Respiratory

Question 1

Normal pH value

Answer 1

7.35-7.45

Question 2

Normal pCO2 Value

Answer 2

35-45

Question 3

Normal HCO3 Value

Answer 3

22-26

Question 4

Normal pO2

Answer 4

80-100

Question 5

Chest tube insertion site

Answer 5

4-5 ICS anterior axillary line

Question 6

Early shock patient’s usually have what type of Acid-Base Imbalance

Answer 6

Respritory alkalosis
Due to increase in respirtory rate increase in early shock as the body attempts to compensate

Question 7

Patient’s ABGs are pH7.43, pCO2 56, HCO3 34, what should you do to correct the pCO2?

Answer 7

analyze electroytes and replace the deficiency because the patient’s pH is normal indicating that they have compensated.

Question 8

Electrical Alternans indicates what and how does it present?

Answer 8

Pericardial effusion
alterations in the QRS complex amplitude or axis between heart beats.

Question 9

Signs and symptoms of Malignant hyperthermia

Answer 9

Increased EtCO2, temp, muscle rigidity
administration of succs, general anesthesia gas agents,

Question 10

Medication for treatment of malignant hyperthermia

Answer 10

Dantrium/dantroline 2.5 mg/kg

Question 11

Prefered site of needle thorocostomy

Answer 11

2nd ics, midlcavicular line

Question 12

Hammons sign

Answer 12

Crunching sounds during heart sound asculation and my be synchronized with heart beat, associated with trachiobronical injury

Question 13

Two vent settings that change effect the patient’s oxygenation

Answer 13

FiO2 and PEEP

Question 14

Mintue Ventilation formula

Answer 14

Vt x RR=VE

Question 15

Normal tidal volume for vent pt

Answer 15

5-8ml/kg of IBW

Question 16

High limit of acceptable pPlat

Answer 16

35cm/h2o

Question 17

test used to most often diagnose PE

Answer 17

VQ lung scan

Question 18

Acute respiratory falure is define as (ABG values)

Answer 18

pO2 <60
pCO2 >50

Question 19

Left Shift on the oxy-hemoglobin curve

Answer 19

Casues increase in the affinity, making oxygen easier for hemoglobin to pick up but harder to relase
remember the L for Left and Low
-LOW/holds on to oxygen
-LOW Temp
-LOW 2,3 DPG (production decreased with septic shock and hypophosphatemia
-LOW pCO2
-aLkaLosis (there is an L in alkalosis)

Question 20

Right shift of the oxy-hemoglobin curve

Answer 20

Causes a decrese in the affinity of the hemoglobin to oxygen making it harder for hemoglobin to bind to oxygen.
R stands for raisted/relases oxygen
-Raised temp (hyperthermia)
-Raised 2,3 DPG
-Raised pCO2
-Acidosis, (there’s no L in Acidosis)

Question 21

Repeated doses of Etomadate can cause

Answer 21

Acute adrenal Insufficiency

Question 22

BNP is used to test for what

Answer 22

Heart failure,
It is an amino acid that is relased by the ventricles in response to excessive streatching of the heart muscle

Question 23

Defaciculation dose of NMB is

Answer 23

10% of the RSI dosage used to prevent faciliculations in truama

Question 24

Elevated Anion Gap is defined by what values and is associated with what acid base balance and why

Answer 24

Metobolic acidosis
AG=Na-(Cl+HCO3)
Normal value is 4-12
abnormal >16

Question 25

Average ET tube for adult male adult female

Answer 25

8-9mmID 7-8mmID

Question 26

Sedative indicated for bronchoconstriction

Answer 26

Ketamine

Question 27

ARDS patient would require from what vent settings most

Answer 27

PEEP, ARDs lungs are typically irregularly inflamed and highly vulnerable to atelectasis, they have decreased compliance and increased deadspace.

Question 28

Airways with inflamation and narrowed passages, hypoxemia stimulates hyperventilation with resultant decrease in PaO2

Answer 28

Asthma

Question 29

Obstrucitve airflow disease, hypersecreastion of mucous preventing airflow to alveoli, hypoventilation resluting in hypercapnea and hypoxemia, VQ mismatch, pulmonary HTN and RV hypertrophy resluting in cor pulmonale

Answer 29

Chronic Bronchitis

Question 30

Destruction on alveoli and loss of elascticity, decreased gas exchange, air trapping, decresed elastic recoil of the lungs, increased RBC and Hematacrit

Answer 30

Emphysema

Question 31

COPD chest x ray finding

Answer 31

Hyperinflation of the lungs and narrow elongated heart shadow, flattened diaphram

Question 32

ARDS chest flim fliding

Answer 32

Ground glass infiltrates

Question 33

Sign for impending acute respiratory failure in the asthma patient

Answer 33

Absence of whezing, indicating the patient cannot ventilate sufficiently to produce breath sounds.

Question 34

Define widened pulse pressures And when is it seen

Answer 34

Pulse Pressure = Systolic Blood Pressure – Diastolic Blood Pressure <40 Seen in Cushings triad (increased ICP) widened pulse pressures, irregular respirations, bradycardia.

Question 35

Define narrow pulse pressures

Answer 35

Pulse Pressure = Systolic Blood Pressure – Diastolic Blood Pressure Narrow pulse pressures occur in several diseases such as heart failure, blood loss, and cardiac tamponade.

Question 36

Diarrheal dehydration can cause what acid base imbalance

Answer 36

metabolic acidosis, loss of hydrogen ion through the kidney or GI tract.

Question 37

Vomiting or suctioning GI contents can cause what acid base imbalance

Answer 37

Metabolic alkalosis by the loss of gastic secreations which is rich in Hydrochloric acid

Question 38

Diuretics use can cause what acid base imbalance

Answer 38

Metabloic alkalosis due to loss of hydrogen ion through the kidney

Question 39

Hypoventilation or resp arrest caused what acid base imbalance

Answer 39

resp aciosis

Question 40

hyperventilation causes what acid base imbalance

Answer 40

resp alkalosis

Question 41

PIP should be less than what

Answer 41

40

Question 42

Ideal body weight formula

Answer 42

IBW (kg) males=50 + 2.3 (height in inches – 60) IBW (kg) females = 45.5 + 2.3 (height in inches – 60)

Question 43

Pplat represents what and should be less than

Answer 43

measures alveolar pressure and should be less than 30

Question 44

Where are the main chemoreceptors located?

Answer 44

Medulla and Pons

Question 45

Would a pulmonary embolism increase or decrease the V/Q ratio?

Answer 45

Increase