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Interventions 2 (RESP 319) > Final Review > Flashcards

Final Review Flashcards

Review of things I got wrong in tests

1
Q

Leads and Infarction MAP:

  • Septal, Anterior, Lateral, and Inferior injuries are reflected by which lines?
A

SALI

  • S = 1 and 2
  • A = 3 and 4
  • L = V1, V2, AVL, Lead 1
  • I = V3, V4, AVF, Lead 2, Lead 3
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2
Q

Hemodynamic normals

A
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3
Q

GCS chart?

A
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4
Q

GINA step up treatments?

  • i.e Steps 1 to 5 (severe)
A
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5
Q

GOLD Treatment step ups and procedures?

i.e ABCD

A
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6
Q

3 types of Emphysema?

A
  1. Centrilobular
  • Rarely occurs in non smokers, more common in men
  • Destruction of the bronchioles, lesions to the upper lobes
  1. Panlobular
  • Generalized distribution
  • Septal destruction
  • Seen in antitrypsin and aging
  1. Bollus
  • Damage at the alveolar level
  • Blebs form, bullae present on CXR
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7
Q

What is emphysema?

A

Enlargement of the air spaces distal to the terminal bronchioles, loss of elastic tissue, destruction of alveolar septal walls

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8
Q

Characteristics of a acute exacerbation?

A
  • SpO2 88-92
  • PaO2 >60
  • SABA/SAAC → Combivent given (nebs or MDI)
  • diuretics/fluid balance
  • Prednisone
  • BiPAP if required
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9
Q

What color does the colorimeter change to if intubated and ventilating properly?

A

Purple to Yellow

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10
Q

How does temperature affect humidity?

A

As temperature increases, evaporation rates increase and the capacity of the atmosphere to hold water increases`

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11
Q

What is absolute humidity?

A

The actual weight of water (content) vapor contained in a given volume of gas (g/m3) → varies with temperature

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12
Q

What is relative humidity?

A

The relationship between the actual water content present and the maximum it can hold at a specific temperature (expressed as a percentage)

  • If temperature increases, RH decreases (indirect relationship)
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13
Q

What is capacity of water vapor at 37 degrees (Carina)?

A

44 mg/dL

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14
Q

What is capacity of water vapor at 20 degrees (Room Air)?

A

17.3 mg/L

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15
Q

What is capacity of water vapor at 37 degrees (body temperature)?

A

47 mmHg

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16
Q

What is the humidity deficit?

A

Moisture difference between the air and the needs of the body.

  • Refer to guide for Calculation
17
Q

What is actual humidity?

18
Q

Relative humidity example

A

At 37 C, if the actual water vapor pressure is 20 mmHg, what is the Relative Humidity?

  • RH = content/capacity x 100
  • RH = 20/47 x 100 = 43%
19
Q

At FRC where is oxygen concentration the highest?

A

The alveoli at the apices contain more volume than the alveoli at the bases at the level of the lungs

  • Standing increases TC (gravity pulls down)
  • Perfusion is greater at the base in a upright lung
20
Q

Normal V/Q ratio?

A

Normal V/Q = 0.8

  • APICES = 3.3
  • Bases = 0.6
21
Q

West lungs zones

  1. Zone 1
  2. Zone 2
  3. Zone 3
A
  1. Zone 1: no blood flow
  • ALVEOLAR > ARTERY Pressure
  1. Zone 2: some blood flow
    (only when)
  • ALVEOLAR < ARTERY Pressure
  1. Zone 3: constant blood flow
  • ALVEOLAR < ARTERY Pressure
  • Pulmonary artery catheter is placed in zone 3
22
Q

Characteristics of Shunt problems

  • Treatment and correction strat?
A
  • PaCO2 decreases as MV increases
  • O2 therapy will decrease myocardial and ventilatory workload
  • PaO2 will drop dramatically
  • If refractory hypoxemia exists → increases in PEEP or proning should correct it
23
Q

Treatment for refractory hypoxemia?

A

Increase PEEP or prone

24
Q

Characteristics of pulmonary Dead space problems

  • Treatment and correction strat?
A

Increases in MV does not change PaCO2

  • Changes in MV are minimal with correction of hypoxemia with O2 therapy
  • Dead space results in ‘wasted ventilation’ → leads to increased WOB
25
Q

What is Anatomic dead space?

A

2.2ml/mg IBW

  • Increases with decreased Vt and increased RR (rapid/shallow breathing), mechanical
    ventilation (increased circuit dead space)
  • Decreases with tracheostomies and pneumothorax
26
Q

What is Alveolar Dead Space?

A

classic PE example* → ratio over 1

  • Contacts alveolar epithelium but no gas exchange occurs due to the lack of capillary
    blood flow
  • Increased by pulmonary emboli and vascular tumors (decreased CO and perfusion)
27
Q

What is the Dead Space Effect?

A

Ventilation in excess of perfusion (small amount of perfusion is present)

  • Normal in the apices (standing patients)
  • Increased by PPV, decreased CO, increased airway resistance (asthma, kinked tube),
    A/c membrane destruction (emphysema)
  • For each doubling of Minute Volume, PaCO2 should decrease by 10 mmHg

**if there is disparity here, then dead space has likely increased

28
Q

As V/Q mismatch improves, what happens to EtCO2?

A

As V/Q mismatch improves, EtCO2 will read closer to PaCO2

  • wide discrepancies can
    be used to determine mismatch
29
Q

When is a synchronized shock is delivered?

A

On the R wave

Interventions 2 (RESP 319) (25 decks)

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