Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nic’s Exam Prep > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is type 1 respiratory failure

A

Involves hypoxaemia <60mmHg with normocapnia PaCO2 35-45mmHG

Example: APO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the causes of a type 1 respiratory failure

A

V/Q mismatch; the volume of air flowing in and out is not matched with the flow of blood to the lung tissue
COPD, APO, pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is type 2 respiratory failure

A

Involves hypoxaemia PaO2 <60mmHg with hypercapnia >45mmHg. Occurs as a result of alveolar hypo ventilation which prevents the patient from being able to adequately oxygenate and eliminate CO2 from their blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is shunting

A

Hypoxaemia caused by inadequate ventilation of well perfumed areas of the lung. Occurs in atelectasis, in asthma as a result of bronchoconstriction, pulmonary oedema, and pneumonia when alveoli are filled with fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the most common causes of V/Q mismatch

A

Asthma, COPD, Fibrosis, Pneumonia, pulmonary HTN, PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Shunt

A

When blood is transported through the lungs without taking part in gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is anatomical dead space?

A

The air in the “conducting zone” of the airways that don’t participate in gaseous exchange.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the clinical manifestations of hypoxia

A

Confusion, anxiety, tachycardia, tachypnoeic, diaphoretic, restlessness, cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define hypercapnia

A

Increased CO2 in arterial blood caused by hypo ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical manifestations of hypercapnia

A

Respiratory acidosis - electrolyte abnormalities occur in response to a low pH that can cause arrhythmias.
Sleepy ,Drowsy, Coma - due to changes in intracranial pressure associated with high levels of arterial carbon dioxide which causes cerebral vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of respiratory failure type 2

A

Increased resistance as a result of airway obstruction (COPD)
Reduced compliance of lung tissue/chest wall ( pneumonia, rib fractures, obesity)
Reduced strength of the respiratory muscles (guillian-barre, MND)
Drugs acting on the respiratory centre reducing overall ventilation (opiates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indications for NIV

A

Respiratory failure type 2
Gives a push behind each breath and creates positive pressure
COPD with respiratory acidosis pH<7.35
Pneumonia
Hypercapnic respiratory failure secondary to chest wall deformity or neuromuscular
Weaning off tracheal intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Indications for CPAP

A

Respiratory failure type 1
Creates positive pressure in the lungs- preventing alveoli from collapsing.
Hypoxia in the context of chest wall trauma
Cardiogenic pulmonary oedema
Pneumonia: as an interim measure before invasive
Congestive heart failure
Obstructive sleep apnoea
* increases gas exchange by recruitment of alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contraindications for CPAP/BiPAP

A 
Vomiting/ excess excretions
Confusion/agitated
Altered conscious state
Bowel obstruction 
Facia burns/trauma
Recent facial trauma
Inability to protect own airway
Pneumothorax (untrained)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Oxygen toxicity symptoms

A 
Nausea, vomiting 
Anxiety 
Visual changes
Hallucinations 
Dry cough
Substernal chest pain
Sob
Pulmonary oedema
Vertigo
Hiccups
Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HiFlow

A

Delivers high flow o2 - respiratory support
Bridge between low flow and NIV (CPAP/BiPAP) and intubation
Able to deliver PEEP 4-8cmH2O

17
Q

Indications for hiflow in children

A

Hypoxaemia with respiratory distress due to bronchiolitis and pneumonia, chronic lung disease, congenital heart disease and post extubation

18
Q

Contraindications of HiFlow in children

A 
Critically ill- requiring higher level of O2 support
Upper airway obstruction 
Central apnoea 
Asthma
Blocked nasal passages
Nasopharynx trauma
Pneumothorax
19
Q

HiFlow flow rate in children

A

2L/kg/min up to 12kg plus 0.5L/kg/min for each kg there after to a max on 50LPM
FiO2 - titrate for SaO2 94-98%
>90% in bronchiolitis

20
Q

Indications for high flow in adults

A

Respiratory distress not responding to regular O2 therapy

Includes: COPD, pneumonia, asthma, APO and acute lung injury

21
Q

Contraindications of HiFlow in adults

A

Co2 >48 mmHg on ABG
Facial trauma (mid maxillary)
Suspected pneumothorax

22
Q

Flow rate HiFlow in adults

A

Commence at 49-60LPM

FiO2 - titrated to maintain SaO2 >90%

23
Q

NIV - BiPAP

A

Gives an inspiratory push (pressure support) behind each breath + PEEP
Increases tidal volumes and decreases CO2
Type 2 respiratory failure

24
Q

SIMV

A

Synchronised intermittent mandatory ventilation:

Pre-set number of breaths of a pre-set volume/pressure; pt triggers spontaneous breaths which are variable

25
Q

Physiological effects of NIV

A 
Reduction of WOB
Stabilisation chest wall in trauma/surgery
Improves oxygenation
Decreases after load 
Reduces V/Q mismatch
26
Q

Indications for BiPAP

A 
Tachypnoea >24
SOB (mod to severe)
Increased WOB accessory muscles/pursed lipped breathing
Hypoxaemia (SpO2 usually less than 90% or PaO2 <200mmHg on high flow FiO2)
Hypercapnic respiratory acidosis (<7.35, PaCO2 > 45mmHg
Heart failure/APO
ARDs
Trauma (flail chest)
Pneumonia 
Chronic/acute respiratory failure 
Atelectasis 
Pancreatitis 
Carbon monoxide poisoning 
Asthma?
27
Q

Nursing assessment of a pt commencing NIV

A 
Response- monitor GCS
A- monitor patency, look for secretions
B- monitor RR/WOB/SpO2/ABG/VBG
Ensure circuit is humidified
Assess speech pattern, talking in sentences/words/nil
Auscultation chest
Repeated focused respiratory assessment 
NIPPV delivery device
28
Q

Titration and adjustments on BiPap

A

Increase iPaP(ps) by 2cmH2O is persistent hypercapnia
Increase IPAP and EPAP 2cmH20 if persistent hypoxaemia- every 10mmol or as clinically tolerated until desired response
Max iPAP should not exceed 20-25cmH2O
Max EPAP should not exceed 10-15cm H20
Aim for the lowest pressure and FiO2 - maintain SaO2 90% or PaO2 60mmHg with out further Clincal deterioration

Nic’s Exam Prep (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions