

A

End Tidal CO2, Capnography, esophageal bulb indicator.

72
Q

What is the preferred patient for nasotracheal intubation?

A

Preferred patient has to be spontaneously breathing

73
Q

LMAs are sized by?

A

Sized by patient weight

74
Q

Combitubes are sized by?

A

Height

75
Q

What is the most common sized combitube?

A

Most common size 5 foot to 6 foot 7

76
Q

Ventilation

A

Chest Movement

77
Q

Respiration

A

air in and out.

78
Q

There is ______% O2 in air.

A

21%

79
Q

When should artificial ventilation’s be considered?

A

Less than 8 or over 30 (with poor pt presentation) ventilation’s per minute need artificial.

80
Q

What is the first attack of an asthma attack?

A

First attack is constriction of lower airway

81
Q

What is the second attack of an asthma attack?

A

Fluid swelling to lower airway

82
Q

Sudden onset Dyspnea is the main symptom experienced by a patient with?

A

Pulmonary Embolism

83
Q

Patients experiencing a pulmonary embolism should be placed?

A

Place on left side if needed.

84
Q

Tall white skinny males prone to this. They grow to fast and make lungs thin.

A

Spontaneous Pneumothorax

85
Q

s/s - first anxiety, then SOB, decreased lung sounds on leaking side, then affected chest rise on affected
side.

A

Spontaneous Pneumothorax S/S

86
Q

Virus comes on slow or fast?

A

Slow

87
Q

_______ have no or mild fever

A

Viruses

88
Q

___________ have clear drainage

A

Viruses

89
Q

______ has colored drainage

A

Bacterial Infections

90
Q

_________ is blue bloater, obese, grunting, breath holder.

A

Chronic Bronchitis

91
Q

Emphysema is?

A

pink puffer, skinny, barrel chest. Club fingers.

92
Q

___________is over stimulated discharge of mucus in bronchus tubes.

A

Bronchitis

93
Q

__________is loss of elasticity of alveoli.

A

Emphysema

94
Q

Long term problem with __________is hypoxic drive

A

COPD

95
Q

_________ occurs with a patient breathing over 40 and shallow.

A

Hyperventilation Syndrome

96
Q

Care: Use a simple face mask at 2 LPM

A

Hyperventilation Syndrome

97
Q

With _____ Fluid collects in plural space of chest

A

Plural Effusions

98
Q

Most common cause of fluid in the lungs is CHF or irritant.

A

Pulmonary Edema

99
Q

What type of respirations are associated with diabetic ketoacidosis?

A

Kussmaul

100
Q

What type of respirations indicate brain stem injury?

A

Cheyne-stokes

101
Q

What kind of respirations indicate increased intracranial pressure?

A

Central neurogenic hyperventilation

102
Q

Snoring is hear in lower or upper airway?

A

Upper

103
Q

Stridor is found in lower or upper airway?

A

Upper

104
Q

Stridor is heard on inhalation or exhalation?

A

Inhale

105
Q

Musical breath sounds are also called?

A

Wheezing

106
Q

Wheezing is typically heard in upper in lower airway?

A

Lower

107
Q

Wheezing is heard on inhale or exhale?

A

Exhale

108
Q

Wheezing is indicative of?

A

Bronchoconstriction

109
Q

What is the ominous breath sound?

A

Stridor

110
Q

Crackles (rales) are indicative of?

A

Fluid in lungs (pulmonary edema)

111
Q

A course rattling breath sound is known as?

A

Rhonchi

112
Q

What is the function of the Colorimetric end-tidal?

A

Used with ETT - Changes color with exhale with detection of CO2.

113
Q

Which bronchus is shorter and straighter?

A

Right

114
Q

What are the drugs that can be pushed through ETT?

A

Lidocaine
Epinephrine
Atropine
Narcan

115
Q

Which advanced airway is the only one that secures the airway?

A

ETT

116
Q

How much air should be placed in the bulb of an ETT?

A

10cc

117
Q

BAM devices are used for what kind of intubation?

A

Nasal

118
Q

What is the function of a BAM device?

