Airway Flashcards
1
Q
What occurs in the exchange of oxygen and carbon dioxide between the organism and the environment?
A
Respiration
2
Q
___ is the exchange of air into and out of the lungs.
A
Ventilation
3
Q
What is intrapulmonic pressure?
A
Pressure of gas in the alveoli
4
Q
What is the normal amount of intrapulmonic pressure?
A
Around 760mmHg
5
Q
What type of pressure is found in the plural space?
A
Intrathoracic
6
Q
What is the normal amount of intrathoracic pressure?
A
It is normally less than intrapulmonic pressure
7
Q
What is compliance?
A
The ease with which the lungs and thorax expand during pressure changes
8
Q
What is the normal tidal volume for an adult?
A
500-600mL
9
Q
Of normal tidal volume, ______mL never make it to alveoli.
A
150
10
Q
What is the total lung capacity?
A
Sum of vital capacity and residual volume
11
Q
What is residual volume?
A
Gas that remains in the respiratory system after forceful expiratory activity
12
Q
What is normal residual volume of an adult?
A
1100mL
13
Q
What process is involved in how oxygen and carbon dioxide are exchanged in the tissues and alveoli?
A
Diffusion
14
Q
________results from destroying or collapsing of alveolar wall.
A
Atelectasis
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
16
Q
What is the term given to decreased oxygen at the tissue level?
A
Hypoxia
17
Q
What is the term given for a decreased oxygen state at the arterial blood level?
A
Hypoxemia
18
Q
Where is the phrenic nerve located?
A
C4
19
Q
What are the two mechanisms responsible for basic respiratory rhythm?
A
Vagal reflex and pneumotaxic center
20
Q
Where is the vagal reflex located?
A
Bronchi, bronchioles, and lungs
21
Q
Where is the pneumotaxic center located?
A
Pons
22
Q
When is the pneumotaxic center active?
A
Only in active breathing
23
Q
The ______ says to stop breathing and the ____ say inhale.
A
Medulla and pons
24
Q
Chemoreceptors do not work well in what type of patient?
A
Shock patients
25
What three parameters are evaluated when assessing airway adequacy?
Rate, regularity, effort
26
What is considered normal respiratory range for an adult?
12-20 per minute
27
What is considered normal respiratory range for a child?
15-30 per minute
28
What is the normal respiratory rate of an infant?
25-50 per minute
29
What is a sign?
Something you can see and/or touch
30
What causes snoring?
Tongue has fallen back and is blocking the airway
31
What causes gurgling?
Fluid in the airway
32
What causes wheezing?
REversible narrowing of the lower airway
33
What causes stridor?
Partial upper airway obstruction. High pitched sound heard on inhalation.
34
What causes rales?
Fine cracking bubbles in alveoli
35
What causes rhonchi?
Fluid in the brochioles
36
Cheyne-Stokes respiration's are seen in patients with?
Head injury and medulla
37
Which respirations are described as fast to slow and deep to shallow and period of apnea?
Cheyne-Stokes
38
What are Kussmaul respirations?
Fast and depp respiration's
39
What are some causes for an increase in respiratory rate?
Acidosis, anxiety, aspirin poisoning, pain, pons damage
40
What are some causes for a decrease in respiratory rate?
Alkalosis, narcotic, obesity
41
A nasal cannula 1-6 LPM contains what percent of oxygen?
24-44%
42
A ventruri mask 4-8 LPM contains what percent of oxygen?
24-50%
43
A simple face mask 6-10 LPM contains what percent of oxygen?
35-60%
44
What are two complications of positive pressure breathing in a non-intubated patient?
Gastric inflation and rupture of lung tissue
45
Inspiratory pressures in adults average _______ to ________.
20-30
46
What is the most likely cardiac dysrhythmia to occur during endotracheal suctioning?
Bradycardia
47
What is the typical ET size is recommended for men?
7-8
48
What typical ET size is recommended for women?
6-7
49
What typical ET size is recommended for toddlers?
Age divided by 4 plus 4
or
16 plus age divided by 4
50
Which intubation tool traps the epiglottis and lifts?
Straight blade
51
Which intubation tool enters the vallecula and lifts?
Curved blade
52
Which intubation tool gives shape and support to ET tube?
Stylet
53
The distance between the teeth and the carina is?
