Respiratory

Question 1

Kussmaul Respirations (MacKussmaul)

Answer 1

• Only associated with Metabolic Acidosis

Question 2

As the pH goes, so goes my patient except for Potassium

Answer 2

• UP (alkalosis)
  
  • hypokalemia, alkalosis, HTN, Tachycardia, Tachypnea, seizures, irritability, spastic, diarrhea, borborygmi, hyperreflexia (+3, +4)
• DOWN (acidosis)
  
  • hyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flaccid, bradypnea

Question 3

Metabolic Alkalosis/Acidosis

Answer 3

• If the patient has prolonged gastric vomiting or suction, pick metabolic alkalosis
• For everything else metabolic acidosis

Question 4

High Pressure Alarms

Answer 4

• triggered by increased resistance to air flow
  
  • kinked tube
  • water in tube
  • Mucus in airway

Question 5

Low Pressure Alarms

Answer 5

• Triggered by decreased resistance to airflow
  
  • disconnection of the tubing
  • disconnection of the oxygen sensor tube

Question 6

Vent settings

Answer 6

• Respiratory alkalosis means vent settings may be too high
• Respiratory acidosis means vent settings may be too low

Question 7

Emphysema

Answer 7

• Tripod positioning in dypneic episodes
• Hx of smoking
• s/s
  
  • clubbing of fingers
  • Alveoli are over-enlarged and under-ventilated
  • appetite decreases
  • weight decreases
  • barrel chest
  • rapid breathing
  • grunting
  • pursed lips
  • cyanotic
• Treatment
  
  • O2 flow rate <2.5 (never exceed 2.5 in COPD
  • Frequent small meals
  • 3 L of fluid per day