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Airway & Ventilation > Airway > Flashcards

Airway Flashcards

1
Q

During a failed intubation, ______ is an acceptable alternative.

A

King LT, Combitube, LMA

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2
Q

What two systems work together to ensure that constant supplies of oxygen and nutrients are delivered to every cell in the body and that carbon dioxide and other waste products are removed from every cell.

A

Respiratory

Cardiovascular

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2
Q

To reduce the risk of aspiration from vomiting during neuromuscular blockage and tracheal intubation, you should:

A

perform a rapid sequence intubation

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2
Q

The respiratory and cardiovascular systems work together to ensure that constant supplies of oxygen and nutrients are delivered to every cell in the body and that carbon dioxide and other waste products are removed from every cell. True or False

A

True

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3
Q

Diffusion allows oxygen to transfer from the air into the:

A

Capillaries

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3
Q

What is the relationship between the false vocal cords and the true vocal cords?

A

the true cords are inferior to the false cords

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3
Q

In addition to observing the tube pass through the cords, observation of rise and fall of the chest, and auscultation of breath sounds, to verify correct tracheal tube placement, you should:

A

apply an end-tidal CO2 monitor

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3
Q

You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?

A

tension pneumothorax to the left hemithorax

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3
Q

You arrive on the scene and find a two-year-old patient sitting in his father’s lap. The child presents with a “seal-type bark” cough and appears to be in mild respiratory distress. The father states, “My son has been sick with a cold over the last few days but seems to get worse at night.”
In order to assess the child, you should:

Upon completing your initial assessment, you would immediately:

As you attempt to administer oxygen with a nonrebreather mask, the child becomes very agitated and begins to cry uncontrollably. Each time you apply the mask to the face of the child, he becomes very upset and cries. You should:

The child becomes increasingly more agitated as you continue with your treatment. The father continuously attempts to calm the child with no success. This may be an indication that the child is:

The condition this child is suffering from is most likely:

A

leave the child in the father’s lap and perform the assessment

Apply humidified oxygen via a nonrebreather mask

with the child in the father’s lap, have the father hold the nonrebreather mask near the child’s face

becoming more hypoxic

tracheolaryngobronchitis

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3
Q

To prevent hypoxia from occurring during intubation attempts, each attempt should be limited to:

A

30 seconds

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3
Q

Internal respiration is the exchange of gases between the ______ and the ______.

a. bronchiole, alveoli
b. blood cells, tissues
c. lungs, blood cells
d. pharynx, lungs

A

b. blood cells, tissues

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3
Q

Diffusion allows oxygen to transfer from the air into the capillaries.

A
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3
Q

The functions of the upper airway include:

A

warming

filtering

humidification of inhaled air

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4
Q

Pulmonary gas exchange takes place at the:

A

alveolar level in the lungs

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4
Q

You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?

A

tension pneumothorax to the left hemithorax

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4
Q

The esophageal detector device is used for:

A

endotracheal tube placement

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4
Q

The mechanics of inspiration is a(n):

A

active process due to contraction of the respiratory muscles

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4
Q

When administering epinephrine for a respiratory emergency, which of the following properties would produce the most desirable effect?

A

beta 2

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5
Q

Where does the upper airway begin?

A

Above the vocal cords

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5
Q

Pulmonary gas exchange takes place at the:

A

alveolar level in the lungs

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5
Q

The terminal end and the functional units of the lower airway are the:

A

alveolar sacs

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6
Q

Jugular vein engorgement that occurs during inspiration is referred to as:

A

Kussmaul’s sign

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7
Q

The upper airway consists of all structures above the vocal cords. There are the:

A

larynx

oropharynx

nasopharynx

tongue

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7
Q

You encounter a patient suffering from a significant pneumothorax. You would expect a(n) _________ PaO2 and a(n) _________ PaCO2.

A

decreased, increased

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7
Q

The upper airway consists of all structures above the vocal cords. There are the:

A

larynx

oropharynx

nasopharynx

tongue

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8
Q

The tongue is a large muscle that is attached to the mandible and the:

A

hyoid bone

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8
Q

You encounter a patient suffering from a significant pneumothorax. You would expect a(n) _________ PaO2 and a(n) _________ PaCO2.

A

decreased, increased

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9
Q

Rapid sequence induction would be a helpful adjunct for advanced airway management for which type of patient?

