Airways Study Guide Flashcards
Describe the pathway of oxygen as it enters the body and gets to the alveoli
Oxygen reaches body tissues and cells through breathing and circulation.
During inhalation, oxygen moves from the atmosphere into the lungs, then crosses the alveolar membrane onto hemoglobin by diffusion.
Then the red blood cells carry the hemoglobin and oxygen through the body and deliver it to the capillaries to oxygenate the body’s cells.
Define the process of diffusion and where it occurs in the lungs
Diffusion is the process where molecules move from a higher level of concentration to an area of lower concentration.
This occurs in the lungs between the gas in the alveoli and the blood in the capillaries in the lungs.
List the steps in caring for a patient who is choking,
including responsive
And unresponsive patients
A responsive patient that is choking may have a mild or severe obstruction. If they have a mild obstruction with good air exchange, you may hear wheezing, and are able to cough forcefully, then encourage them to keep coughing and continue to monitor.
If they have a mild obstruction with poor air exchange, you may hear stridor and that sounds high pitched, you would treat this as if it were a severe airway obstruction.
A severe airway obstruction in a responsive patient is treated with abdominal thrusts. In a patient that is unresponsive, not breathing, and without a pulse, begin CPR. If there is resistance during the ventilations, then begin a tongue jaw lift after the 30 compressions. Pull the mouth/jaw open and look inside, if you can see the object remove it with your index finger or with suction.
If you still can’t remove the object, immediately transport and continue to reattempt. If the patient is conscious with a mild obstruction, and good air exchange, provide them with oxygen as you transport them.
Describe the indications for suctioning and describe the technique for doing so
Gurgling is a sign that they need suctioning, also if there is resistance during ventilations
Contrast the rigid suction and soft suction catheter including when to use each
The soft suction catheter (Sometimes called French or whistle tip, non-rigid) are used for patients with a stoma, suctioning the nose, and liquid secretions in the back of the mouth and clenched teeth. when a rigid suction catheter can’t be used. Never more than 15 secs for an adult, 5 for a child
List the indications for the head tilt chin-lift and jaw thrust maneuvers
Use Head tilt chin lift on patients NOT suspected of having spinal trauma. Pull up chin while holding head down.
Use Jaw thrust on patients with suspected spinal trauma
Describe the technique for applying an oropharyngeal and nasopharyngeal airway
B
List the steps in the primary assessment including the pertinent findings
B
Describe which muscles are working during inhalation and exhalation
When a person inhales, the diaphragm and intercostal Contract.
Exhalation. Doesn’t usually need muscular help. The diaphragm and intercostal muscles relax.
Describe the role of the phrenic nerve
The phrenic nerve, found in the thorax innervates the diaphragm muscle , allowing it to contract. Necessary for adequate breathing to occur
List the upper and lower airway sounds and which condition would likely be heard with each
B
List the proper oxygen flow rate in liters per minute for the nasal cannula, non-rebreather mask, and bag-valve-mask.
Nasal cannula - 1-6 liters
Non-rebreather - 10-15 liters
BVM - Bag valve Mask - 15 liters
Contrast the signs and symptoms and breathing rates of a patient suffering from respiratory distress and respiratory failure (remember this is also what differentiates who gets assisted ventilations or oxygen via non-rebreather mask
Respiratory Distress
Assisted Ventilation
Continuous Positive Airway Pressure (CPAP)
Respiratory Failure
List the steps for ventilating a patient who has a stoma
If there is a tube, ventilating with a BVM can be done by attaching the BVM directly to the tracheostomy tube with the attached adapter (remove the mask from the BVM). Your patient should also get high flow 02 at 15 LPM by attaching the oxygen tubing directly to the BVM.
If the patient does not have a tube, use an infant or child mask to create an airtight seal around the stoma. Seal the mouth and nose with one hand (if you are alone) and ventilate the patient through the stoma with the BVM in the other hand
- Look for adequate chest rise then release the seal on the nose and mouth allowing more air to escape through the upper airway during exhalation.
- If patient with stoma or tracheostomy does not have adequate chest rise while ventilating, try suctioning the stoma and mouth with a soft tipped catheter before you attempt to deliver breathes through the patient’s mouth or nose. If you have to ventilate through the mouth or nose of a tracheostomy patient you may find it easier if the actual stoma in the trachea is sealed during the delivery of ventilations. Remember that unlike other patients, patients who are being ventilated via a stoma will not benefit from the head tilt chin lift maneuver nor the jaw thrust maneuver in an attempt to open the airway. The tracheostomy opening is far below the pharynx and potential occlusion by the tongue.
