Cardioresp Flashcards
What is SARS? What are the physical findings?
Severe acute respiratory syndrome
- atypical resp illness caused by coronovirus
Findings - Dry cough - decreased WBC, platelets, lymphocytes - increased liver function tests - CXR abnormal -
What are the different stages of COPD?
Mild: FEV1/FVC = 80% predicted
Moderate: FEV1/FVC <50%, with chronic respiratory failure.
What does it mean if FEV1 < 50%?
chronic resp failure
What are the findings of resp alkolosis?
Dizziness, syncope, tingling, numbness, early tetany - increased pH and decreased PaCo2 - HCO3 - WNL CAUSED BY: - alveolar hyperventilation
What are the findings of resp acidosis?
decreased pH, increased PaCO2 - HCO3 - WNL - Early: anxiety, restlessness, dysnpnea, headache Late: confusion, somnlence, coma CAUSED BY: - alveolar hypo ventilation
What are the findings for metabolic aklalosis?
- Increased ph
- PaCO2 - WNL
- HCO3 increased
- Vague symptoms: weakness, mental dullness, possible early tetnay
CAUSED BY: - bicarbonate ingestion, vomiting, diuretics, steroids, adrenal disease
What are the findings for metabolic acidosis ?
- decreased pH
- PaCO2 - WNL
- HCO3- decreased
secondary to hyperventilation, (Kussmaul breathing), nausea, lethargy, and coma
CAUSED BY: - diabetic, lactic or uremic acidosis, prolonged diarrhea
When looking at alveolar ventilation what value should you look at first?
ph
What are the normal values for alveolar ventilation? (ABG’s)
pH = 7.35 - 7.45 PaCO2 = 35 - 45 mmHg HCO3 = 22- 28 mEq/mL PaO2 = 80-100mmHg SaO2 = 95-100mmHg
What is Cor pulmonale?
Cor pulmonale (Latin cor, heart + New Latin pulmōnāle, of the lungs) or pulmonary heart disease is enlargement of the right ventricle of the heart as a response to increased resistance or high blood pressure in the lungs (pulmonary hypertension).
Chronic cor pulmonale usually results in right ventricular hypertrophy (RVH), whereas acute cor pulmonale usually results in dilatation.
Obstructive diseases present typically wit this type of chest?
Barrel chested, decreased recoil of lungs
Obstructive diseases have decreased breath sounds: True or False
True
What are 7 ways to help with secretion clearance?
1) Cough
2) Huffing
(needs to be followed by deep breathing exs.)
3) Assisted cough
- contraindicated for rupture diaphragm
- follow breathing rate, apply J-stroke at peak inspiration
4) ACB- active cycle breathing
- breath normal (3 breaths
- Deep breathing (3)
- Max inspiration with 3 sec HOLD (this is key)
- Breathing normal (3)
- Forced expiratory technique (FET) (2) = HUFF
- do as many reps in 15-30min repeat 2x/day
5) Postural drainage (pair with percs/vibes)
6) Percussions
- triple threat = rib spring + vibes + percs
7) Vibrations
- apply during exhalation in direction fo the ribs soft tissue
What is a PEP and how does it work?
Positive expiratory pressure mask - one way valve - inhale slowly - exhale against resistance - 1:3 with FET (5-20x) - good for kids with CF - 15 breaths x 2 huffs \+ pressure is created in the PEP & lungs on exhale; allows air to get behind plug through the collateral branches, keeps airway open on exhalation. - keeps the mucus moving fwd.
Oscillating PEP what is it how does it work?
- breath into it, vibrates on INHALE
- dislodge mucus in small and large airway
- ex acapella
(inspire larger then normal breath no not max; hold breath 3sec; exhale 3-4sec device vibrates) - desired ratio 1:3
- 10-20 PEP breaths
- 2 huffs
- 2-7 sets