A

21-year-old combative male with severe head injuries

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9
Q

You arrive on the scene and find a two-year-old patient sitting in his father’s lap. The child presents with a “seal-type bark” cough and appears to be in mild respiratory distress. The father states, “My son has been sick with a cold over the last few days but seems to get worse at night.”
In order to assess the child, you should:

A

leave the child in the father’s lap and perform the assessment

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10
Q

You are treating a 40-pound-child and medical direction has requested that you administer a bolus of lidocaine for a cardiac dysrhythmia, followed by an infusion. Which dose of lidocaine should this patient receive?

A

18 milligrams IV push followed by 360 mcg/minute infusion

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10
Q

Rapid sequence induction would be a helpful adjunct for advanced airway management for which type of patient?

A

21-year-old combative male with severe head injuries

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11
Q

When assessing a 14-month-old, you would consider which of the following respiratory rates to be within the normal rate range for this patient?

A

20-30 breaths per minute

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11
Q

You are treating a 40-pound-child and medical direction has requested that you administer a bolus of lidocaine for a cardiac dysrhythmia, followed by an infusion. Which dose of lidocaine should this patient receive?

A

18 milligrams IV push followed by 360 mcg/minute infusion

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12
Q

Upon identification of the sonorous sounds in the patient, you should immediately:

A

perform a head-tilt chin-lift maneuver to open the airway

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12
Q

When assessing a 14-month-old, you would consider which of the following respiratory rates to be within the normal rate range for this patient?

A

20-30 breaths per minute

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13
Q

Indication of terminal bronchiole and alveolar atelectasis in the neonate may be evident clinically by:

A

grunting on exhalation

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13
Q

Upon identification of the sonorous sounds in the patient, you should immediately:

A

perform a head-tilt chin-lift maneuver to open the airway

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14
Q

You find an unresponsive and apneic patient in a local restaurant. You attempt to ventilate and are unable to move any air. You should immediately:

A

perform a laryngoscopy and remove the object with Magill forceps

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14
Q

Indication of terminal bronchiole and alveolar atelectasis in the neonate may be evident clinically by:

A

grunting on exhalation

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15
Q

An acute bronchial rupture should be suspected in the field when:

A

a tension pneumothorax does not respond to chest decompression

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15
Q

You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.

You should suspect the patient is suffering from which of the following conditions?

Your treatment for the patient in sequence of priority would include:

After you have successfully carried out your treatment, the patient continues to deteriorate and the signs and symptoms remain the same and begin to worsen. You have performed all the procedures correctly. At this point you suspect the patient may be suffering from:

A

tension pneumothorax to the left hemithorax

  1. assist ventilation with supplemental oxygen attached to the ventilation device
  2. needle decompression of the left thorax

a rupture of the left bronchus

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15
Q

You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.

After you have successfully carried out your treatment, the patient continues to deteriorate and the signs and symptoms remain the same and begin to worsen. You have performed all the procedures correctly. At this point you suspect the patient may be suffering from:

A

a rupture of the left bronchus

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16
Q

The lower airway consists of all structures below the vocal cords and consist of the:

A

trachea

mainstem bronchi

bronchioles

pulmonary capillaries

alveoli.

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16
Q

An acute bronchial rupture should be suspected in the field when:

A

a tension pneumothorax does not respond to chest decompression

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17
Q

After successfully placing the endotracheal tube, you should secure the tube in place by:

A

applying a commercial tracheal tube holder

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17
Q

You arrive on the scene and find a patient experiencing hyperventilation syndrome due to an emotionally charged situation. You would expect this patient to initially be in:

A

respiratory alkalosis

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17
Q

You arrive on the scene at the local bar and find a 22-year-old female patient who is agitated and confused. Her airway is open and she is breathing. Her blood pressure is 240/180 mmHg. Her radial pulse is present and bounding and the respiratory rate is 32 breaths per minute. Her blood glucose reading is 82 mg/dl. Her skin is slightly pale, cool, and clammy. Her pupils are equal and reactive but sluggish to respond to light. The pulse oximeter reading is 86%. The monitor shows a sinus tachycardia at 128 bpm. Your priority treatment for this patient should be:

