Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ACUTE CARE > AIRWAY COMPRØMISE!!!!!!!!!!!!!!!!!!!!!! > Flashcards

AIRWAY COMPRØMISE!!!!!!!!!!!!!!!!!!!!!! Flashcards

1
Q

What is going on in a patient with poor ventilation?

A

Blood is flowing, but does not become adequately oxygenated by the lungs. Typically caused by an obstruction or defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is going on in a patient with poor perfusion?

A

Patient is ventilating normally, but blood is not adequately reaching the lungs for blood/air transfer. Typically caused by a Pulmonary embolism or a decrease in cardiac output.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the difference between Hypoxemia and Hypoxia?

A

Hypoxemia - Decrease in O2 in the blood - typically asymptomatic

Hypoxia - Significant loss of O2 in the blood to cause symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause Hypoxemia?

A

Diseases in the respiratory system (COPD, Chronic Bronchitis)

Alteration in circulatory function

Dysfunction of neurological system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can Hypoxemia occur?

A

Hypoventilation

Impaired diffusion of gases

Inadequate circulation of blood through pulmonary capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
Which of the Following can Occur in Hypoxemia? Why?
A/ Metabolic Alkalosis
B/ Metabolic Acidosis
C/ Respiratory Acidosis
D/ Respiratory Alkalosis
A

Metabolic Acidosis

Anaerobic metabolism that builds up lactic acid levels -> leading to metabolic acidosis. (Typically not until PaO2 falls below 60%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What occurs in the mild-moderate-chronic stages of hypoxemia?

A

Mild

  • Tachycardia
  • Peripheral vasoconstriction
  • Diaphoresis
  • Mild increase in BP

Moderate

  • Restlessness
  • Agitation
  • Euphoria
  • Impaired Judgment
  • Delirium
  • Stupor
  • Coma (late sign)

Chronic

  • May be insidious onset and attributed to other causes
  • Increased ventilation
  • Pulmonary vasoconstriction
  • Increased production of RBCs
  • Cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Hypercapnia? What causes it?

A

Increase in CO2 levels within the body (Acidosis).

Caused by:
Abnormalities in airway/alveoli
CNS suppression (Decreased drive to breathe)
Limited chest wall expansion
Neuromuscular conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the clinical manifestations of Hypercapnia?

A

Respiratory Acidosis

Impaired Kidney/cardiovascular/NS functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Would you give a patient with Hypercapnia a CPAP machine?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a pneumothorax? Differentiate between primary and secondary spontaneous types.

A

*Presence of air in the pleural space with a partial or complete lung collapse

Primary
- Ruptured Bleb (Alveoli)
(Typically occurs in Tall boys)

Secondary

  • Caused by underlying lung disease (More serious)
  • Can be caused by injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Differentiate between a Traumatic pneumothorax and a Tension pnuemothorax

A

Traumatic

  • Penetrating or non-penetrating wound that allows air to enter or leave.
  • May be accompanied by a hemothorax

Tension

  • Air can enter but cannot leave
  • LIFE THREATENING
  • Compression of great vessels/heart/lungs
  • Mediastinal shift occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which is more common in a pneumothorax….
Hypotension
Hypertension

A

Hypotension

Typically due to a loss of fluids/blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a hemothorax? Differentiate between a minimal - moderate - large hemothorax

A

Blood present in the pleural cavity -> secondary to injury, surgery, malignancy, or rupture of vessel

Minimal - 300-500cc, usually corrects itself

Moderate - 500-100cc, signs of lung compression, drainage needed with fluid replacement. Surgery may be indicated.

Large - 1000cc or more, bleeding from intercostal space or artery. Requires IMMEDIATE drainage and fluid replacement and surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some clinical manifestations of a hemothorax

A
  • Hypoxemia
  • Decreased ventilation
  • Increased effort in breathing
  • Tachypnea
  • Decreased air entry
  • Hypovolemia possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is atelectasis (AT-te-lect-ta-sis)

A

Incomplete lung expansion due to obstruction/compression/loss of surfactant

17
Q

Harvey, a 5”2 obese Cat whisperer comes onto your unit having difficulty breathing, is cyanotic, and has decreased chest expansion. With an X-ray, you notice a tracheal and mediastinal shift, but no sign of trauma to the chest. There are also signs that he has a loss of surfactant. What is wrong with Harvey?