27 cm
54
What is the #1 cause of airway obstruction?
Tongue
55
What is the formula for minute volume?
Tidal volume x respiratory rate
56
Typical tidal volume is ____ cc.
500
57
Alveolar volume is found by?
Subtracting 150 from tidal volume
58
What is the acceptable pulse ox range for a COPD patient?
90-92%
59
What is the result of CO2 retention?
Hypoxic Drive
60
At what range in CO2 does a COPD patient "flip" to the hypoxic drive?
When the CO2 levels rise from normal (35 to 45%) to greater than 60%.
61
At what range in O2 does a COPD patient "flip" to the hypoxic drive?
When the O2 levels drop from normal (80 to 100%) to less than 60%.
62
___________ allowed users to sleep by keeping the airways open
CPAP
63
What is the major problem with CPAP?
The person had to exhale against the extra pressure
64
What is BiPAP?
Air is delivered through a mask can be set at one pressure for inhaling and
another for exhaling
65
Which types of patients benefit the most with the use of BiPAP?
Patients with congestive heart failure and lung disorders as well as Sufferers of atelectasis
66
What is Atelectasis?
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
Inspiratory pressures in adults average?
20 to 30 cm H2O
68
What is the most likely cardiac dysrhythmia to occur during endotracheal suctioning and
how can it be avoided?
Bradycardia
69
How many ml of air do you put in the cuff of the ET tube?
10mL
70
What are the primary methods for confirming tube placement?
Chest rise, visualization, tube condensation, color improves, lung sounds
71
What are the secondary methods for confirming tube placement?
End Tidal CO2, Capnography, esophageal bulb indicator.
72
What is the preferred patient for nasotracheal intubation?
Preferred patient has to be spontaneously breathing
73
LMAs are sized by?
Sized by patient weight
74
Combitubes are sized by?
Height
75
What is the most common sized combitube?
Most common size 5 foot to 6 foot 7
76
Ventilation
Chest Movement
77
Respiration
air in and out.
78
There is ______% O2 in air.
21%
79
When should artificial ventilation's be considered?
Less than 8 or over 30 (with poor pt presentation) ventilation's per minute need artificial.
80
What is the first attack of an asthma attack?
First attack is constriction of lower airway
81
What is the second attack of an asthma attack?
Fluid swelling to lower airway
82
Sudden onset Dyspnea is the main symptom experienced by a patient with?
Pulmonary Embolism
83
Patients experiencing a pulmonary embolism should be placed?
Place on left side if needed.
84
Tall white skinny males prone to this. They grow to fast and make lungs thin.
Spontaneous Pneumothorax
85
s/s - first anxiety, then SOB, decreased lung sounds on leaking side, then affected chest rise on affected
side.
Spontaneous Pneumothorax S/S
86
Virus comes on slow or fast?
Slow
87
_______ have no or mild fever
Viruses
88
___________ have clear drainage
Viruses
89
______ has colored drainage
Bacterial Infections
90
_________ is blue bloater, obese, grunting, breath holder.
Chronic Bronchitis
91
Emphysema is?
pink puffer, skinny, barrel chest. Club fingers.
92
___________is over stimulated discharge of mucus in bronchus tubes.
Bronchitis
93
__________is loss of elasticity of alveoli.
Emphysema
94
Long term problem with __________is hypoxic drive
COPD
95
_________ occurs with a patient breathing over 40 and shallow.
Hyperventilation Syndrome
96
Care: Use a simple face mask at 2 LPM
Hyperventilation Syndrome
97
With _____ Fluid collects in plural space of chest
Plural Effusions
98
Most common cause of fluid in the lungs is CHF or irritant.
Pulmonary Edema
99
What type of respirations are associated with diabetic ketoacidosis?
Kussmaul
100
What type of respirations indicate brain stem injury?
Cheyne-stokes
101
What kind of respirations indicate increased intracranial pressure?
Central neurogenic hyperventilation
102
Snoring is hear in lower or upper airway?
Upper
103
Stridor is found in lower or upper airway?
Upper
104
Stridor is heard on inhalation or exhalation?
Inhale
105
Musical breath sounds are also called?
Wheezing
106
Wheezing is typically heard in upper in lower airway?
Lower
107
Wheezing is heard on inhale or exhale?
