Exam 1 Flashcards

1
Q

What is ventilatory failure?

A

Inability of pulm system to maintain proper CO2 removal

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2
Q

1) Ventilation Failure is also called__________

2) Oxygenation Failure is also called__________

A

1) Hypercapneic RF

2) Hypoxic RF

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3
Q

What is oxygenation failure?

A

Severe hypoxemia that doesn’t respond to mod to high (50-100%) of suppl O2

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4
Q

What is a traditional tidal vol?

A

6-8 ml/kg

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5
Q

How to calculate minute ventilation?

A

Vt x RR = LPM

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6
Q

What parameters does ventilation affect?

What setting can you manipulate?

A

1) pH, pCO2, and HCO3

2) minute ventilation

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7
Q

What parameters oxygenation affect?

What settings can you manipulate?

A

1) O2 and PaO2

2) PEEP and FiO2

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8
Q

1) How is Rapid Breathing Index or Rapid Shallow Breathing Index calculated?
2) What range is highly predictive of successful extubation?

A

1) f/Vt (resp rate / tidal vol)

2) <100

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9
Q

What is the first intervention after identifying symptomatic bradycardia (narrow or wide QRS)?

A

Atropine IV
1st dose: 0.5 mg bolus
Repeat: 3-5 min
Max: 3 mg

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10
Q

What alternatives can be used after INITIAL therapy is ineffective for symptomatic bradycardia (narrow or wide QRS)?

A

1) Transcutaneous pacing
2) Dopamine; 2-10 mcg/kg/min
3) Epi; 2-10 mcg/min

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11
Q

Interventions for pulseless dysrhthmia identified?

A

1) CPR
2) Epi/vasopressin
3) Atropine

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12
Q

Initial Rx intervention for symptomatic narrow regular QRS tachycardia?

A

Adenosine IV:
First dose - 6 mg RAPID IVP –> NS flush
Second - 12 mg

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13
Q

Other alternatives for treatment of symptomatic narrow regular QRS tachycardia?

A

1) Vagal maneuvers
2) Synchronized cardioversion
3) CCBs and BBs

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14
Q

What is initial Rx therapy for symptomatic wide complex tachycardia?

A

Amiodarone:

  • First dose: 150 mg over 10 mins
  • Repeat if VT cont
  • Then maint. infusion of 1 mg/min for 1st 6 hours
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15
Q

When is adenosine an option for symptomatic wide complex tachycardia?

A

regular or monomorphic

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16
Q

What are the interventions for pulseless wide complex tachycardia?

A

1) Defibrillation
2) CPR
3) Epi/vasopressin
4) Amiodarone/Lidocaine

17
Q

What Rx is indicated for torsades do pointes (wide complex polymorphic vent tachycardia)

A

magnesium

18
Q

Causes of shunting

A
  • small airway occlusions (bronchitis, asthma, mucus plugs)
  • Fluid in alveoli
  • Atelectasis
  • ASD, VSD
19
Q

What is the V/Q ratio for shunt?

A

V/Q <1

20
Q

Initially, shunting is hypoxemic and __________?

A

hypocapnic

21
Q

Dead space is caused by?

A
  • loss of alveolar area
  • pulm embolus
  • low blood flow states
  • artificial airways (ETT)
22
Q

What is the V/Q ratio for Dead Spacing?

A

V/Q ratio >1

23
Q

Dead spacing is hypoxemic and ___________?

A

hypercapnic

24
Q

How is P:F ratio calculated?

A

PaO2 / FiO2

25
Q

What are the following P:F ratios?

1) Normal
2) On PPV
3) Shunt of >20%

A

1) 450
2) > 300
3) <200

26
Q

Definition of Hypoxemic

A

On suppl O2 to keep Pt > 90%

27
Q

Definition of Hypercapnia

A

pCO2 > 45mmHg and not compensating for met alkalosis (HCO3 > 27)

28
Q

Obvious reasons to intubate?

A
  • GCS <9
  • Cardiopulm Arrest
  • Impending Airway Compromise
29
Q

What is ARDS

A
  • diffuse injury to lungs –> inflammation that’s not a primary condition
  • Extra-pulm or intrapulm
  • Starts w/ neutrophils
30
Q

CHAD Vasc

A
  • Age
  • Sex
  • CHF
  • CVD
  • Valvular Dz
31
Q

Clinical features of ARDS

A
  • Acute onset
  • Bilat infiltrates on CXR
  • Non-cardio pulm edema
  • Severe hypoxemia (w/ PEEP of 5)
32
Q

What are the P:F ranges for mild, moderate, severe ARDS

A

< 300 mild
< 200 moderate
< 100 severe

33
Q

First 3 things to rule out when chest pain presents?

A
  • ACS
  • Aortic Dissection
  • Pulmonary Emboli
34
Q

Unstable angina definition

A
  • new onset or angina at rest
  • ## angina occurring at increasing frequency
35
Q

Conditions that elevate BNP?

A
  • Advanced age
  • Obesity
  • Renal Dysfunction
  • Anemia
  • Arrhythmia
  • Toxic Metabolic Insults