Chapter 15 Flashcards by Gail I

patients often complain of …: shortness of breath or difficulty breathing
can be caused by many different conditions
cause can be difficult to determine

dyspnea

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respiratory system includes all the structures that contribute to breathing: 
… 
… 
… of breathing 
… to the …

diaphragm
chest wall muscles
accessory muscles
nerves to the muscles

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upper airway consists of structures above the vocal chords: 
… and … 
… 
… 
… 
…

nose; mouth
jaw
oral cavity
pharynx
larynx

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the principal function of the lungs is … (the exchange of oxygen and carbon dioxide)
air travels through .. into lungs, then on to bronchi, bronchioles, and alveoli

respiration; trachea

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there are two processes that occur during respiration: … and …
oxygen is provided to the blood and carbon dioxide is removed. in healthy lungs, this exchange of gases takes place … at the level of the alveoli

inspiration; expiration; rapidly

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the alveoli lie against the …
oxygen passes freely through tiny passages in the … into these capillaries through the process of diffusion–> it is carried to the heart and pumped throughout the body
carbon dioxide returns to the lungs and is exhaled out of the body
the … senses the level of carbon dioxide in the arterial blood–> if the level of carbon dioxide drops too low, the person automatically breathes at a … rate and … deeply
if the level of carbon dioxide rises above normal, the person breathes more … and more …

pulmonary capillary vessels; alveolar wall; brain stem; slower; less; rapidly; deeply

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oxygen exchange can be hindered by: 
conditions in the … of the airway 
… processes
… conditions
abnormalities in …

anatomy;
disease
traumatic
pulmonary vessels

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CO2 retention and hypoxic drive:
patients will sometimes have an elevated level of CO2 in their arterial blood–> if levels remain elevated for a period of years, the … center in the brain may not function properly
the brain gradually accommodates high levels of carbon dioxide and then uses a “backup system” to control breathing based on low levels of oxygen, known as …
use caution when administering oxygen to these patients

respiratory; hypoxic drive

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patients often have dyspnea/hypoxia with: 
… 
… 
… 
obstruction of the … 
… syndrome 
…/… exposure
… overdose

pulmonary edema
hay fever
pleural effusion 
airway
hyperventilation
environmental/industrial 
drug

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dyspneic patients may have: 
… obstructed
damaged. ..
obstructed … 
obstructed … to the lungs
excess … in the pleural space

gas exchange
alveoli
air passages
blood flow
fluid

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dyspnea is a common complaint in patients with cardiopulmonary diseases:
congestive heart failure causes the heart to pump … and deprives the body of oxygen
severe pain can cause a patient to experience .., … breathing without the presence of a primary pulmonary dysfunction

inefficiently; rapid; shallow

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infectious diseases causing dyspnea may affect all parts of the airway–>oxygenation is a problem of inadequate oxygen delivery to the tissues
some form of obstruction causes dyspnea:
… and … obstructing airflow in major passages
… of soft tissues in upper airways
impaired .. in the alveoli

mucus; secretion
swelling
exchange of gases

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croup:
inflammation and swelling of …, …, and …
typically seen in children between 6 months and 3 yrs of age

pharynx; larynx; trachea

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epiglottitis:
…. infection causing inflammation of epiglottis
children are found in the … position and …
position comfortably and provide oxygen

bacterial; tripod; drooling

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respiratory syncytial virus (RSV)
common cause of illness in young children
causes infection in the .. and ..
treat .. and … problems 
look for signs of …

lungs; passages; airway; breathing; dehydration

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bronchiolitis is often caused by RSV:
usually affects … and ..
bronchioles become inflamed, …, and fill with…
provide … and frequently reassess for signs of respiratory distress

newborns; toddlers; swell; mucus; oxygen therapy

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bacterial pneumonia will come on quickly and result in …
viral pneumonia presents more … and is less severe
especially affects people who are chronically ill
assess temp and provide airway support and supplemental oxygen

high fever; gradually

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pertussis:
… infection that mostly affect children under 6 years
patients will be feverish and exhibit a “whoop” sound after a coughing attack
watch for …and suction as needed
highly contagious and is passed through … infection

airborne bacterial; dehydration; droplet

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influenza type A:
became pandemic in 2009
symptoms include …, …, .., .., .., and ..
may lead to pneumonia or dehydration

