Ch 9: Pulmonary Disorders

Question 1

Oxygen therapy should not __ ________ for fear of causing progressive respiratory acidemia.

Answer 1

be withheld

p. 318

Question 2

What are the 7 indications for tracheal intubation?

Answer 2

(1) hypoxemia despite supplemental oxygen
(2) upper airway obstruction
(3) impaired airway protection
(4) inability to clear secretions
(5) respiratory acidosis
(6) progressive general fatigue, tachypnea, use of accessory respiratory muscles, or mental status deterioration
(7) apnea

(p. 318)

Question 3

Patients in respiratory failure who undergo a trial of NIPPV and do not improve within __ to __ minutes should be intubated.

Answer 3

30 to 90

p. 318

Question 4

Cuff inflation pressure should be kept below 20 mmHg if possible to minimize…

Answer 4

…tracheal mucosal injury.

p. 318

Question 5

Barotrauma is manifested by…

Answer 5

…subcutaneous emphysema, pneumomediastinum, sub pleural air cysts, pneumothorax, or systemic gas embolism.

(p. 318)

Question 6

The term volutrauma is sometimes used to refer to subtle parenchymal injury due to…

Answer 6

…overdistention of alveoli from excessive tidal volumes without alveolar rupture, mediated through inflammatory rather than physical mechanisms.

(p. 319)

Question 7

The principle strategy to avoid volutrauma is the use of…

Answer 7

…low tidal volume ventilation.

p. 319

Question 8

What is the correct clinical term for “breath stacking”?

Answer 8

dynamic hyperinflation

p. 319

Question 9

In addition to facilitating mechanical ventilation in patients who are dyssynchronous with the vent, NMB agents also lower….

Answer 9

…the body’s oxygen consumption.

p. 319

Question 10

In patients receiving NMBAs, myopathy is more common in those who have…

Answer 10

…kidney injury or those given concomitant corticosteroids.

p. 319

Question 11

There is some concern that PPI and H2 blockers, which raise gastric pH, may permit…

Answer 11

…increased growth of gram-negative bacteria in the stomach, predisposing to pharyngeal colonization and ultimately HCAP; many clinicians therefore prefer sucralfate.

(p. 319)

Question 12

What is the definition of respiratory failure?

Answer 12

Respiratory dysfunction resulting in abnormalities of oxygenation or ventilation severe enough to threaten the function of vital organs.

(p. 317)

Question 13

The generally ABG criteria for respiratory failure are…

Answer 13

…a PO2 under 60 mmHg or a PCO2 over 50 mmHg.

p. 317

Question 14

What are the 2 cardinal symptoms of hypercapnia?

Answer 14

dyspnea and headache

p. 317

Question 15

PE is the _____ leading cause of death among hospitalized patient.

Answer 15

3rd

p. 294

Question 16

Pulmonary emboli will develop in 50 to 60% of patients with…

Answer 16

…proximal deep venous thrombosis.

p. 295

Question 17

What percentage of patients with symptomatic pulmonary emboli will have lower extremity DVT when evaluated?

Answer 17

50 to 70%

p. 295

Question 18

The most common inherited cause in white populations is resistance to activated protein C, also known as…

Answer 18

…factor V Leiden.

p. 295

Question 19

What are the essentials of diagnosis for pulmonary tuberculosis?

Answer 19

Fatigue, weight loss, fever, night sweats, and productive cough.
Risk factors for acquisition of infection: household exposure, incarceration, drug use, travel to an endemic area.
Chest radiograph: pulmonary opacities, most often apical.
Acid-fast bacilli on smear of sputum or sputum culture positive for M tuberculosis.

Question 20

M tuberculosis infects ___ _____ of the world’s population.

Answer 20

one-third

Question 21

The initial stage of infection with TB is known as primary tuberculosis and is usually clinically and _____ _____.

Answer 21

radiographically silent

Question 22

Individuals with latent tuberculosis infection do not have _____ _______ and cannot _______ the organism to others.

Answer 22

active disease

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