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Medical Nursing > Cardiorespiratory emergencies > Flashcards

Cardiorespiratory emergencies Flashcards

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1
Q 
Define dysponea
Tachyponea 
Orthoponea 
Hyperponea
Stridor 
Stertor
A

Difficulty breathing
Increased rate of breathing
Only able to breath standing or sitting up
Increased depth of breathing
Harsh sound obstruction of trachea or larynx
Heavy snoring nasopharynx pharynx

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2
Q

Describe the 7 causes of upper airway obstruction

A 
Tracheal collaps 
Polyps 
Foreign body 
Laryngeal paralysis 
BOAS
Neoplasia 
Anaphylaxis
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3
Q

Describe the 15 causes of lower respiratory tract obstruction

A 
Asthma 
Pleural effusion 
Pneumothorax 
Chylothorax
Haemothorax 
Narrowing of the bronchi 
Bronchitis 
Pulomanary odema 
Smoke inhalation
Pulmonary contusions 
Pulmonary fibrosis 
Pulmonary embolisms
Pyothorax 
Hydrothorax
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4
Q

List the emergency interventions required for the dysponeaic patient

A 
Do not stress patient 
Oxygenate (oxygen kennel, nasal prongs, mask, nasal catheters
Leave alone 
If fluid present drain
Emergency tracheostomy
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5
Q

How do you preform a tracheostomy and what equipment do you need?

A 
Et tube ventilate  
Surgical kit blade 
Clippers 
Tracheostomy tube
Suture material 
Sedate or induce patient 
Cut placed between the thoracic inlet and the larynx 
Flow by or attach anaesthetic circuit 
Stay sutures upper and lower tracheal ring labelled
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6
Q

What equipment do you need to preform a thoracentesis and how is it preformed?

A 
Sedate patient oxygenate 
Large clip 7th-9th rib
IIf fluid ventral (2/3 up chest) if air dorsal (1/3 down chest)
Prep area  Chlorhex 
Sterile gloves
Butterfly catheter 21g 23g 
Three way tap attached to syringe 
Insertion site 7th to 8th rib
Measure volume me of fluid/air removed  if effusion sample fluid
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7
Q

What actions should you take if a BOASpatient comes into practice?

A

Oxygenate
Sedate (prevent stress)
Cool if 40.9 (pour tap water over patient focus on paws inguinal areas cool until 39.9 towel dry
Fan

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8
Q

What do audible crackles caudally or cranially indicate?

A

Caudal=pulmonary odema

Cranial=aspiration pneumonia

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9
Q

What do dull lung sounds dorsally or ventrally indicate

A

Ventrally=pleural effusion

Dorsally=pneumothorax

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10
Q

What equipment and measurements can be used to monitor oxygen delivery?

A

Pulse oximetry spO2

Blood gass PaO2

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11
Q

What determinants effect oxygen delivery?

A 
Cardiac output=SV *HR 
Paranchymal happiness 
SpO2 
PAO2 
Hb concentration
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12
Q

What is the equation for the A-a gradient?

A

((760-47)xFiO2-PaCO2/0.8)-PaO2

The lower the better

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13
Q

What are the breathing patterns associated with restrictive conditions?

A

Rapid shallow breaths
Pulomary fibrosis
Pulmonary odema
Pleural effusions

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14
Q

What are the breathing patterns associated with obstructive conditions?

A

Increased respiratory effort (upper trachea)
Increased expiratory efforct (lower bronchioles)
Feline asthma

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15
Q

What process should you take when a dyspneoic patient comes into practice?

A 
Physical exam
Respiratory rate and effort 
SpO2 
MM CRT 
Auscultation lung quadrants 
Oxygenate
Pulse quality and heart rate
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16
Q

What is important to monitor and consider in the dyspnoeoc patient?

A 
Resp rate and effort
CRT MM 
SpO2 
Careful with toxic oxygen radicals (<60% o2 for long term) 
Position keep in sternal 
Monitor temperature
Check eyes for dryness 
Portable oxygen 
Have ET use available 
Monitor blood gas 
HR and pulse quality 
Ventilation 
Nebulisation
Postural feeding 
Behaviour
17
Q

List right sided cardia emergencies

A

Tricuspid valve disease
Pulmonary stenosis
Pericardial effusion

18
Q

Left sided cardiac emergencies

A

Mitral valve degenerative disease

19
Q

Whole cardiac diseases

A 
Dilated cardiac myopathy 
Hypertrophic cardiomyopathy 
Congenital defects (patent ductus arteriosus, stenosis large vessels, ventricular septal defect) 
Endocarditis 
Atrial fibrillation 
Ventricular fibrillation 
3rd degree av block 
Sick sinus syndrome
20
Q

Nursing management cardiac patient

A 
Iv access 
ECG
HR pulse quality 
MM CRT 
SPO2 
Blood pressure 
Oxygen 
PUPD after furosemide 
RR
Water
21
Q

Clinical signs of right sided heart failure

A 
Ascities 
Distended jugulars 
Poor pulse quality 
Peripheral odema 
Pulse deficits  
Hepatomegaly 
Splenomegaly 
Pale MM prolonged CRT 
Electrical alterans(tamponade)
22
Q

Clinical signs left sided heart failure

A 
Coughing 
Pulmonary odema 
Tachypnoea 
Dysponea 
Arrhythmia 
Murmur
Poor pulse quality 
Pulse deficits pale or cyanotic MM
23
Q

Diagnostic tools for heart failure

A

Ultrasound radiographs pro BNP Echo bloods electrolytes haem bichem

24
Q

What is dilated cardiomyopathy?

A

Common in large dog breeds dilation if the ventricles
poor contractility
Atrial fibrillation
Enlargement of atrium
Aims to decrease congestion and improve contractility

25
Q

What is hypertrophic cardiomyopathy?

A

Affects cats thickening of the ventricle walls
Reduced cardiac filling less cardiac output
Atrial enlargement
Pulomary odema treated with frusomide
Hypotension!!!
Goals decrease resistance improve diastolic function

26
Q

What is cardiac tamponade?

A 
Pericardial effusion
Always affects the right side more than the left less muscle 
Effects CO 
Obstructive shock
Pericardiocentesis 
Likely neoplasia
27
Q

How do you preform pericardiocentesis?

A 
Clip and prep over the apex of the heart 
Long needle ultrasound guided 
Check fluid drained is not clotting 
Culture and cytology
Mild sedation
28
Q

What is endocarditis?

A

Inflammation of the endocardium due to bacteria infection
Commonly effects mitral and aortic valves
Anti arrhythmia
Antibiotic and supportive care

29
Q

What is degenerative value disease?

A

Genetic disease cavies
Valves degenerate allow for regurgitate of blood back into atrium
Heart failure
Frusomide ACE inhibitors

30
Q

List the 6 types of arrhythmia and describe each of them

A

Ventricular tachycardia- HR above 180 treat lidocaine
Supra-ventricular-tachycardia HR above 180 treat ditaziem
3rd degree AV block- bradycardia pacemaker
Atrial fibrillation- HR above 180 pimobendan
Ventricular fibrillation- dying defibrillator
Sick sinus syndrome- bradycardia pacemaker

31
Q

Describe each grade of heart murmur

A

Grade one- difficult to localise very quiet
Grade two- quieter than heart sounds
Grade three- the same sound as heart sounds obvious murmur
Grade four- louder than heart sounds
Grade five- very loud associated with pericardial thrill
Grade six- can hear without stethoscope touching the chest with pericardial thrill

Medical Nursing (22 decks)

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