A

administration of oxygen via a nonrebreather mask

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17
Q

You arrive on the scene at the local bar and find a 22-year-old female patient who is agitated and confused. Her airway is open and she is breathing. Her blood pressure is 240/180 mmHg. Her radial pulse is present and bounding and the respiratory rate is 32 breaths per minute. Her blood glucose reading is 82 mg/dl. Her skin is slightly pale, cool, and clammy. Her pupils are equal and reactive but sluggish to respond to light. The pulse oximeter reading is 86%. The monitor shows a sinus tachycardia at 128 bpm. Your priority treatment for this patient should be:

A

administration of oxygen via a nonrebreather mask

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18
Q

Your 5-year-old patient appears acutely ill. He is sitting in a tripod position, is leaning forward, and is drooling. He has dyspnea and a loud inspiratory stridor. His mother reports that he was relatively fine this morning, but he now has a temperature of 104 degrees. You suspect that this child is suffering from:

A

epiglottitis

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18
Q

You arrive on the scene and find a patient experiencing hyperventilation syndrome due to an emotionally charged situation. You would expect this patient to initially be in:

A

respiratory alkalosis

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19
Q

__________ is contraindicated in patients with facial and head injuries

A

nasotracheal intubation

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19
Q

Your 5-year-old patient appears acutely ill. He is sitting in a tripod position, is leaning forward, and is drooling. He has dyspnea and a loud inspiratory stridor. His mother reports that he was relatively fine this morning, but he now has a temperature of 104 degrees. You suspect that this child is suffering from:

A

epiglottitis

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20
Q

You are in danger of injuring what gland if you do not correctly identify the landmarks when performing a needle cricothyrotomy?

A

thyroid

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20
Q

__________ is contraindicated in patients with facial and head injuries

A

nasotracheal intubation

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20
Q

Upon completion of the initial assessment, you also find the radial pulse is present and strong with a rate of 122 bpm. The skin is normal color, warm and dry. The pulse oximeter reads 92%. You should immediately:

A

apply a nonrebreather mask at 15 lpm

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21
Q

Cerebrospinal fluid that leaks from the nose is called:

A

cerebrospinal rhinorrhea

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21
Q

You are in danger of injuring what gland if you do not correctly identify the landmarks when performing a needle cricothyrotomy?

A

thyroid

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22
Q

A patient who suffers a spinal cord injury at the level of C5 would likely present with which of the following signs or symptoms?

A

difficulty in breathing

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23
Q

You are treating a patient who has been removed from a burning residential structure by the fire department. You suspect the patient has smoke inhalation. You note carbonaceous sputum and singed nasal hair. He has a respiratory rate of 45 per minute. He does not respond to painful stimuli. You note cyanosis and diaphoresis to the skin. You should immediately:

A

begin positive pressure ventilation with a bag-valve-mask connected to supplemental oxygen

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23
Q

A patient who suffers a spinal cord injury at the level of C5 would likely present with which of the following signs or symptoms?

A

difficulty in breathing

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24
Q

The purpose of the distal cuff on the tracheal tube when inflated with 5 to 10 cc of air is to:

A

seal the trachea to prevent air from escaping and aspiration

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24
Q

As you attempt to place the tracheal tube using the straight blade, the patient begins to gag and retch. You should immediately:

A

discontinue intubation efforts and ventilate, using the bag-valve-mask

24
Q

Which of the following respiratory diseases causes a distortion in the alveolar surface area and decreases the alveolar-capillary interface?

A

emphysema

24
Q

As you attempt to place the tracheal tube using the straight blade, the patient begins to gag and retch. You should immediately:

A

discontinue intubation efforts and ventilate, using the bag-valve-mask

25
Q

Alveoli resist collapse due to the presence of a chemical that reduces surface tension called:

A

surfactant

25
Q

The purpose of the distal cuff on the tracheal tube when inflated with 5 to 10 cc of air is to:

A

seal the trachea to prevent air from escaping and aspiration

26
Q

Your patient experiences difficulty breathing only when lying supine. The difficulty subsides when the patient is sitting erect. This condition is known as:

A

orthopnea

26
Q

Alveoli resist collapse due to the presence of a chemical that reduces surface tension called:

A

surfactant

27
Q

Dysphonia can be best defined as:

A

Difficulty speaking

27
Q

Your patient experiences difficulty breathing only when lying supine. The difficulty subsides when the patient is sitting erect. This condition is known as:

A

orthopnea

28
Q

The lateral borders of the glottis are the:

A

vocal cords

28
Q

Dysphonia can be best defined as:

A

Difficulty speaking

29
Q

The spasmodic closure of the vocal cords is known as:

A

Laryngospasm

30
Q

Which muscles, which are used during times of respiratory distress, include the sternocleidomastoid muscles of the neck.

