Exam 1 - Emergency Respiratory Decision Making Flashcards

1
Q

what is the normal I:E ratio of respiration in a eupnic patient?

A

1:3

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2
Q

if you can hear respiratory sounds without touching the patient, where does this localize your problem to?

A

pharynx & carina - large airway!!

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3
Q

what are some action steps if you have localized your respiratory problem to the nose?

A

hemorrhage control, humidification, foreign body removal, & sedation

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4
Q

what clinical signs are associated with a respiratory problem that has been localized to the nose?

A

stertor/sneezing - inspiratory!

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5
Q

what er diagnostics are used for a respiratory problem that has been localized to the nose?

A

dependent on the nature of condition - bleeding vs. airflow, CHECK PLATELETS

baseline minimum database, met check, skull films, & set them up for advanced diagnostics

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6
Q

what are some clinical signs of a respiratory problem that has been localized to the larynx?

A

heard on inspiration, +/- wheeze

dyspneic, long inspiration, vocal change, history of coughing/retching, & heat/humidity intolerant

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7
Q

what action steps may be taken for a respiratory problem that has been localized to the larynx?

A

sedation, oxygen therapy, intubation, foreign body removal, tracheostomy, treatment for hyperthermia

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8
Q

why should you do thoracic rads for a respiratory problem that has been localized to the larynx?

A

assessing for non-cardiogenic pulmonary edema - potential for aspiration pneumonia

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9
Q

what er diagnostics are used for a respiratory problem that has been localized to the larynx?

A

oral exam, baseline testing, chest rads, set them up for surgery, make sure they aren’t hyperthermic

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10
Q

what clinical signs are associated with a respiratory problem that has been localized to the trachea?

A

inspiratory turbulence more common than expiratory turbulence

honking cough

heat/humidity intolerance

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11
Q

what action steps can be taken for a respiratory problem that has been localized to the trachea?

A

sedation, oxygen therapy, intubation, maybe give them a steroid/antibiotic if indicated

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12
Q

what er diagnostics are used for a respiratory problem that has been localized to the trachea?

A

baseline testing & chest rads to look at the trachea!

set them up later for advanced imaging & surgery

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13
Q

what diseases commonly affect small airways in the lung?

A

asthma & neoplasia

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14
Q

what diseases commonly affect the alveoli in the lungs?

A

pneumonia, edema, & neoplasia

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15
Q

what animals are most commonly affected by bronchial disease?

A

cats - history of a cough, change in season/moving

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16
Q

what clinical signs are associated with bronchial disease?

A

expiratory dyspnea, abdominal press, wheeze, dry rales/rub

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17
Q

what are the action steps that should be taken for bronchial disease?

A

oxygen!!!! sedation, bronchodilator

later - steroid & inhalation meds (feline asthma)

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18
Q

what er diagnostics should be used for bronchial disease?

A

baseline testing & chest rads

later - do a fecal for lungworms, a heart worm test, CT, & potential lung wash

19
Q

T/F: pneumonia in cats out of the south is abnormal

20
Q

T/F: cats with alveolar disease is not as common for cats as it is in dogs

21
Q

what should be assessed in the case of potential alveolar disease?

A

inspiratory dyspnea - cats can have a bronchiolar response

crackles - fine or coarse

murmur? temp? wet or deep cough? at night? history of vomiting (aspiration)? anybody else sick?

22
Q

what action steps are required for alveolar disease?

A

sedation, oxygen, potential antibiotic/furosemide

23
Q

what er diagnostics should be used for alveolar disease?

A

baseline testing, thoracic rads, HWT, & ecg

later - potential echo & lung wash

24
Q

paradoxical abdominal motion seen during respiration is specific for what localization?

A

pleural space disease

25
what clinical signs are associated with pleural space disease?
paradoxical abdominal motion, air hunger, decreased lung sounds, & clear heart sounds with fluid
26
what action steps should be done for pleural space disease?
sedate & provide oxygen do a TFAST & thoracocentesis - could be anticoagulant rodenticide or trauma sample fluid for cytology & culture or quantify air removed
27
what er diagnostics should be used for pleural space disease?
baseline testing, chest rads, fluid analysis & culture for later - echo, CT, surgery
28
what should be monitored on a patient with pleural space disease?
hourly heart rate, respiratory rate, & respiratory effort recheck tfast
29
what criteria must be met for an emergency chest tube?
more than 2 taps required or excessive air volume
30
what action steps should be taken for chest wall problems?
sedation, oxygen therapy, intubation, pain management, & possible ventilation
31
what er diagnostics should be used for chest wall problems?
baseline testing, chest rads, arterial blood gas later - ct & surgery
32
why does panting cause more respiratory problems?
increased frequency, decreased tidal volume, increased percentage of breath is dead space, & increased energy requirement dyspnea is painful!! relaxed breathing is more efficient
33
what are some indications for oxygen therapy?
hypoxemia, increased work of breathing, & hypoventilation
34
what are the parameters that define hypoxemia?
SpO2 <95% PaO2 < 75mmHg room air!!!
35
what are some contraindications for oxygen therapy?
evil patient that is fractious
36
what is hypoventilation?
PaCO2 > 45 mmHg
37
what are the exceptions to hypoventilation?
lower airway obstruction, increased metabolism, & rebreathing CO2
38
T/F: LMN/CNS patients may not be in distress when hypoventilating
true
39
T/F: hypoventilation requires ventilation for correction
true
40
50-150 ml/kg/min gets you how much oxygen supplementation through a cannula?
30-50% oxygen
41
what is required for an oxygen-rich environment for oxygen supplementation?
need a CO2 monitor/scrubber limited patient access hard to get over 60%
42
what is required for high flow oxygen therapy?
air-oxygen bender generates up to FiO2 = 1.0 compressor creates a flow rate of up to 60L/min active heated humidifier for 100% humidity
43
what are the pros & cons of intubation for a patient in respiratory distress?
pros - decreases airway resistance cons - difficult to control FiO2 & requires sedation