Chapter 11 Flashcards
What is supplemental oxygen theory?
A medical treatment that provides additional oxygen to a patient who is not receiving enough oxygen from the air they breathe.
Minute volume?
the amount of air or gas a person inhales or exhales in one minute
What is the ideal O2 saturation?
94-99
What is Tidal volume
How much air you move in one breath
Hypoxic Drive?
the physiological process in which the body’s respiratory rate is stimulated by low levels of oxygen in the blood (hypoxemia)
What is a normal PH Range?
7.35-7.45
When is acidosis?
when your PH balance is below 7.35.
When is Alkalosis?
When your PH balance is above 7.45
Breathing is controlled by an area in the…
Brainstem (pons and medulla oblongata)
Fresh air that is inspired into the lungs contains about _____ percent oxygen when it is inhaled and ____ percent when it is exhaled.
21%
16%
The EMT should assess a patient’s tidal volume by:
A. observing for adequate chest rise.
B. assessing the facial area for cyanosis.
C. counting the patient’s respiratory rate.
D. measuring the patient’s oxygen saturation.
A. observing for adequate chest rise.
Rationale: Tidal volume—the volume of air that is moved into or out of the lungs in a single breath—is assessed by observing for adequate chest rise. If shallow chest rise is noted, the patient’s tidal volume is likely reduced.
In an otherwise healthy individual, the primary stimulus to breathe is a(n):
A. increased level of oxygen in the blood.
B. decreased level of oxygen in the blood.
C. increased level of carbon dioxide in the blood.
D. decreased level of carbon dioxide in the blood.
C. increased level of carbon dioxide in the blood.
Rationale: Under control of the brainstem, rising levels of carbon dioxide in arterial blood normally stimulate breathing in an otherwise healthy patient.
During insertion of an oropharyngeal airway into an unconscious patient, she begins to vomit. The first thing you should do is:
A. turn the patient on her side.
B. remove the airway at once.
C. suction the patient’s mouth.
D. use a smaller-sized oral airway.
A. turn the patient on her side.
In which of the following patients would a nasopharyngeal airway be contraindicated?
A. A semiconscious patient with a gag reflex
B. An unconscious patient with an intact gag reflex
C. A patient who fell 20 feet and landed on his or her head
D. An unconscious patient who gags when you insert an oral airway
C. A patient who fell 20 feet and landed on his or her head
Rationale: Nasopharyngeal (nasal) airways are contraindicated in patients with severe head or facial injuries and should be used with caution in patients who have delicate nasal membranes or are prone to nosebleeds. The nasal airway is better tolerated in patients who are semiconscious and/or those with a gag reflex.
You are delivering oxygen to a patient with a nasal cannula at 4 L/min when he begins to complain of a burning sensation in his nose. You should:
A. remove the nasal cannula.
B. apply a nonrebreathing mask.
C. attach an oxygen humidifier.
D. increase the flow rate to 6 L/min.
C. attach an oxygen humidifier.
A patient is found unconscious after falling from a third-floor window. His respirations are slow and irregular. You should:
A. place him in the recovery position.
B. apply oxygen via a nonrebreathing mask.
C. suction his airway for up to 15 seconds.
D. assist his breathing with a bag-mask device.
D. assist his breathing with a bag-mask device.
Rationale: The patient is not breathing adequately. Slow, irregular respirations will not result in adequate oxygenation. You should assist the patient’s breathing with a bag-mask device attached to 100% oxygen. Suctioning is indicated if the patient has blood or other liquids in the airway; there is no evidence of this in the scenario.
When ventilating an apneic adult with a bag-mask device, you should squeeze the bag:
A. until it is empty.
B. over a period of 2 seconds.
C. at a rate of 20 breaths/min.
D. until visible chest rise is noted.
D. until visible chest rise is noted.
Rationale: When ventilating any apneic patient with a bag-mask device, you should squeeze the bag over a period of 1 second and observe for visible chest rise. Ventilate the apneic adult at a rate of 10 breaths/min (one breath every 6 seconds). Ventilate infants and children at a rate of 20 to 30 breaths/min (one breath every 2 to 3 seconds).
You and your partner are ventilating an apneic adult when you notice that his stomach is becoming distended. You should:
A. suction his airway for up to 15 seconds.
B. reposition his head.
C. increase the rate and volume of your ventilations.
D. decrease your ventilation rate but use more volume.
B. reposition his head.
Rationale: Gastric distention occurs when air enters the stomach. Severe gastric distention can result in vomiting and aspiration if not recognized and treated. To minimize the amount of air that enters the stomach during ventilations, you should reposition the patient’s head.
Which of the following statements regarding normal gas exchange in the lungs is correct?
A. The oxygen content int he alveoli is highest during the exhalation phase.
B. Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries.
C. The actual exchange of oxygen and carbon dioxide occurs in the capillaries.
D. Blood that returns to the lungs from the body has low levels of carbon dioxide.
B. Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries.
Which of the following structures is contained within the mediastinum?
A. Lungs
B. Larynx
C. Bronchioles
D. Esophagus
D. Esophagus
The _____________ is the central compartment of the thoracic cavity, located between the lungs.
mediastinum
The lungs are located in the _____________.
Pleural cavities
The larynx is located in the upper or Lower airway?
Upper airway
______________ refers to the process of adding oxygen to the blood.
Oxygenation
____________ refers to the movement of air into and out of the lungs (breathing)
Ventilation
In mines or confined places, where oxygen levels are low, __________ may continue despite inadequate ______________.
ventilation.
oxygenation.