A

Accessory muscles

31
Q

Which signs and symptoms would you not commonly see with a patient suffering from carboxyhemoglobin?

A

Kussmaul’s respirations

31
Q

_______ are which are used during times of respiratory distress, include the sternocleidomastoid muscles of the neck.

A

Accessory Muscles

32
Q

During transillumination intubation, the following pieces of equipment are necessary:

A

Lighted stylet

32
Q

Which signs and symptoms would you not commonly see with a patient suffering from carboxyhemoglobin?

A

Kussmaul’s respirations

33
Q

_________is the act of moving air into and out of the lungs. For _________to occur, the diaphragm and intercostal muscles must function properly.

A

Ventilation

Ventilation

33
Q

During transillumination intubation, the following pieces of equipment are necessary:

A

Lighted stylet

34
Q

The _______ is the major muscle of breathing; it is innervated by the ________ _________.

A

Diaphragm

phrenic nerves

34
Q

Ventilation is the act of moving air into and out of the lungs. For ventilation to occur, the diaphragm and intercostal muscles must function properly.

A
35
Q

The size of the ET tube used in pediatric patients is ____ to _____.

A

2.5-4.5

35
Q

The _______ is the major muscle of breathing; it is innervated by the ________ _________.

A

Diaphragm

phrenic nerves

36
Q

The narrowest portion of the laryngeal airway in children is the:

A

cricoid cartilage

36
Q

The size of the ET tube used in pediatric patients is ____ to _____.

A

2.5-4.5

37
Q

What are the muscles between the ribs, that are innervated by the intercostal nerves.

A

Intercostal muscles

37
Q

The narrowest portion of the laryngeal airway in children is the:

A

cricoid cartilage

38
Q

What anatomic feature marks the beginning of the hypopharynx?

A

hyoid bone

38
Q

The intercostal muscles, the muscles between the ribs, are innervated by the intercostal nerves.

A
39
Q

You have just administered a medication containing beta-adrenergic properties. You would expect which of the following physiologic effects?

A

bronchodilation

39
Q

What anatomic feature marks the beginning of the hypopharynx?

A

hyoid bone

40
Q

You are called to the scene of a local factory for a patient who had a syncopal episode. Upon your arrival, you find the patient sitting at the desk in the foreman’s office. He is very diaphoretic and ashen gray. The patient responds to verbal stimuli with incomprehensible sounds.
Your first priority in the assessment and management of the patient is to:

You should immediately perform which of the following?

A

ensure the patient has a patent airway

administer oxygen via a nonrebreather at 15 lpm

40
Q

You have just administered a medication containing beta-adrenergic properties. You would expect which of the following physiologic effects?

A

bronchodilation

41
Q

You are at the scene and treating a 47-year-old patient who reports a history of asthma for the last 40 years. His BP is 142/98 mmHg, radial pulse is 136 beats per minute, and respirations are 36 per minute. He is cyanotic and is using his accessory muscles when breathing. When you auscultate his lungs, no wheezing is heard in any lung fields. The SpO2 reading is 78%.
You should suspect that there is no wheezing because:

As you continue your assessment, you note that the blood pressure falls by approximately 18 mmHg as the patient inhales. You would note this as:

The above sign is an indication that the patient:

As part of the patient treatment, you should immediately:

A

the bronchioles are maximally constricted and there is minimal air movement

pulsus paradoxus

has a severe increase in his intrathoracic pressure from air trapping

place the patient on a nonrebreather mask at 15 lpm and administer albuterol via a nebulizer as quickly as possible

41
Q

You are called to the scene of a local factory for a patient who had a syncopal episode. Upon your arrival, you find the patient sitting at the desk in the foreman’s office. He is very diaphoretic and ashen gray. The patient responds to verbal stimuli with incomprehensible sounds.
Your first priority in the assessment and management of the patient is to:

You should immediately perform which of the following?

A

ensure the patient has a patent airway

administer oxygen via a nonrebreather at 15 lpm

42
Q

Which of the following is not a pathophysiologic response to the chemical mediators being released in an anaphylactic reaction?

