Chapter 16 - Respiratory Emergencies

Question 1

the resp system can be divided into three portions :

Answer 1

first two:
the upper/lower with the vocal cords being the transition between the two

third:
lungs/accessory muscles

Question 2

findings consistent with a Pt who is breathing adequately:

Answer 2

open airway
normal RR
normal rise and fall of the chest
normal resp rhythm 
breath sounds present bilaterally
chest expansion and relaxation
some to no accessory muscle use

norm skin cond.
norm mental status
norm Spo2
norm muscle tone

Question 3

receptors near the alveoli that detect when the alveolar-capillary beds are becoming abnormally engorged with blood as a result of heart failure

Answer 3

juxtacapillary receptors

Question 4

three basic types of abnormal breath sounds that you might hear upon auscultation of the thorax - may be early indicators of impending resp distress.

Answer 4

wheezing
rhonchi
crackles

Question 5

high pitched, musical, whistling sound that is best heard initially on exhalation but may also be heard during inhalation in more severe cases. an indication of swelling and constriction of the inner lining of the bronchioles.

Answer 5

wheezing

Question 6

sounds heard here represent airflow through the larger conducting airways. airway structure are still supported by cartilage. abnormal sounds heard best here include stridor and rhonchi

Answer 6

second intercostal space, midclavicular line

Question 7

sounds hear here represent airflow through smaller conducting airways (bronchioles). you may also be able to hear some airflow into the air sacs (alveoli). the abnormal breath sound heard best in this location is wheezing

Answer 7

third intercostal space, anterior axillary line

OR

fourth intercostal space, midaxillary line

Question 8

while the Pt is sitting upright, the sounds heard here represent airflow into the alveoli. this is the best location to hear alveolar airflow. the abnormal sound heard here is most commonly crackles (rales)

Answer 8

fifth or sixth intercostal space, posterior midscapular line

Question 9

snoring or rattling noises heard upon auscultation. they indicate obstruction of the larger conducting airways of the respiratory tract by thick secretions or mucus.

Answer 9

rhonchi

Question 10

bubbly or crackling sounds heard during inhalation. these sounds are associated with fluid that has surrounded or filled the alveoli or very small bronchioles.

Answer 10

crackles AKA rales

Question 11

decreased O2 in the bloodstream typically defined as an SpO2 reading of

Answer 11

hypoxemia

Question 12

difficulty breathing or shortness of breath

Answer 12

dyspnea

Question 13

complete respiratory arrest/not breathing

Answer 13

apnea

Question 14

hypercarbia

Answer 14

increased CO2 levels in the blood

Question 15

a Pt who is having difficulty breathing but has an adequate tidal volume and RR is said to be in___________.

Answer 15

respiratory distress

Question 16

if either tidal volume or the RR becomes or is inadequate, the Pts resp statue becomes inadequate.
the Pt is said to be in _________, since the resp tidal volume or rate is no longer able to provide an adequate ventilatory effort.

Answer 16

respiratory failure

Question 17

______ is when the breathing effort ceases completely. can lead to cardiac arrest in minutes

Answer 17

respiratory arrest

Question 18

a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. a permanent disease characterized by destruction of the alveolar walls and distension of the alveolar sacs

Answer 18

emphysema

Question 19

COPD that involves inflammation, swelling, and thickening of the lining of the bronchi and bronchioles and excessive mucus production.

Answer 19

chronic bronchitis

Question 20

a prolonged life-threatening attack that produces inadequate breathing and severe signs and symptoms is called_______. a severe asthmatic attack that does not respond to either oxygen or medication.

Answer 20

status asthmaticus

Question 21

an abnormally large drop is systolic BP during inspiration

Answer 21

pulsus paradoxus

Question 22

a primarily acute infectious disease caused by bacterium or a virus that affects the lower resp tract and causes lung inflamation and fluid- or pus-filled alveoli. can also be cause by inhalation of toxic irritants or aspiration of vomitus and other substances

Answer 22

pneumonia

Question 23

a sudden blockage of blood flow through a pulmonary artery or one of its branches, usually caused by a blood clot, but it may also be caused by an air bubble, a fat particle, a foreign body, or amniotic fluid.

Answer 23

pulmonary embolism

Question 24

______occurs when an excessive amount of fluid collects in the spaces between the alveoli and the capillaries

Answer 24

acute pulmonary edema

Question 25

typically related to an inadequate pumping function of the heart that drastically increases the pressure in the pulmonary capillaries, which in turn forces fluid to leak into the spaced between the alveoli and capillaries and, eventually, into the alveoli themselves.

Answer 25

cardiogenic pulmonary edema

Question 26

AKA acute resp distress syndrome (ARDS), results from destruction of the capillary bed that allows fluid to leak out.

Answer 26

noncardiogenic pulmonary edema

Question 27

a sudden rupture of a portion of the visceral lining of the lung, not cause by trauma, that causes the lung to partially collapse

Answer 27

spontaneous pneumothorax

Question 28

areas of weakened lung tissue

Answer 28

blebs

Question 29

the ________ syndrome Pt is often anxious and experiences the feeling of not being able to catch his breath. is commonly associated with situations in which the Pt is emotionally upset or very excited.

