Extra credit

Question 1

What is acute respiratory failure

Answer 1

State of disturbed gas exchange resulting in abnormal arterial blood gas values of hypoxemia (less than 60 PaO2) and hypercapnia (greater than 50 PaCO2)

Question 2

What are early signs of acute respiratory failure

Answer 2

Rapid/Shallow breathing. Increased inspiratory muscle movement.

Question 3

What are late signs of acute respiratory failure

Answer 3

Cyanosis, nasal flaring, sternal/intercostal retractions, cool clammy skin, dysrhythmias, decreased capillary refill.

Question 4

What does ventilation/perfusion ratio look like with pulmonary emboli

Answer 4

It is high, the patient is adequately ventilated but not perfused

Question 5

Give normal values for Acid-Base

Answer 5

Absolute pH 7.4, range 7.35-7.45. PaCO2 35-45, PAHCO3 22-26

Question 6

Describe backwards and forward effects of left ventricular heart failure

Answer 6

Backwards effects are fluid accumulation in the pulmonary system behind the failing left ventricle. Forward effects are decreased perfusion to brain, organs and tissues and thus hypoxemia due to poor Cardiac output

Question 7

Describe backwards and forward effects of right ventricular heart failure

Answer 7

Backwards effects are the entire venous system as opposed to the pulmonary system in left sided heart failure, so we’ll see things like Ascites, hepatomegaly, splenomegaly and other issues. Forward effects are the same as left ventricle as Cardiac output is still the problem with forward effects.

Question 8

Compare stenosis and regurgitation

Answer 8

Stenosis is the valve not opening all the way leading to an increase in resistance for the heart to push against as the pathway is narrowed. Regurgitation is due to the valve not closing all the way and thus blood flows backwards into the previous chamber, a prolapse is where the whole valve balloons backwards into the previous chamber

Question 9

Describe septic shock

Answer 9

bacterial toxins in the blood cause extreme hypotension, and sometimes an inability to form clots. They will have a warm skin temperature, this is why it’s called “warm shock”

Question 10

Describe cardiogenic shock

Answer 10

This is somewhat similar to septic in that we have severe hypotension, but the hypotension isn’t due to vasodilation it’s due to a severe lack of cardiac output

Question 11

Describe obstructive shock

Answer 11

Often a mechanical obstruction leading to decreased cardiac output such as tension pneumothorax or pulmonary embolism

Question 12

Describe hypovolemic shock

Answer 12

This type of severe hypotension is due to a sudden loss of fluids, often due to burns or most commonly hemorrhage

Question 13

What is distributive shock

Answer 13

Hypotension due to a sudden and drastic increase in vascular space due to vasodilation

Question 14

Describe anaphylactic shock

Answer 14

Allergic induced shock that has bronchoconstriction along with peripheral vasodilation and increased capillary permeability

Question 15

Describe neurogenic shock

Answer 15

Loss of ability for the vasculature to constrict due to interruption of neural signaling often due to a brain injury, this like all the other shocks leads to dangerous hypotension

Question 16

Describe respiratory failure

Answer 16

Early signs are rapid/shallow breathing and increased inspiratory muscles. Late signs are nasal flaring, cyanosis, and dysrhythmias. Gases will be less than 60 O2, greater than 50 CO2 and pH less than 7.3 It is either a failure in respiration leading to hypoxia or a failure in ventilation leading to hypercapnia.