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CP Test 4 > B4-054 Respiratory Failure > Flashcards

B4-054 Respiratory Failure Flashcards

1
Q

indications for mechanical ventilation:
respiratory failure

4

A
  • hypoxia
  • hypercarbia
  • perioperative
  • metabolic
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2
Q

indications for mechanical ventilation:
upper airway obstruction

3

A
  • anaphylaxis
  • angioedema
  • trauma
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3
Q

indications for mechanical ventilation: airway protection

3

A
  • decreased GCS
  • cardiac arrest
  • prevention of aspiration
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4
Q

type 1 respiratory failure

A

hypoxemia

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5
Q

type 2 respiratory failure

A

hypercarbia

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6
Q

type 3 respiratory failure

A

perioperative

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7
Q

type 4 respiratory failure

A

metabolic

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8
Q

occurs with alveolar flooding and subsequent VQ mismatch and intrapulmonary shunt physiology

A

type 1 hypoxia

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9
Q

pulmonary edema, lung injury, pneumonia or hemorrhage can cause what type of respiratory failure?

A

type 1 hypoxia

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10
Q

low inspired oxygen
VQ mismatch
shunt
diffusion limitation

cause

A

type 1- hypoxia

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11
Q

in the case of a shunt, will supplying supplemental oxygen improve ventilation?

A

no

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12
Q
  • impaired CNS drive to breathe
  • impaired neuromuscular strength
  • impaired resistance

cause

A

type 2 hypercarbia

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13
Q

lab findings pH < 7.2 and PaCO2 >45 or significantly elevated from baseline

A

type 2 hypercarbia

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14
Q
  • atelecstasis
  • decreased airway protection
  • airway injury
  • procedural need

causes for

A

type 3 perioperative

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15
Q

hypoperfusion of respiratory muscles

can cause

A

type 4 metabolic

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16
Q

what should you do if your patient is hypoxic?

A
  • sit up
  • oxygenate
  • stimulate
  • history
  • labs/imaging
  • call for help
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17
Q

flow 1-6L
FiO2 24-45%

A

nasal cannula

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18
Q

flow 1-7 L
FiO2 30-55%

A

reservoir nasal cannula

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19
Q

flow 10-60 LPM
FiO2 21-100%

A

heated high flow cannula

he also called this comfort care

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20
Q

flow 6-10 LPM
FiO2 35-50%

A

simple face mask

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21
Q

flow 2-15 LPM
FiO2 24-60%

A

venturi mask

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22
Q

flow 10-15 LPM
FiO2 -80%

A

non rebreather

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23
Q

induction agents

4

A
  • propofol
  • ketamine
  • etomidate
  • benzodiazepines
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24
Q

blunting of airway reflexes

2

A
  • lidocaine
  • opiods
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25
neuromuscular blockage
depolarizing vs nondepolarizing
26
GABA receptor agonist | 3
* propofol * benzos * etomidate
27
* most common agent used before surgery * used to maintain general anesthesia before surgery
propofol
28
NMDA receptor antagonist
ketamine
29
* decreases pain with injection of propofol and etomidate * causes tinnitus, perioral tingling
lidocaine
30
* typically IV fentanyl * causes respiratory depression
opioids
31
succinylcholine is a
depolarizing agent
32
mimics acetylcholine and produces sustained depolarization of the post junctional membrane
succinylcholine
33
rocuronium, vecuronium, cisatracurium are
non depolarizing agents
34
most common trigger for perioperative anaphylactic events
non depolarizing agents
35
reversal agent for rocuronium/vecuronium
suggamadex
36
MH trigger
succinylcholine
37
history red flags for intubation
* OSA * neck radiation * difficulty controlling secretions
38
physical exam finding red flags for intubation
* BMI > 30 * neck circumference > 40 * edentulous * small mouth * limited neck mobility * thyromental distance < 6 * beard
39
purpose of preoxygenation
breathing 100% oxygen can replace nitrogen and increase the amount of oxygen lungs can hold
40
proper positioning for intubation
* 35 degrees of cervical flexion * elevation of the head on firm cushion
41
* rapid anesthesia induction, short DOA * may cause respiratory depression and decreased BP
propofol
42
* causes hallucination, vivid dreams * sympathomimetic
ketamine
43
an intrapulmonary problem associated with an A-a gradient
type 1 hypoxemia
44
* ventilatory problem * the integrity of the alveolar capillary unit is normal * A-a gradient normal
type 2 hypercarbia
45
normal A-a gradient
(Age + 10)/4
46
acute hypercapnea is always accompanied by
respiratory acidosis
47
PaCO2> 45 mmHg
hypercapnea
48
hypercapnic respiratory failure is typically caused by two things
decreased minute ventilation increased dead space
49
alveolar gas exchange is inversely related to
PaCO2
50
a change of 10 in CO2 causes a pH change of
0.08
51
If alveolar ventilation is reduced by half, PaCO2 will
double
52
usually due to alveolar hypoventilation
respiratory acidosis
53
usually due to alveolar hyperventilation
respiratory alkalosis
54
due to: * increased production of acids * increased loss of bicarb * decreased renal excretion of acids
metabolic acidosis
55
due to: * intracellular shift of H+ ions * GI H+ loss * excessive renal loss of H+
metabolic alkalosis
56
* causes inhibition of 11B hydroxylase resulting in short term adrenal insufficiency * low cortisol, hyponatremia, hyperkalema, fatigue, weakness, hypotension
etomidate
57
* typically given during intubation and mechanical ventilation to blunt reflexes * can also be given for pain control and sedation
fentanyl
58
* commonly used to provide rapid muscle relaxation during rapid sequence induction * causes depolarization of neuromuscular junction leading to paralysis
succ
59
* most significant side effect is MH * rapid elevation of temperature, muscle rigidity, metabolic acidosis, and CV instability
succ
60
potential side effect is pseudocholinesterase deficiency causing prolonged paralysis
succ
61
* commonly used for induction and sedation that acts on GABA * short acting, rapid anesthesia, quick recovery
propofol
62
potential side effect causing metabolic acidosis, rhabdomyolysis, hyperkalemia, cardiac dysfunctio, renal failure
propofol infusion syndrome
63
normally respiratory muscles consume 5% of total CO, but in shock, up to [...] of the CO can be redirected to respiratory muscles
40% | mechanical ventilation may be required just to let CO distribute properl
64
acute respiratory acidosis, pH should be about
7.24
65
acute metabolic acidosis, PCO2 should be
low
66
metabolic alkalosis, pH should be [...] and HCO3 should be [...]
pH > 7.4 HCO3 > 24
67
with chronic respiratory alkalosis, pH should be [...] and HCO3 should be [...]
pH: near normal HCO3: low
68
alveolar ventilation increases as RR
increases
69
alveolar ventilation increases as tidal volume
increases
70
alveolar ventilation increases as dead space
decreases
71
opioid overdoses cause what type of respiratory failure?
hypercapnic | respiratory acidosis

CP Test 4 (15 decks)

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