Chapter 16 - Respiratory Emergencies

Question 1

apnea

Answer 1

absence of breathing: respiratory arrest

Question 2

bronchoconstriction

Answer 2

constriction of the smooth muscle of the bronchi and bronchioles causing narrowing of the air passageway

Question 3

broncodilator

Answer 3

a drug that relaxes the smooth muscle of the bronchi and bronchioles

Question 4

dyspnea

Answer 4

shortness of breath or perceived difficulty in breathing

Question 5

hypercarbia

Answer 5

increased carbon dioxide levels in the blood. Also called hypercapnia

Question 6

hypoxemia

Answer 6

a low oxygen content in arterial blood

Question 7

metered dose inhaler (MDI)

Answer 7

device consisting of a plastic container and a canister of medication that is used to form an aerosolized medication that a patent can inhale

Question 8

hypoxia

Answer 8

a reduced oxygen delivery to the tissues

Question 9

pulsus paradoxus

Answer 9

a decrease in pulse strength during inhalation; a drop in blood pressure of more than 10mmHg during inhalation resulting from increased pressure within the chest that suppresses the filling of the ventricles of the heart with blood

Question 10

respiratory arrest

Answer 10

complete stoppage of breathing. Also called apnea

Question 11

respiratory distress

Answer 11

increased respiratory effort resulting from impaired respiratory function, while tidal volume and respiratory rate are still adequate.

Question 12

respiratory failure

Answer 12

insufficient respiratory rate and/or tidal volume

Question 13

small volume nebulizer (SVN)

Answer 13

a device that uses compressed air or oxygen to nebulize a liquid medication into a mist that a patient can inhale.

Question 14

spacer

Answer 14

a chamber that is connected to the metered dose inhaler to collect the medication until it is inhaled.

Question 15

tripod position

Answer 15

a position in which the patient sits upright, leans slightly forward, and supports the body with the arms in front and elbows locked. This is a position commonly round in respiratory distress.

Question 16

normal breathing

Answer 16

an intact open airway

normal respiratory rate

normal rise and fall of the chest

normal respiratory rhythm

breath sounds that are present bilaterally

chest expansion and relaxation that occurs normally

minimal to absent use of accessory muscles to aid in breathing

normal mental status

normal muscle tone

normal pulse oximeter reading (_>_94%)

normal skin condition findings

Question 17

abnormal breathing

Answer 17

increased width of the space between the alveoli and blood vessels

lack of perfusion of the pulmonary capillaries from the right ventricle of the heart

filling of the alveoli with fluid, blood, or pus

Question 18

wheezing

Answer 18

high pitched, musical, whistling sound best heard on exhalation but also during inhalation in extreme cases

indication of swelling and constriction of the inner lining of the bronchioles

if bilateral it is a primary indication for the administration of a beta 2 agonist by MDI or SVN

usually heard in asthma, emphysema, and chronic bronchitis

can also be heard in pneumonia, congestive heart failure, and other conditions that cause bronchoconstriction

with severe obstruction of the lower airways by bronchoconstriction and inflammation, wheezing may be significanly diminished or absent, because the velocity of air movement through the bronchioles is no longer sufficient to produce the wheezing sound.

Question 19

rhonchi

Answer 19

snoring or rattling noises

indicates obstruction of larger conducting airways by thick secretions of mucus

often heard in chronic bronchitis, emphysema, aspirations, and pneumonia

quality can change when patient coughes or changes position

Question 20

crackles

Answer 20

also known as rales

bubbly or crackling sounds heard during inhalation

sounds are associated with fluid that has surrounded or filled the alveoli or very small bronchioles

sound is commonly associated with the alveolie and terminal brochioles popping open with inhalation

bases of lungs posteriorly will reveal crackles first because of the natural tendency of fluid to be pulled downward by gravity

may indiate pulmonary edema or pneumonia

typically does not change with coughing or movement