fever; cough; sore throat; muscle aches; headache; fatigue

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tuberculosis
bacterial infection that most often affects the …
can remain inactive for years
patients often complain of fever, coughing, fatigue, …, and weight loss
wear gloves, eye protection and an N-95 respirator

lungs; night sweats

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acute pulmonary edema:
the left side of the heart cannot … from the lung as fast as the right side … it
… builds up within the alveoli and in lung tissue–> this accumulation of fluid is referred to as pulmonary edema
usually results from …

remove blood; delivers; fluid; congestive heart failure

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acute pulmonary edema cont: ‘
patient usually experiences dyspnea with .., … respirations
ins evere cases, a … forms at the nose and mouth
not all patients with pulmonary edema have heart disease

rapid; shallow; frothy pink sputum

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COPD:
slow process of … and disruption of airways and alveoli
caused by …
tobacco smoke can create chronic …–> excess mucus is produced, obstructing small airways and alveoli
umbrella term used to describe a few lung diseases including emphysema and chronic bronchitis

dilation; chronic bronchial obstruction; bronchitis;

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chronic oxygenation problems can also lead to … and …: pneumonia develops easily, repeated episodes of irritation and pneumonia cause .. in the lung and some dilation of the obstructed alveoli, leading to …

right heart failure; fluid retention; scarring; COPD

COPD cont: | patients with pulmonary edema will have … lung sounds (.., …) and patients with COPD will often have … lung sounds (…)

wet; rhonchi; crackles; dry; wheezes

asthma, hay fever, and anaphylaxis result from an … to a substance asthma is acute … of smaller air passages (…)

allergic rxn; spasm; bronchioles

asthma affects all ages: most prevalent in children 5-17 yrs produces characteristic … asthma attack may be caused by .. rxn to foods/allergens or severe .., …, and … infections associated with excessive … production and swelling of the mucous lining of the respiratory passages

wheezing; allergic; emotional distress; exercise; respiratory; mucus

hay fever causes …-like symptoms, including a runny nose, sneezing, congestion, and sinus pressure--> allergens include pollen, dust mites, pet dander anaphylactic rxn can produce severe … and dilation of the blood vessels--> .. is possible; … is the treatment of choice; … and … are helpful

cold; airway swelling; total obstruction; epinephrine; oxygen; antihistamines

spontaneous pneumothorax: pneumothorax is accumulation of … in pleural space most often caused by .. may be caused by medical conditions--> "..." … pressure in pleural space is lost--> when the lung is disrupted, air escapes into the pleural cavity and the negative pressure is lost

air; trauma; spontaneous pneumothorax; vacuum-like

spontaneous pneumothorax cont: occurs with … or in … lungs patient becomes .. and might complain of pleuritic chest pain breath sounds may be … on affected side

lung infections; weak; dyspneic; absent;

``` pleural effusion: collection of … … the lung it … the lung and causes dyspnea can stem from irritation, infection, …, or … patient feels better … ```

fluid outside; compresses; congestive heart failure; cancer; sitting upright

patient with dyspnea may have … obstruction | may be caused by … of vomitus or foreign object or … blocking the airway

mechanical; aspiration; tongue

pulmonary embolism: a … that circulates through the venous system--> … cut off partially or completely, significantly decreases …, if large enough, can cause ...

blood clot; circulation; blood flow; sudden death

an … is anything in the circulatory system that moves from its point of origin to a distant site and lodges there, obstructing blood flow. they can be foreign bodies such as a ...

embolus; bubble of air

``` signs and symptoms of pulmonary emboli include the following: … … … varying degrees of .. … … … ```

``` dyspnea tachycardia tachypnea hypoxia cyanosis acute chest pain hemoptysis ```

hyperventilation is defined as overbreathing to the point that the level of … falls below normal--> this may be an indicator of a life-threatening illness the body may be trying to compensate for .. (the buildup of excess acid in blood or body tissues)

arterial carbon dioxide; acidosis

hyperventilation cont: can result in … --> the buildup of excess base or lack of acids in body fluids this can cause symptoms of hyperventilation syndrome (..), including: … … … … of the hands and feet … of the hands and or feet (carpopedal spasms)