Airflow into the lungs?
Ventilation
Blood flow to the lungs?
Perfusion
A ventilation/perfusion (V/Q ration) mismatch occurs when:
A. ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange.
B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide int he lungs, even though the alveoli are filled with fresh oxygen.
C. ventilation is compromised, resulting int he accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body.
D. a traumatic injury or medical condition impairs the body’s ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.
B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide int he lungs, even though the alveoli are filled with fresh oxygen.
You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your FIRST action should be to:
A. palpate for the presence of a carotid pulse.
B. log roll him as a unit to a supine position.
C. assess the rate and quality of his breathing.
D. open his airway with a jaw-thrust maneuver.
B. log roll him as a unit to a supine position.
A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face, and his respirations are slow and shallow. The EMT must immediately:
A. insert a nasopharyngeal airway.
B. perform oropharyngeal suctioning.
C. apply oxygen via a non breathing mask.
D. begin assisting the patient’s ventilations.
D. begin assisting the patient’s ventilations.
Which of the following statements regarding oxygen correct?
A. Oxygen cylinders must always remain in an upright position.
B. Oxygen is flammable and may explode if under high pressure.
C. Oxygen supports the combustion process and may cause a fire.
D. Oxygen is most safely administered in an enclosed environment.
C. Oxygen supports the combustion process and may cause a fire.
What occurs when a patient is breathing very rapidly and shallowly?
A. Minute volume increases because of a marked increase in both tidal volume and respiratory rate.
B. Air moves primarily in the anatomical dead space and does not participate in pulmonary gas exchange.
C. Air is forcefully drawn into the lungs due to the negative pressure created by the rapid respirations.
D. The majority of tidal volume reaches the lungs and diffuses across the alveolar-capillary membrane.
B. Air moves primarily in the anatomical dead space and does not participate in pulmonary gas exchange.
Which of the following statements regarding the one-person bag-mask technique is correct?
A. Bag-mask ventilations should be delivered every 2 seconds when the device is being operated by one person.
B. The C-clamp method of holding the mask to the face is not effective when ventilating a patient
C. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device.
D. The bag-mask device delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique.
C. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device.
While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He is unable to cough and becomes cyanotic around the lips. You should:
A. encourage him to cough as forcefully as he can.
B. deliver up to five back blows and reassess him.
C. place him in a supine position and open his airway.
D. stand behind him and administer abdominal thrusts.
D. stand behind him and administer abdominal thrusts.
Which of the following structures is NOT found in the upper airway?
A. Larynx
B. Pharynx
C. Bronchus
D. Oropharynx
C. Bronchus
Structures of the lower airway include all of the following, except:
A. alveoli
B. the trachea
C. the epiglottis
D. bronchioles
C. the epiglottis
The diaphragm is innervated by the ________ nerve, which allows it to contract.
Phrenic
Which of the following factors will cause a reduction in minute volume in an adult?
A. Shallow breathing
B. Increased tidal volume
C. Respirations of 20 breaths/min
D. Slight increase in respiratory rate
A. shallow breathing
Which of the following is a late sign of hypoxia?
A. Anxiety
B. Cyanosis
C. Tachycardia
D. Restlessness
B. Cyanosis
Gas exchange in the lungs is facilitated by:
A. adequate amounts of surfactant.
B. water or blood within the alveoli
C. surfactant-destroying organisms
D. pulmonary capillary constriction
A. adequate amounts of surfactant.
The presence of elevated carbon dioxide levels in the blood is called…
hypercarbia (or hypercapnia)
Which of the following patients is breathing adequately?
A. a conscious male with respirations of 19 breaths/min and pink skin.
B. a conscious female with facial cyanosis and rapid, shallow respirations
C. a conscious male with respirations of 18 breaths/min and reduced tidal volume
D. an unconscious 52-year-old female with snoring respirations and cool, pale skin.
A. a conscious male with respirations of 19 breaths/min and pink skin.
Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called:
A. ataxic respirations
B. agonal respirations
C. eupneic respirations.
D. cheyne-stokes respirations.
D. cheyne-stokes respirations.
What is the MOST common cause of airway obstruction in an unconscious patient?
The Tongue
Which of the following organs or tissues can survive the longest without oxygen?
A. muscle
B. heart
C. liver
D. kidneys
A. muscle
An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:
A. 200 psi
B. 500psi
C. 1000 psi
D. 1500 psi
B. 500psi
The hypoxic drive is influenced by:
A. high blood oxygen levels.
B. low blood oxygen levels.
C. low blood carbon dioxide levels.
D. high blood carbon dioxide levels.
B. low blood oxygen levels.
A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a…
non-rebreathing mask
At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to…
44%
High-flow oxygen with a nasal cannula during the pre oxygenation phase of endotracheal intubation is called…
apneic oxygenation
With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the non breathing mask is capable of delivering up to _____% inspired oxygen.
A. 70
B. 80
C. 90
D. 100
C. 90
Condition that occurs when the body is exposed to high concentrations of oxygen for prolonged periods, leading to damage in tissues, particularly in the lungs and central nervous system.
Oxygen toxicity
The pressure of gas in a full cylinder of oxygen is approximately ________ pounds per square inch (psi)
A. 500
B. 1000
C. 2000
D. 3000
D. 3000 psi
Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?
A. vertical-position flowmeter
B. bourdon-gauge flowmeter
C. ball-and-float flowmeter
D. pressure-compensated flowmeter
B. bourdon-gauge flowmeter