Answer 29

hyperventilation

Question 30

signs and symptoms:
anxious, alert, and oriented
dyspneic
uses accessory muscles
thin, barrel-chest
coughing with little sputum
prolonged exhaustion
diminished breath sounds
wheezing and rhochi
pursed-lip breathing
dyspnea on minimal exhertion
tachyapnea
tachycardia
diaphoresis

Answer 30

emphysema

Question 31

signs and symptoms:
cough, vigorous coughing produces sputum
typically overweight
prominent peripheral edema
chronic jugular vein distention 
chronic cyanosis 
scattered rales and coarse rhonchi
wheezes and possible, crackles at the base of the lungs

Answer 31

chronic bronchitis

Question 32

signs and symptoms:
dyspnea
cough, worsens at night
wheezing
tachypnea
tachycardia
accessory muscle use
anxiety
possible fever
runny nose
chest tightness
pulsus paradoxus

Answer 32

asthma

Question 33

signs and symptoms:
decreased appetite
fever
cough
dyspnea
tachypnea
tachycardia
chest pain
decreased chest wall movement
splinting of thorax by Pt with arm
crackles, localized wheezing, and rhonchi
altered mental status
diaphoresis
cyanosis

Answer 33

pneumonia

Question 34

signs and symptoms:
sudden onset of unexplained SOB
sudden onset of sharp, stabbing chest pain
cough ( may cough blood)
tachypnea
tachycardia
syncope
cool, moist skin
restlessness, anxiety, or sense of impending doom
cyanosis
crackles
fever

Answer 34

pulmonary embolism

Question 35

signs and symptoms:
dyspnea
difficulty breathing when lying flat
frothy sputum
tachycardia
anxiety, apprehension, combativeness, confusion
tripod position
fatigue
crackles and possible wheezing
cyanosis or dusky color skin
pale, moist skin
cough

Answer 35

pulmonary edema

Question 36

signs and symptoms:
sudden onset of SOB
sudden onset of sharp chest pain or shoulder pain
decreased breath sounds to one side of the chest
subcutaneous emphysema
tachypnea
diaphoresis
pallor
cyanosis

Answer 36

spontaneous pneumothorax

Question 37

signs and symptoms:
fatigue
nervousness and anxiety
dizziness
SOB
chest tightness
numbness and tingling around the mouth, hands, and feet
tachypnea
tachycardia
spasms of the fingers and feet causing cramps

Answer 37

hyperventilation syndrome

Question 38

an inflammation affecting the upper airway, can be acute, severe, life-threatening condition if left untreated.

Answer 38

epiglottitis

Question 39

signs and symptoms:
upper resp tract infection, usually 1-2 days prior
dyspnea (usually rapid onset)
high/mild fever
sore throat and pharyngeal pain
inability to swallow with drooling
anxiety
tripod
fatigue 
stridor
cyanosis
trouble or pain during speaking

Answer 39

epiglottitis

Question 40

resp disease characterized by uncontrolled coughing. it is highly contagious and effects the resp system and is caused by bacteria that reside in the upper airway of an infected person.

Answer 40

pertussis AKA whooping cough

Question 41

signs and symptoms:
Hx of upper resp infection
sneezing, runny nose, low-grade fever
increasing cough
coughing fits
inspiratory whoop heard at end of cough burst
possible cyanosis
diminishing SpO2
exhaustion
trouble speaking and breathing during burst

Answer 41

pertussis (whooping cough)

Question 42

mucous glands in the lining of the resp system that produce an overabundance in mucus, which is very thick and sticky. as the thick layer develops, there is blockage of the airways as well as an increase in the incidence of lung infections, since bacteria can readily grow in the thick mucus.

Answer 42

cystic fibrosis

Question 43

signs and symptoms:
commonly a known Hx of disease
recurrent coughing
expectoration of thick mucus during coughing
Hx of pneumonia, bronchitis, and sinusitis
gastrointestinal complaints
abd pain from gas
malnutrition despite healthy app
dehydration
clubbing of the digits
trouble breathing
signs of pneumonia

Answer 43

cystic fibrosis

Question 44

signs and symptoms:
Hx consistent w/an inhalation injury
presence of chemicals 
finding of resp distress 
cough, stridor, wheezing, or crackles
oral or pharyngeal burns
dizziness
H/A, confusion, altered mental status
seizures
cyanosis
N/V
abd distress/pain
copious secretions
vital sign changes

Answer 44

poisonous exposures

Question 45

condition of the resp system caused by a virus. common VRI’s include bronchiolitis, colds, and the flu.

Answer 45

viral respiratory infections

Question 46

signs and symptoms:
nasal congestion
sore or scratchy throat
mild resp distress, coughing
fever (usually around 101-102)
malaise 
H/A and body aches
irritability in infancts
tachypnea
exacerbation of asthma if Pt is asthmatic

Answer 46

viral respiratory infections

Question 47

a drug that is commonly prescribed for Pts with uncontrolled asthma - NOT FOR EMERGENCY USE

Answer 47

advair

Question 48

a condition with no respirations or respiratory effort; however, a pulse is still present.

Answer 48

respiratory arrest

Question 49

commonly seen in children, involves the swelling of the larynx, trachea, and bronchi, causing breathing difficulty. the child typically does not feel well, has a sore or horse throat, and has a fever.

Answer 49

croup

Question 50

pallor

Answer 50

pale skin

Question 51

air trapped under the skin. felt as crackling sensations, often described as rice krispies under the fingertips

Answer 51

subcutaneous emphysema

Question 52

deminished or absent breath sounds on one side of the chest mean that the lung is not being adequately ventilated because of _______, ______, or _______________.

Answer 52

obstruction, collapse, or surrounding air or fluid.

Question 53

signs of inadequate breathing are present – poor chest rise and fall, poor volume heard and felt, diminished or absent breath sounds, inadequate rate, or severely altered mental status.

Answer 53

respiratory failure

Question 54

breathing is adequate (adequate chest rise and fall, good volume of air being breathed in and out, good breath sounds bilaterally, and adequate rate) but the Pt complains of difficulty in breathing.

Answer 54

respiratory distress