``` alkalosis; panic attack anxiety dizziness numbness tingling painful spasms ```

pesticides, cleaning solutions, chemicals, chlorine, and other gases can be released CO: … highly poisonous produced by … appliances and … people with CO poisoning complain of .. symptoms and even … … by … is the best treatment for conscious patients

odorless; fuel-burning; smoke; flu-like; dyspnea; high-flow oxygen; nonrebreathing mask

scene safety: use standard precautions and PPE consider possibility of … or … if there are multiple people with dyspnea, consider the possibility of an airborne hazardous material release MOI/NOI: ask why 911 was activated question the patient family, and/or bystanders to determine NOI

infectious disease; toxic substance

primary assessment: identify immediate life threats form a general impression: note age and position of patient, use AVPU, ask patient about chief complaint make sure airway is patent and … evaluate for adequate breathing (rate, rhythm, quality) assess ...

adequate; breath sounds

assessing breath sounds: listen over bare chest determine whether breath sounds are … (vesicular, bronchial), …, .., or … (adventitious breath sounds) listen to breath sounds for a full … abnormal sounds include snoring, wheezing, crackles, rhonchi, and stridor

normal; decreased; absent; abnormal; respiratory cycle

primary assess cont circulation: assess pulse rate, rhythm, and quality; assess for … and …, assess skin CTC transport decision: address any life threats, proceed with rapid transport

shock; bleeding

``` History: ' investigate chief complaint SAMPLE history OPQRST assessment … assessment for patients with dyspnea ```

paste

secondary assessment: more in-depth, proceed only after addressing life threats look for signs of .. versus .. patients with COPD are usually: older than … yrs of age often have a history of … problems are almost always long-term active/former … complain of … in the chest and constant .. chest may have a …-like appearance often use … to breathe exhibit … breath sounds

``` COPD; congestive heart failure; 50 lung cigarette smokers tightness; fatigue barrel accessory muscles abnormal ```

``` reassessment: repeat the primary assessment and assess for changes in condition interventions may include: oxygen via NRB at 15 L/min positive pressure ventilations airway management technique … assisting with … communicate all relevant info to the staff at the receiving hospital ```

positioning; respiratory medications

emergency medical care: administer oxygen and monitor respirations patient may have … or … consult medical control and make sure … is indicated most medications are used to … the muscles that surround the air passages in the lungs

metered-dose inhaler; small-volume nebulizer | medication; relax

``` common side effects of inhalers: increased … … … medication from an inhaler is delivered through the respiratory tract to the lung ```

pulse rate nervousness muscle tremors

``` upper/lower airway infection administer .. (if available) do not attempt to .. the airway or place an .. position comfortably transport promptly ```

humidified ox; suction; OPA

``` acute pulmonary edema: provide … .. if necessary position comfortably provide … if indicated and allowed by protocol transport promptly ```

100% ox suction CPAP

chronic obstructive pulmonary disease: assist with ..--> watch for side effects from overuse position comfortably transport promptly

prescribed inhaler

asthma, hay fever, and anaphylaxis: be prepared to … assist asthma patient with .. provide aggressive airway management, oxygen, and prompt transport … is unlikely to need emergency treatment … will respond to epinephrine

suction; prescribed inhaler; hay fever; anaphylaxis

``` spontaneous pneumothorax: provide … transport promptly and monitor carefully pleural effusion: fluid removal must be done in hospital provide .. transport promptly ```

supplemental oxygen; oxygen

obstruction of airwY: partial obstruction--> provide .. and transport complete obstruction--> … the obstruction and administer … for both: transport rapidly to ED

supplemental oxygen; clear; oxygen

pulmonary embolism … is necessary position comfortably if hemoptysis is present, … transport promptly

supplemental oxygen; clear airway

``` hyperventilation: complete primary assessment and gather history do not have patient … reassure patient provide … transport promptly ```

breathe into paper bag; supplemental ox

``` environmental/industrial exposure: ensure patients are … treat with …, adjuncts, and suction based on presentation foreign body aspiration: clear the airway provide … and transport ```

decontaminated; oxygen; oxygen

``` tracheostomy dysfunction: position comfortably … provide … asthma: provide .,.. use … ```

suction; oxygen; blow-by oxygen; MDIs

cystic fibrosis: … disorder that affects the lungs and digestive system … and .. as needed symptoms range from sinus congestion to wheezing and asthma-like complaints

genetic; suction; oxygenate