A

reduction in bronchiole mucosal inflammation

42
Q

You are at the scene and treating a 47-year-old patient who reports a history of asthma for the last 40 years. His BP is 142/98 mmHg, radial pulse is 136 beats per minute, and respirations are 36 per minute. He is cyanotic and is using his accessory muscles when breathing. When you auscultate his lungs, no wheezing is heard in any lung fields. The SpO2 reading is 78%.
You should suspect that there is no wheezing because:

As you continue your assessment, you note that the blood pressure falls by approximately 18 mmHg as the patient inhales. You would note this as:

The above sign is an indication that the patient:

As part of the patient treatment, you should immediately:

A

the bronchioles are maximally constricted and there is minimal air movement

pulsus paradoxus

has a severe increase in his intrathoracic pressure from air trapping

place the patient on a nonrebreather mask at 15 lpm and administer albuterol via a nebulizer as quickly as possible

43
Q

In fatal anaphylactic reactions, the most prominent clinical features identified that are related to the fatal episode are:

A

bronchoconstriction, vasodilation, and an increase in capillary permeability

43
Q

Which of the following is not a pathophysiologic response to the chemical mediators being released in an anaphylactic reaction?

A

reduction in bronchiole mucosal inflammation

44
Q

The spasmodic closure of the vocal is known as:

A

Laryngospasm

44
Q

In fatal anaphylactic reactions, the most prominent clinical features identified that are related to the fatal episode are:

A

bronchoconstriction, vasodilation, and an increase in capillary permeability

45
Q

During the expiration phase of the respiratory cycle, which physiologic process takes place?

A

intrathoracic pressure increases

45
Q

During inhalation, the diaphragm _________ and the intercostal muscles _______.

A

Contracts, Contract

46
Q

Lung overinflation due to a rapid ascent in a diving incident may result in:

A

air embolism

46
Q

During the expiration phase of the respiratory cycle, which physiologic process takes place?

A

intrathoracic pressure increases

47
Q

You have just placed a tracheal tube in an unresponsive apneic patient. You should determine correct tube placement by:

A

viewing the tube pass the glottic opening during direct observation

47
Q

Lung overinflation due to a rapid ascent in a diving incident may result in:

A

air embolism

48
Q

You are called to the scene of a fire at a trailer park. When you arrive, you find the fire department on the scene battling a fully engulfed trailer. The fire officer directs you over to an open area where you find what appears to be a male patient in his fifties lying supine on the ground. The fire officer reports that the patient was burned when he suddenly was awakened by the fire and he stood straight up and tried to get out. The firefighters arrived and removed him from the trailer that he lived in. Upon approaching the patient, you note the skin is reddened and blistered circumferentially to the entire face, neck, upper body, and upper extremities. The hands are brown and charred, with skin sloughing off. The patient is not responding to verbal stimuli. You note stridor on inspiration and soot around his nose and mouth. His respirations are 42/minute with very little chest rise. His radial pulse is present at 132 bpm.
Your first immediate action is to:

A

begin positive pressure ventilation and prepare for

tracheal intubation

48
Q

You have just placed a tracheal tube in an unresponsive apneic patient. You should determine correct tube placement by:

A

viewing the tube pass the glottic opening during direct observation

49
Q

You arrive on the scene and find an adult patient lying supine in bed, breathing with agonal respirations. You should:

A

immediately begin bag-valve-mask ventilation

49
Q

You are called to the scene of a fire at a trailer park. When you arrive, you find the fire department on the scene battling a fully engulfed trailer. The fire officer directs you over to an open area where you find what appears to be a male patient in his fifties lying supine on the ground. The fire officer reports that the patient was burned when he suddenly was awakened by the fire and he stood straight up and tried to get out. The firefighters arrived and removed him from the trailer that he lived in. Upon approaching the patient, you note the skin is reddened and blistered circumferentially to the entire face, neck, upper body, and upper extremities. The hands are brown and charred, with skin sloughing off. The patient is not responding to verbal stimuli. You note stridor on inspiration and soot around his nose and mouth. His respirations are 42/minute with very little chest rise. His radial pulse is present at 132 bpm.
Your first immediate action is to:

A

begin positive pressure ventilation and prepare for tracheal intubation

50
Q

What three items are crucial for the tissues to receive the needed nutrients.

