Lecture 14 - Respiratory distress intro (specht) Flashcards
respiratory distress is a sign of ineffective __
02 delivery to tissues
cause may or may not be respiratory problem
__ can significantly worsen respiratory distress, must be very careful
stress
if pleural dz is suspected upon PE p may require __ before anything else
thoracocentesis
if __ is suspected, mild sedation and O2 therapy can be effective in improving condition
laryngeal paralysis
severe upper airway dz or obstruction may require emergency
bypass
when observing patient in respiratory distress look at
rate, effort, characterize (IvE) postural changes abdominal movement (effort, paradoxical, flail)
inspiratory distress/prolonged inspiratory phase often indicates
extra-thoracic airway obstruction
extrathoracic trancheal collapse
lar par
pleural space dz
expiratory distress/prolonged expiratory phase indicates
intra-thoracic airway obstruction intrathroacic tracheal collapse chronic bronchitis asthma pneumonia
true respiratory distress automatically localizes problem to the
larynx or lower
laryngeal, or other upper airway dz generally presents as
loud stridor
head/neck extension
inspiratory component
cardiac dz significant enough to cause distress is usually associated with
tachycardia
murmur
pulse abnormalities
expiratory effort with auscultable wheezes is highly suggestive of a
bronchoconstrictive dz
absence of lungs sounds, esp if only ventral, in face of tachypnea/dyspnea is suggestive of
pleural space dz
differentials for upper airways obstruction
laryngeal paralysis
tracheal collapse
masses
FB
ddx for lower airway dz
asthma (bronchitis) pulmonary fibrosis bronci collapse airway obstruction infectious bronchitis
ddx for lung dz
pneumonia CHF PTE Neoplasia electrocution strangulation
ddx for pleural space dz
air or fluid
don’t forget about other ddx not respiratory tract related
anemia
smoke
drowning
5 mechanisms of hypoxemia
decreased inspired O2 (FIO2) hypoventilation diffusion abnormalities anatomic shunts v/q mismatch
brachycephalic dogs think
congenital abnorms
small breed dogs predisposed to
collapsing trachea
old labrador think
laryngeal paralysis
cockers think
IMHA (predisposes to PTE)
inspiratory wheezes associated with
extrathoracic airway obstruction (masses, stenosis, collapse of upper airway)
expiratory wheezes associated with
intrathroacic airway obstruction (COPD, intrathroacic collapse, stenosis, mass)
in a standing patient the dorsal area of lungs auscults dull
pneumothorax
most important dx when inspiraotry distress is observed
oropharyngeal exam (lar par, masses esp in cats)
when sedating for a oropharyngeal exam in a patient with distress always be prepared to
intubate
the measurement of __ in arterial specimens provides useful info about pulmonary function
PaO2
PaCO2
helps differentiate pulmonary dz from hypoventilation
normal PaO2 for animal healthy breathing room air
85-100mmHg
normal PaCO2 for animal healthy breathing room air
40+/-4 mmHg
normal HCO3 for animal healthy breathing room air
24+/-4 mmol/L
normal pH for animal healthy breathing room air
7.4 +/- 4
if the PaO2 is very low and patient is normal physically
may have mixed or venous sample
PaO2 less than __ is considered dangerous and should be tx asap
60mmHg
less than 50mmHg and patient will need assisted ventilation bc of pulmonary failure
__ occurs as result of increased concentration of non-O2 hgb in blood
cyanosis
function of hgb concentration and oxygenation
Normal FIO2: PaO2 on 100% oxygen is
400-500
pulse oximetry measures
oxygen saturation (SpO2)
a low pulse ox indicates that
insufficient amt of O2 bound to hgb in blood
T/F: a normal SpO2 value rules out hypoxia
false
can’t r/o (ie anemia)