A

Sits on top of ETT - whistles during exhale through glottis

119
Q

Typical ETT tube size for males is?

A

8.0 - 8.5

120
Q

Typical ETT tube size for female?

A

7.0, 7.5, 8.0

121
Q

Tube depth is usually?

A

20-22 cm

122
Q

What is the formula for ETT placement in a pediatric?

A

4

123
Q

Where is the larynx located?

A

C5 C6

124
Q

Which blade is inserted into the vallecula?

A

Mac

125
Q

Which intubation blade indirectly lifts the epiglottis?

A

Mac

126
Q

Which intubation blade directly lifts epiglottis up?

A

Straight(miller) blade

127
Q

Which blade is placed past vallecula and over epiglottis?

A

Miller (straight) blade

128
Q

What is the fail safe signs of proper ETT placement?

A

ETT visualized between cords

129
Q

What is the function of EDD devices?

A

Bulb refills? = tube is in trachea

Bulb does not refill? = tube in esophagus

130
Q

What is a contraindication of nasal intubation?

A

Possible basilar skull fracture

131
Q

First bulb of combitube takes how much air?

A

100ml

132
Q

First bulb of combitube occludes?

A

Hypopharynx

133
Q

What are the contraindications of a combitube?

A

Height (greater than 6”6)
Gag reflex
Ingestion of corrosive or volatile substances

134
Q

King tubes are based on?

A

Height

135
Q

Purple king tube is meant for patients over?

A

6 feet

136
Q

What is the only airway that is designed to be moved?

A

King

137
Q

What are the contradictions of RSI?

A

Hypersensitivity

Hypotension

138
Q

RaSPO2 less than 90% indicates?

A

Respiratory distress

139
Q

Pulse oximetry readings for a COPD patient range between ____% and __%.

A

88%-92%

140
Q

How does carbon monoxide effect sPO2?

A

SPo2 could remain the same

141
Q

CO2 is produced by?

A

The metabolism of glucose

142
Q

_____ measures the amount of CO2 produced.

A

Capnography

143
Q

Pulse ox cannot measure ______.

A

Ventilation

144
Q

What is a normal ETCO2 capnography measurement?

A

35-45

145
Q

CO2 is above 45torr indicates?

A

Hypoventilation
Respiratory Acidosis
Hypercarbic
Hypercapnea

146
Q

What is the fix for CO2 greater than 45torr?

A

BVM ventilation

147
Q

CO2 less than 35torr indicates?

A

Hyperventilating
Respiratory Alkalosis
Hypocarbic

148
Q

Mean arterial pressure less than 60 indicates?

A

Lack of perfusion to brain

149
Q

Phase 1 of a capnogram is?

A

Inspiration

150
Q

CO2 measurement in capnogram takes place in phase ____.

A

3

151
Q

A rising baseline on capnography indicates?

A

Rebreathing CO2

152
Q

A sharkfin waveform on capnography indicates?

A

Bronchoconstriction associated with asthma

Hypercarbic

153
Q

A fix for a sharkfin capnography waveform?

A

Bronchodilator

154
Q

A delayed phase 4 on capnography indicates?

A

ETT tube has become deflated or ETT is too small

155
Q

A stairstepping upwards waveform on capnography indicates?

A

Hypoventilation

156
Q

A stairstepping decreasing waveform on capnography indicates?

A

Hyperventilation

157
Q

A sudden drop in capnography waveform indicates?

A

A sudden drop in cardiac output

158
Q

A capnography waveform that suddenly drops to zero indicates?

A

Patient has died OR tube has dislodged

159
Q

What is pulsus paradoxus?

A

A drop in blood pressure of greater than 10 torr during inspiration

160
Q

What is pulsus paradoxus indicative of?

A

Severe obstructive lung disease

161
Q

What is lung compliance?

A

The stiffness or flexibility of the lung tissue

162
Q

Patients with asthma cannot be prescribed what type of drug?

A

Beta blocker

163
Q

What are the 4 main antihypertensive drugs?

A

Beta blockers
Vasodilator
ACE inhibitors
Diuretics

Exam 3 Intro Pharm Airway (4 decks)

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