Chapter 7 Flashcards
What is hyperventilation?
Condition in which the patient breathes faster and/or deeper than the metabolic needs of the body, thus eliminating more carbon dioxide than is being produced.
What is the normal respiration rate?
12-20 respirations/minute
True or False
A patient who is hyperventilating may experience a respiration rate between 22 and 40 respirations/minute
True
True or False
Hyperventilation syndrome reportedly affects 6% to 15% of the population and is predominantly found in females in 30-40 age range.
True
True or False
Fear and anxiety are common precipitating factors in the dental setting and can cause hyperventilation.
True
What is respiratory alkalosis?
Increase in the pH of the circulating blood
What is the optimal pH for the blood.
7.4
What are signs and symptoms of hyperventilation?
Abnormally prolonged rapid and deep respiration
High pH and low CO2 causes vasoconstriction of the arteries, leading to decreased cardiac output and reduced coronary blood flow, which gives the patient the symptoms of heart palpations and possibly chest pain.
Impairment of problem-solving abilities, motor coordination, balance, perceptual tasks, vision
Lightheadedness
Dizziness
Seizures
Tetany-twitching of the muscles
Parasthesia or numbness
Chvostek’s sign - abnormal spasm of facial muscles
Apprehension
Trembling
Fatigue
What is hypocalcemia?
Reduction in the calcium levels in the blood stream.
What is tetany?
Twitching of the muscles or spasms, with sharp flexion of the wrist and ankle joints (carpopedal spasms)
What is parasthesia?
Numbness in the extremities
What is Chvostek’s sign?
Abnormal spasm of the facial muscles elicited by light taps on the facial nerve
What is diaphoresis?
Extreme sweating
What is circumoral parasthesia?
Numbness or tingling around the oral cavity
True or False
The basic premise for treatment is to increase blood carbon dioxide levels while addressing the physiological factors the patient is experiencing.
True
What is a pulmonary embolism?
Blockage of the pulmonary artery by some type of obstruction, such as fat, air, a tumor, or thrombus
What is the recommended treatment to cure hyperventilation?
Place the patient in the position of his or her choice
Loosen tight clothing around the neck region
Work with the patient to control the rate of respirations (having the patient count to 10 in one breath)
Breathing through pursed lips or nose will help, or even having the patient hold his or her breath for as long as possible
True or False
If the condition does not improve, the healthcare professional may consider IM or oral administration of a benzodiazepine to help alleviate symptoms.
True
Lorazepam (1-2 mg) or diazepam (2-5 mg)
diazepam 10-15 oral dose
True or False
The vasoconstriction of the blood vessels in the brain can lead to feelings of lightheadedness, dizziness, and impaired vision.
True
True or False
Hyperventilation is frequently a secondary complication to a psychological event, such as a family dispute (anger), death of a family member, pain, or excitement.
True
True or False
The symptoms of hyperventilation can mimic many respiratory disorders, such as: pulmonary embolism.
True
What are the risk factors for a pulmonary embolus?
Abdominal/pelvic surgery Immobilization Recent lower limb trauma Pregnancy Previous deep vein thrombosis
True or False
The embolism will lead to reduced arterial carbon dioxide levels, which are also an etiologic factor of hyperventilation.
True
True or False
The symptoms between the two conditions are very similar, yet one is a fairly benign condition and the other is life threatening.
True
What is a way to differentiate between pulmonary embolism and hyperventilation?
People suffering from pulmonary embolism will not exhibit spasm of the hands and ankles, nor will they experience tingling in the mouth and fingers.
True or False
Two-thirds of all patients with pulmonary embolism die within two hours of onset, so accurate diagnosis and treatment are essential
True
True or False
Asking the patient to breathe into his or her cupped hands may be effective
True
Able to breathe in CO2 enriched exhaled air
Warm the patient’s cold hands.
