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FA2 Respiratory > Lecture 23 11/8/24 > Flashcards

Lecture 23 11/8/24 Flashcards

1
Q

What is dyspnea?

A

subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity

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2
Q

What are the signs of resp. distress?

A

-increased resp. rate
-increased resp. effort
-orthopnea/shortness of breath
-open mouth breathing
-cyanosis
-stridor

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3
Q

What are the characteristics of resp. distress in the ER?

A

-common cause of presentation
-life threatening
-patient and owner both in distress

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4
Q

What are the causes of resp. distress?

A

-hypoxemia resp. failure
-hypercapnic resp. failure

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5
Q

What are the hallmarks of hypoxemia?

A

-PaO2 less than 80 mmHg
-SpO2 less than 95%

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6
Q

What are the normal values for PaO2 and SpO2?

A

-PaO2 between 80 and 100 mmHg
-SpO2 greater than 95%

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7
Q

What are the life threatening values for PaO2 and SpO2?

A

-PaO2 less than 60 mmHg
-SpO2 less than 90%

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8
Q

What are the two forms of oxygen in the blood?

A

-dissolved in blood/PaO2
-carried by hemoglobin/SpO2 or SaO2

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9
Q

What are the characteristics of pulse oximetry?

A

-differential absorption of infrared light by oxygenated and deoxygenated hemoglobin
-red and infrared wavelengths of light used
-oxygenated hemoglobin absorbs more infrared light

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10
Q

What are the two types of pulse ox probes?

A

-transmissive probe
-reflectance probe

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11
Q

What are the characteristics of a transmissive pulse ox probe?

A

-most commonly used
-can be placed on lip. tongue, pinna, toe webbing, prepuce, or vulva
-challenging in awake patients

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12
Q

What are the characteristics of a reflectance pulse ox probe?

A

-often better tolerated
-must be used over a bony surface
-placed at the tail base, rib, metacarpal area, or metatarsal area

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13
Q

What can affect pulse ox?

A

-ambient light
-peripheral vasoconstriction
-darkly pigmented skin
-hypothermia/hypoperfusion
-anemia
-tachycardia
-hyperbilirubinemia

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14
Q

What are the limitations of pulse ox?

A

-poorly tolerated in awake patients
-must be over an area of pulsatile blood flow
-patient’s HR must match pulse ox reading
-abnormal Hb species
-carboxyhemoglobin
-methemoglobin

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15
Q

What are the characteristics of arterial blood gas?

A

-gold standard
-technically challenging and painful
-need special equipment to run samples

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16
Q

Which arterial sites are used to collect samples for arterial blood glass?

A

dogs:
-dorsal pedal
-femoral
-coccygeal
-sublingual
-dorsal auricular
cats:
-femoral

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17
Q

What is measured on an arterial blood gas?

A

-PaO2
-SaO2
-PaCO2
-pH

18
Q

What are the characteristics of cyanosis?

A

-gray/blue discoloration of mucous membranes
-requires 5 mg/dL of deoxygenated hemoglobin to be visualized
-visualization can be affected by anemia, room lighting, and visual acuity

19
Q

What can cause respiratory failure?

A

-failure to ventilate
-failure to maintain airway
-failure to oxygenate

20
Q

What are the causes of hypoxemic resp. failure?

A

-pneumothorax
-hemothorax
-pleural effusion
-pneumonia
-pulmonary edema
-pulmonary contusions
-pulmonary thromboembolism

21
Q

What are the characteristics of hypercapnic resp. failure?

A

-can be due to failure of the resp. center, diaphragm, intercostal muscles, or by airway obstruction
-results in partial pressure of CO2 (PaCO2) greater than 60 mmHg

22
Q

What are the causes of hypercapnic failure?

A

-head trauma
-cervical spine disease
-lower motor neuron diseases
-laryngeal paralysis
-upper airway obstruction
-flail chest

23
Q

What are the characteristics of oxygen?

A

-most important therapeutic drug
-widely available
-relatively inexpensive
-FiO2 of 21% in room air
-FiO2 of 100% in medical oxygen

24
Q

What are the characteristics of medical oxygen?

A

-can cause oxygen toxicity
-may administer a lower conc. depending on route utilized
-should be humidify if used for more than a few hours

25
Q

What are the characteristics of flow-by oxygen?

A

-provides 25-40% oxygen
-flow rate of 2 to 3 L a minute
-well tolerated
-can be used during initial patient treatment

26
Q

What are the characteristics of mask oxygen?

A

-requires tight fitting mask held to patient’s face
-can provide 50-60% oxygen with high oxygen flow rates
-poorly tolerated

27
Q

What are the characteristics of nasal oxygen?

A

-unilateral or bilateral
-easily placed
-can provide 30-70% FiO2
-50 to 150 ml/kg/min

28
Q

Which tools can be used for oxygen administration?

A

-e-collar
-intratracheal oxygen
-nasal cannula
-oxygen cage
-intubation

29
Q

What are the characteristics of sedation?

A

-alleviates anxiety
-excellent for cases with upper airway distress
-may be used with caution with lower airway disease

30
Q

Which medications and admin routes are used for sedation?

A

butorphanol or acepromazine given IV, IM, or SQ

31
Q

How is stress minimalized in animals undergoing resp. distress?

A

-minimize handling
-complete exam in stages
-wait to perform major diagnostics until patient is stable
-keep patient in quiet areas

32
Q

What is thoracocentesis used for?

A

-relieve pleural effusion
-relieve pneumothorax
-diagnostic tool/fluid collection

33
Q

What are the characteristics of intubation?

A

-ascertains patent airway
-provides immediate control of oxygenation and ventilation
-life saving
-done when patient is in overt resp. distress

34
Q

What are the steps of tracheostomy?

A

-place patient in dorsal recumbency
-make a midline incision
-blunt dissection on midline
-incision into trachea
-stay sutures placed around dorsal and ventral aspects
-insert tube

35
Q

Why do temporary tracheostomies require 24 hour nursing care?

A

-prone to obstruction with mucus
-cleaning needed around stoma site
-cuff needs deflated/reinflated every 4 hours

36
Q

What are the characteristics of cricothyrotomy?

A

-incision made into cricothyroid membrane
–tracheostomy or ET tube is inserted directly into incision
-faster than tracheostomy
-less tissue dissection than tracheostomy

37
Q

What are the characteristics of TFAST?

A

-focused assessment with sonography for trauma
-assess two sites on thorax
-assess chest tube site and pericardial site

38
Q

Which sites are assessed with a Vet BLUE ultrasound?

A

-cranial
-middle
-perihilar
-caudal

39
Q

What are the characteristics of thoracic radiographs?

A

-always indicated in any animal with trauma
-can be used to assess for diaphragmatic hernia and pneumothorax

40
Q

What is the minimum data base?

A

-PCV
-total solids
-blood glucose
-lactate

41
Q

Which advanced diagnostics are done in patients with resp. distress?

A

-CBC
-chem
-electrolytes
-urinalysis

42
Q

Which diagnostics are done as indicated in resp. cases?

A

-bronchoscopy/tracheoscopy
-thoracic CT
-abdominal rads
-abdominal ultrasound

FA2 Respiratory (33 decks)

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