A

Ventilation

Oxygenation

Respiration

50
Q

You arrive on the scene and find an adult patient lying supine in bed, breathing with agonal respirations. You should:

A

immediately begin bag-valve-mask ventilation

51
Q

You are called to the scene of a residence and have just delivered a baby. You cut the umbilical cord. As you are assessing the newborn, you note that the heart rate is 82 beats per minute and the core of the body and extremities are cyanotic.
You should immediately:

As you continue with the above treatment, you note that the heart rate is now 58 beats per minute. You should immediately:

A

begin positive pressure ventilation

begin chest compressions and positive pressure ventilation

51
Q

Ventilation, oxygenation, and respiration are crucial for the tissues to receive the needed nutrients.

A
52
Q

What is the primary effect of an exposure to cyanide?

A

cellular asphyxia due to inhibition of cell enzymes

52
Q

You are called to the scene of a residence and have just delivered a baby. You cut the umbilical cord. As you are assessing the newborn, you note that the heart rate is 82 beats per minute and the core of the body and extremities are cyanotic.
You should immediately:

As you continue with the above treatment, you note that the heart rate is now 58 beats per minute. You should immediately:

A

begin positive pressure ventilation

begin chest compressions and positive pressure ventilation

53
Q

Alternative to endotracheal intubation:

A

nasogastric tube

53
Q

What is the primary effect of an exposure to cyanide?

A

cellular asphyxia due to inhibition of cell enzymes

54
Q

You are now controlling the airway with a tracheal tube that has been successfully placed. Based on the mechanism of injury and patient presentation, the second most immediate critical concern with the patient’s condition while he is in your care is:

A

effects from toxic inhalation

54
Q

Alternative to endotracheal intubation:

A

nasogastric tube

55
Q

Digital intubation is accomplished by using which of the following?

A. Laryngospasm

B. Your hand

C. Stylet

D. BronchoscopeB. Your

A

B. Your hand

55
Q

You are now controlling the airway with a tracheal tube that has been successfully placed. Based on the mechanism of injury and patient presentation, the second most immediate critical concern with the patient’s condition while he is in your care is:

A

effects from toxic inhalation

56
Q

You are ventilating an infant with the bag-valve-mask device. At what ventilation rate should the patient be ventilated?

A

minimum of once every 3 seconds, delivered over 1 to 1.5 seconds

56
Q

You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?
tension pneumothorax to the left hemithorax
Your treatment for the patient in sequence of priority would include:
1. assist ventilation with supplemental oxygen attached to the ventilation device
2. needle decompression of the left thorax
3. initiate an intravenous line of normal saline
4. rapid transport

A

1, 2, 4, 3

57
Q

You arrive on the scene and find a 45-year-old female patient with poor hygiene in the local homeless shelter. Upon your assessment you find the following: unresponsiveness; tachycardia; pale, cool skin; rapid, deep respirations at 34/minute. You note a fruity odor on the breath of the patient. The supervisor at the shelter indicates that she is a regular there. He states that he believes she is an alcoholic; however, he believes that she quit drinking a few days ago. Her medical history reveals no significant chronic diseases or conditions. Her BP is 122/66 mmHg; ECG shows a sinus tachycardia; and SpO2 is 98% on room air.
Your initial differential diagnosis of this condition is:

Your initial treatment would consist of:

If you were able to measure the blood gases in this patient, you would suspect the pH to be:

The type of respirations the patient is displaying is referred to as:

A

diabetic ketoacidosis

  1. nonrebreather at 15 lpm
  2. IV line of normal saline

less than 7.35 mmHg

Kussmaul’s Sign

57
Q

You are ventilating an infant with the bag-valve-mask device. At what ventilation rate should the patient be ventilated?