Define the following respiratory-related terms: tidal volume, minute volume, compliance, seesaw respirations, dyspneic, and apneic
Tidal volume: the amount of air (in milliliters) that is moved in or out of the lungs during one relaxed breath; about 500 mL for an adult
Minute volume: another measure used to assess the amount of air that moves in and out of the lungs in 1 minute -> Respiratory rate x Tidal volume= minute volume
Compliance: the ability of the alveoli to expand when air is drawn in during inhalation
Seesaw respirations: chest and abdominal muscles alternately contract to look like a seesaw
Dyspneic: shortness of breath
Apneic: there is no movement of the muscles in inhalation so there is no breathing
Describe the signs and symptoms of a patient suffering from anaphylaxis including why the signs and symptoms occur.
Signs and symptoms…
Flushed skin or hives
Generalized edema (edema is the presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area).
Decreased blood pressure
Laryngeal edema with dyspnea (shortness of breath or difficulty breathing)
Wheezing or stridor
Why? : allergic reaction that may include shock and respiratory failure
Describe the signs and symptoms of a patient suffering from epiglottitis including why the signs and symptoms occur
- Signs and symptoms:
- Dyspnea (shortness of breath)
- High fever
- Stridor
- Drooling
- Difficulty swallowing
- Severe sore throat
- Tripod or sniffling
WHY? Disease where the epiglottis becomes inflamed and enlarged and may cause an upper airway obstruction
Describe the signs and symptoms of a patient suffering from asthma, including why the signs and symptoms occur
Signs and symptoms:
- Wheezing on inspiration/expiration
- bronchospasm
Why? Acute spasm of the smaller air passages, bronchioles, associate with excessive mucus production and with swelling of the mucous lining of the respiratory passages
Define what a beta 2 agonist medication is and why it should be administered to a respiratory patient
Beta 2 agonist medication is used to treat asthma and COPD and causes a dilation of bronchial passages
Describe the signs and symptoms of a patient suffering from chronic bronchitis, including why the signs and symptoms occur
Signs and symptoms:
- Chronic cough
- Sputum
- Wheezing
- Tachypnea (increased breathing rate)
- cyanosis
Describe the signs and symptoms of a patient suffering from emphysema, including why the signs and symptoms occur
Signs and symptoms:
- Barrel chest
- Pursed lip breathing
- Dyspnea on exertion
- Cyanosis
- Wheezing / decreased breath sounds
WHY? Smoking
Contrast the signs and symptoms of a patient suffering from a pneumothorax and tension pneumothorax and differentiate between the two
Pneumothorax (collapsed lung) symptoms:
- Sharp chest pain
- Decreased breath sounds (affected
side)
- Subcutaneous emphysema (crackling
sensation felt on palpation of the
skin, caused by the presence of air
in soft tissues
WHY? Partial or complete accumulation of air or gas in the pleural space
Tension symptoms: (Sucking chest wound)
- SEVERE shortness of breath
- decreased/ altered level of
consciousness
- neck vein distension (enlarged)
- tracheal deviation
- hypotension; signs of shock
WHY? Accumulation of air or gas in the pleural space that progressively increases the pressure in the chest and interferes with cardiac function and can lead to death
Describe the signs and symptoms of a patient suffering from cystic fibrosis, including why the signs and symptoms occur
Symptoms:
- in children this ranges from sinus congestion to wheezing and asthma like complaints.
- Chronic cough that produces thick, discoloured mucus
- Dyspnea
- Treatment: suctions and oxygen using age appropriate attachments
Why? CF disrupts the balance of salt and water used to maintain a normal coating of fluid and mucus inside the lungs and other organs. This results in thick sticky mucus that has germs an infects the lungs
Describe the signs and symptoms of a patient suffering from a pulmonary embolism, including why the signs and symptoms occur
Signs and symptoms:
- Sudden shortness of breath
- Tachycardia
- Various degrees of hypoxia
- Cyanosis
- Chest pain
- Irregular heartbeat
- Sweating
- Hemoptysis - Coughing blood
- Low blood pressure
- Lightheadedness
WHY? A blood clot that develops in a blood vessel in the body that then travels to the lung artery where it suddenly blocks blood flow
Describe the signs and symptoms of a patient suffering from congestive heart failure including why the signs and symptoms occur
Signs and symptoms:
- Abdominal distention
- Dependent edema (swelling in the part of the body closest to the ground)
- Tachycardia
- Increased respiratory rate
- Anxiety
- Inability to lie flat
- Ashen or cyanotic skin
- Confused LOC
- Distended neck veins
- Shortness of breath (sudden onset)
- crackling , wheezing sounds
List the assessment steps in Start Triage and how to triage a patient
B
List the 6 steps of administering a medication to a patient.
The six steps are:
- Right patient
- Right Medication
- Right Dose
- Right Administration (route)
- Right time
- Right documentation
Describe the signs and symptoms of a patient suffering from pneumonia, including why the signs and symptoms occur
Signs and symptoms:
- dyspnea
- chills, fever
- cough
- green, red, or rust colored sputum
(mucus that is coughed up)
- localized wheezing or crackles
WHY? Infectious disease of the lung that damages lung tissue. It’s cause can be bacterial, viral or fungal
