I can't breathe

Question 1

Hypoxia

Answer 1

Insufficient supply of oxygen to tissues

Question 2

Hypoventilation

Answer 2

Breathing at an abnormally slow rate, resulting in an increased amount of carbon dioxide in the blood

Question 3

Hypoxaemia

Answer 3

Decreased oxygen concentration measured by PaO2

Question 4

Hypercapnia

Answer 4

Increased blood levels of carbon dioxide measured by PaCO2

Question 5

Pulse Oximetry

Answer 5

Monitors arterial oxygen saturation

Measures the saturation level of the haemoglobin molecule with oxygen

Question 6

SpO2

Answer 6

Peripheral capillary oxygen saturation 95-100%

Question 7

PaO2

Answer 7

Partial pressure of oxygen in arterial blood normal range 80-100mmhg

Question 8

PaCO2

Answer 8

Partial pressure of Carbon Dioxide in arterial blood Normal Range 35-45 mmhg

Question 9

ABG

Answer 9

Arterial Blood Gases a type of blood test which measures the pH or acidity of the blood, as well as gases, such as oxygen (O2) and carbon dioxide (CO2)

Question 10

Four important causes of low oxygen levels in the arterial blood

Answer 10

1. Hypoxia
2. Hypoventilation
3. Ventilation and perfusion mismatch
4. Diffusion abnormalities

Question 11

What is Ventilation and perfusion matching?

Answer 11

In respiratory physiology, the ventilation/perfusion ratio (V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching of two variables: V - ventilation - the air that reaches the alveoli. Q - perfusion - the blood that reaches the alveoli via the capillaries.

Question 12

A - G assessment

Answer 12

A - Airway 
B - Breathing 
C - Circulation
D - Disability (Neurological Observation)
E - Exposure 
F - Fluid Status 
G - Glucose

Question 13

Symptoms of Respiratory Crisis

Answer 13

• Respiratory rates go up
• Laboured breathing
• Difficulty speaking
• Use accessory respiratory muscles
• Change position to make breathing easier (E.G. sitting up, leaning forward)
• Suprasternal and supraclavicular retraction
• Beware of hypoxia and breathlessness as a cause in the confused and combative patient.

Question 14

Simple measures for breathlessness

Answer 14

Sit the patient up 
Reassure them 
Give supplemental oxygen 
Call for help if not improving 
Never leave a patient without a priority management and review plan

Question 15

What is Cyanosis and what is its cause

Answer 15

Blue discolouration of the skin, lips or nail bed.
Caused by oxygen poor haemoglobin
Central cyanosis - blue discolouration of the lips
Peripheral Cyanosis - blue discolouration of the fingers, toes and nail beds

Question 16

Key things to assess when monitoring clients respiratory function

Answer 16

• Rate
• Rhythm
• Sound
• Quality of respiration
• Oxygen Saturation
• Arterial blood gas
• Conscious state
• VQ scan

Question 17

Perfusion status (V/Q)

Answer 17

• Effective gas exchange depends on the relationship between ventilation and perfusion
• Respiratory and circulatory systems must work together to ensure that adequate gas exchange occur and O2 reaches all the cells of the body
• Effective gas exchange in the alveoli depends on ventilation matching with perfusion (V/Q)

Question 18

Disorders that interfere with ventilation:

Answer 18

Pulmonary Oedema
Asthma
Pneumonia

Question 19

Disorders that interfere with perfusion

Answer 19

Pulmonary Embolus
Pulmonary Haemorrhage
Decreased Cardiac Output

Question 20

What is pneumonia?

Answer 20

Infection of the lungs caused by bacteria, viruses or fungi

Question 21

Signs and symptoms of pneumonia

Answer 21

Chills, fever and cough
Tachycardia
Dyspnoea
Decreased chest expansion on affected side
Limited breath sounds and fine crackles are heard on affected side

Question 22

What is Pulmonary Oedema?

Answer 22

Fluid accumulation in the lungs, which collects in air sacs

This fluid collects in air sacs in the lungs, making it difficult to breathe

It leads to impaired gas exchange and may cause respiratory failure.

Question 23

Signs and symptoms of Pulmonary Oedema?

Answer 23

Extreme shortness of breath or difficulty breathing (dyspnea) that worsens when lying down

A feeling of suffocating or drowning

Wheezing or gasping for breath

Anxiety, restlessness or a sense of apprehension

A cough that produces frothy sputum that may be tinged with blood

Question 24

What is a pulmonary embolism

Answer 24

A pulmonary embolism clogs the artery that provides blood supply to part of the lung

Prevents the exchange of oxygen and carbon dioxide and decreases blood supply to the lung tissue

Potentially causing lung tissue to die (infact)

A pulmonary embolus is life-threatening

Causes chest pain, shortness of breath

Question 25

Signs and symptoms of pulmonary embolism

Answer 25

• Dyspnoea (difficulty breathing)
• Severe chest pain
• Chest wall tenderness
• Cyanosis
• Palpitation
• Circulatory collaps

Question 26

What is decreased cardiac output?

Answer 26

The medical condition, decreased cardiac output, is the reduction in outflow of blood from the ventricles of the heart. There could be a variety of different reasons behind the decrease in the cardiac output.

Question 27

Causes of Decreased Cardiac Output?

Answer 27

The common causes behind this medical condition are hypertension, myocardial infection, congenital heart disease, valvular heart disease, arrhythmias pulmonary disease, cardiomyopathy, fluid overload, drug effects, electrolyte imbalance and decreased fluid volume.

Geriatric (elderly) patients are at a high risk of suffering from decreased cardiac output due to the reduced compliance of ventricles which results from ageing.

Question 28

Symptoms of Decreased Cardiac Output?

Answer 28

• Arrhythmias
• Tachypnea, orthopnea, dyspnea
• frothy sputum
• Abnormal arterial blood gases
• Oedema, weight gain
• Decreased urine output
• Dizziness, syncope, restlessness, anxiety
• Weakness
• Cold clammy skin
• Decreased peripheral pulses
• Change in mental status