A

minimum of once every 3 seconds, delivered over 1 to 1.5 seconds

58
Q

The amount of air that actually reaches the alveoli (alveolar tidal volume) and is involved in gas exchange in the average-sized adult person is approximately (based on a normal tidal volume):

A

350 ml

58
Q

You arrive on the scene and find a 45-year-old female patient with poor hygiene in the local homeless shelter. Upon your assessment you find the following: unresponsiveness; tachycardia; pale, cool skin; rapid, deep respirations at 34/minute. You note a fruity odor on the breath of the patient. The supervisor at the shelter indicates that she is a regular there. He states that he believes she is an alcoholic; however, he believes that she quit drinking a few days ago. Her medical history reveals no significant chronic diseases or conditions. Her BP is 122/66 mmHg; ECG shows a sinus tachycardia; and SpO2 is 98% on room air.
Your initial differential diagnosis of this condition is:

Your initial treatment would consist of:

If you were able to measure the blood gases in this patient, you would suspect the pH to be:

The type of respirations the patient is displaying is referred to as:

A

diabetic ketoacidosis

  1. nonrebreather at 15 lpm
  2. IV line of normal saline

less than 7.35 mmHg

Kussmaul’s Sign

59
Q

You are treating a firefighter who has inhaled noxious toxins in a fire. The patient presents with confusion and a severe headache and breathing is labored at 38 times a minute. You should first:

A

assist ventilations with a bag-valve-mask and intubate

59
Q

The amount of air that actually reaches the alveoli (alveolar tidal volume) and is involved in gas exchange in the average-sized adult person is approximately (based on a normal tidal volume):

A

350 ml

60
Q

What is the purpose of the second hold in the barrel of an endotracheal tube, known as the Murphy’s Eye?

A

it enables airflow even if the end of the tube is occluded

60
Q

You are treating a firefighter who has inhaled noxious toxins in a fire. The patient presents with confusion and a severe headache and breathing is labored at 38 times a minute. You should first:

A

assist ventilations with a bag-valve-mask and intubate

61
Q

In children, the most common cause of conscious airway obstruction is:

A

Food

61
Q

What is the purpose of the second hold in the barrel of an endotracheal tube, known as the Murphy’s Eye?

A

it enables airflow even if the end of the tube is occluded

62
Q

You are preparing to intubate an apneic 12-day-old infant. What size laryngoscope blade and tracheal tube would be appropriate in this situation?

A

size 1 straight blade with a 3.5 ET tube

62
Q

In children, the most common cause of conscious airway obstruction is:

A

Food

63
Q

Choose the correct statement that pertains to the epiglottis.

A

the epiglottis lies above (superior) to the larynx

63
Q

You are preparing to intubate an apneic 12-day-old infant. What size laryngoscope blade and tracheal tube would be appropriate in this situation?

A

size 1 straight blade with a 3.5 ET tube

64
Q

Tracheal intubation would be initially contraindicated for which of the following patients?

A

76-year-old male who has ingested a large amount of Darvon pills

64
Q

Choose the correct statement that pertains to the epiglottis.

A

the epiglottis lies above (superior) to the larynx

65
Q

Total lung capacity in the average adult male is approximately:

4L

5L

6L

7L

A

6L

65
Q

Tracheal intubation would be initially contraindicated for which of the following patients?

A

76-year-old male who has ingested a large amount of Darvon pills

66
Q

Choose the statement that is associated with the use of the straight blade during tracheal intubation.

A

it provides greater displacement of the tongue, thus it is preferred in treating infants

66
Q

Upon completing your initial assessment, you would immediately:

A

Apply humidified oxygen via a nonrebreather mask

67
Q

In infants and children, normal tidal volume is approximately:

4 to 6 mL/kg

5 to 7 mL/kg

6 to 8 mL/kg

7 to 9 mL/kg

A

6 to 8 mL/kg

67
Q

Choose the statement that is associated with the use of the straight blade during tracheal intubation.

A

it provides greater displacement of the tongue, thus it is preferred in treating infants

68
Q

Ventilation is the process of moving air:

a. into the body tissues
b. into and out of the lungs
c. into the cellular level
d. into the alveoli

A

b. into and out of the lungs

69
Q

The phrenic nerves stimulate the:

a. diaphragm
b. sternocleidomastoid
c. intercostal muscles
d. all of the above

A

a. diaphragm

70
Q

Hyperventilation occurs when ________ elimination exceeds ________ production.

a. oxygen, CO2
b. CO2, Oxygen
c. oxygen, oxygen
d. CO2, CO2

A

CO2, oxygen

71
Q

During a failed intubation, which of the following is an acceptable alternative?

a. King LT airway
b. Combitube
c. Laryngeal mask airway
d. All of the Above

A

D. All of the above

72
Q
A

Airway & Ventilation (1 decks)

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