Exhale
108
Wheezing is indicative of?
Bronchoconstriction
109
What is the ominous breath sound?
Stridor
110
Crackles (rales) are indicative of?
Fluid in lungs (pulmonary edema)
111
A course rattling breath sound is known as?
Rhonchi
112
What is the function of the Colorimetric end-tidal?
Used with ETT - Changes color with exhale with detection of CO2.
113
Which bronchus is shorter and straighter?
Right
114
What are the drugs that can be pushed through ETT?
Lidocaine
Epinephrine
Atropine
Narcan
115
Which advanced airway is the only one that secures the airway?
ETT
116
How much air should be placed in the bulb of an ETT?
10cc
117
BAM devices are used for what kind of intubation?
Nasal
118
What is the function of a BAM device?
Sits on top of ETT - whistles during exhale through glottis
119
Typical ETT tube size for males is?
8.0 - 8.5
120
Typical ETT tube size for female?
7.0, 7.5, 8.0
121
Tube depth is usually?
20-22 cm
122
What is the formula for ETT placement in a pediatric?
16+age
------------
4
123
Where is the larynx located?
C5 C6
124
Which blade is inserted into the vallecula?
Mac
125
Which intubation blade indirectly lifts the epiglottis?
Mac
126
Which intubation blade directly lifts epiglottis up?
Straight(miller) blade
127
Which blade is placed past vallecula and over epiglottis?
Miller (straight) blade
128
What is the fail safe signs of proper ETT placement?
ETT visualized between cords
129
What is the function of EDD devices?
Bulb refills? = tube is in trachea
| Bulb does not refill? = tube in esophagus
130
What is a contraindication of nasal intubation?
Possible basilar skull fracture
131
First bulb of combitube takes how much air?
100ml
132
First bulb of combitube occludes?
Hypopharynx
133
What are the contraindications of a combitube?
Height (greater than 6"6)
Gag reflex
Ingestion of corrosive or volatile substances
134
King tubes are based on?
Height
135
Purple king tube is meant for patients over?
6 feet
136
What is the only airway that is designed to be moved?
King
137
What are the contradictions of RSI?
Hypersensitivity
| Hypotension
138
RaSPO2 less than 90% indicates?
Respiratory distress
139
Pulse oximetry readings for a COPD patient range between ____% and __%.
88%-92%
140
How does carbon monoxide effect sPO2?
SPo2 could remain the same
141
CO2 is produced by?
The metabolism of glucose
142
_____ measures the amount of CO2 produced.
Capnography
143
Pulse ox cannot measure ______.
Ventilation
144
What is a normal ETCO2 capnography measurement?
35-45
145
CO2 is above 45torr indicates?
Hypoventilation
Respiratory Acidosis
Hypercarbic
Hypercapnea
146
What is the fix for CO2 greater than 45torr?
BVM ventilation
147
CO2 less than 35torr indicates?
Hyperventilating
Respiratory Alkalosis
Hypocarbic
148
Mean arterial pressure less than 60 indicates?
Lack of perfusion to brain
149
Phase 1 of a capnogram is?
Inspiration
150
CO2 measurement in capnogram takes place in phase ____.
3
151
A rising baseline on capnography indicates?
Rebreathing CO2
152
A sharkfin waveform on capnography indicates?
Bronchoconstriction associated with asthma
| Hypercarbic
153
A fix for a sharkfin capnography waveform?
Bronchodilator
154
A delayed phase 4 on capnography indicates?
ETT tube has become deflated or ETT is too small
155
A stairstepping upwards waveform on capnography indicates?
Hypoventilation
156
A stairstepping decreasing waveform on capnography indicates?
Hyperventilation
157
A sudden drop in capnography waveform indicates?
A sudden drop in cardiac output
158
A capnography waveform that suddenly drops to zero indicates?
Patient has died OR tube has dislodged
159
What is pulsus paradoxus?
A drop in blood pressure of greater than 10 torr during inspiration
160
What is pulsus paradoxus indicative of?
Severe obstructive lung disease
161
What is lung compliance?
The stiffness or flexibility of the lung tissue
162
Patients with asthma cannot be prescribed what type of drug?
Beta blocker
163
What are the 4 main antihypertensive drugs?
Beta blockers
Vasodilator
ACE inhibitors
Diuretics