A

Atelectasis - Collapsed lung with Ø presence of air in pleural space.

Not a spontaneous pneumothorax because HArvey is SHort and Fat. The loss of surfactant is a clinical sign of atelectasis

18
Q

Clint, a 56 year old basket-weaver comes onto your floor with a HR of 138, chest pain, hypotension, an open wound in his chest wall, and noticeable amounts of blood in his pleural cavity. Whats up with Clint?

A

Hemothorax… probably a Large one too 1000cc or more.

19
Q

What are the advantages of an Endotracheal tube?

A

Protects against aspiration

Allows suctioning of tracheal/bronchial secretions

Provides route for mechanical ventilation/oxygenation

Airway can be secured rapidly

20
Q

What are some indications for an Endotracheal tube?

A

Upper airway obstruction

Apnea

High risk of aspiration

Ineffective clearance of airway

Respiratory Distress

21
Q

When is a Nasal Endotracheal tube indicated over a oral one?

A

When a suspected neck or head injury has occurred - secure spine and deplete the need for a head tilt.

22
Q

When would a tracheotomy endotracheal tube be indicated?

A

When an artificial airway is expected to be needed over the long term.

23
Q

What has happened if CO2 is detected in a patient with an Endotracheal tube?

A

Tube has been placed in the esophagus

Reinsertion required. Batteries not included.*

24
Q

What are some complications of intubation?

A 
Bronchospasms
Laryngospasms
Aspiration
Tooth damage
Injury to lips/mouth/vocal cords
Hypoxemia
Tracheal stenosis, erosion or necrosis
25
Q

What should you do if the tube has been incorrectly placed?

A

CALL FOR HELP

Stay with patient and maintain patent airway***

Support ventilation and use Bag-valve-mask (BVM) with 10% O2 if needed

26
Q 
What pressure should and ET tube remain at while in the patient?
A/ 20-30mmHg
B/ 25-30mmHg
C/ 20-25mmHg
D/ 30-35mmHg
A

C/ 20-25mmHg

27
Q

What are some clinical signs of respiratory distress?

A

Use of accessory muscles

Hypoventilation with dusky skin

Hyperventilation with numbness and tingling

28
Q

Which of the following is False about ET tubes?
A/ Suction when secretions are visible in the tube
B/ Suction ET tube Routinely
C/ Dysrhythmias can occur due to suctioning
D/ Suction pressure should not exceed 120mmHg

A

B/ DO NOT suction routinely, only as needed.

*Risk of injury

29
Q

How can you manage thick mucous secretions in patients with ET tubes?

A

Provide adequate hydration/humidification

30
Q

What might be some indications for mechanical ventilation?

A

*Anything that impedes ability to ventilate on their own.

  • Acute respiratory failure
  • Respiratory depression from CNS
  • Neuromuscular disorders (MS, ALS, etc).
31
Q

A positive pressure mechanical ventilator does what?

A

Provides pressure during inspiration, increasing tidal volume.

Forces lungs to take in more air

32
Q

What is a controlled ventilation?

A

A machine that delivers a predetermined rate and volume of gas independent of client’s effort

Does all the breathing for them.

33
Q

What is the KEY criteria for the use of a CPAP machine?

A

Patient MUST have their own spontaneous ventilation.

Must be able to breathe on their own.

34
Q

What can cause I high-pressure alarm in an ET tube?

A

Secretions

Pt. biting the tube

Coughing/anxiety -> sedatives

35
Q

What can cause a low pressure alarm in an ET tube?

A

Break/leak in system.

36
Q

How often do you assess cardiopulmonary status in a patient with an ET tube?

A

q2h-q4h

ACUTE CARE (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions