respiratory

Question 1

minute ventilation

Answer 1

-TV x RR = MV

Question 2

type 2 alveolar cells

Answer 2

-make surfactant
-repair type 1 cells
-damage type 2 by overinflating pts

Question 3

alveolar ventilation

Answer 3

(TV - dead space) x RR = alveolar ventilation

Question 4

unwell pt -> paradoxical breathing, eyes closed, lethargic, cyanotic

Answer 4

-intubate
-bypass ABG
-shock = intubation

Question 5

Mendelson’s syndrome

Answer 5

-aspiration of Hcl

Question 6

AC

Answer 6

-assist control
-gives the minimum amount of breaths + the pt taking breaths
-take your own breaths but always the same volume pressure
-ventilator has set volume and pressure
-assists in the breath

Question 7

CMV

Answer 7

-continuous mandatory ventilation
-pre-determined tidal volume at set time
-in total control of MV
-if someone was hyperventilating -> respiratory alkalosis
-no triggered breath

Question 8

IMV

Answer 8

-intermittent mandatory ventilation
-tidal volume is NOT fixed
-can take their own breaths in between
-timed breath can come at a time when they are trying to breath -> stacks the breath -> too much tidal volume
-better but not perfect
-not used

Question 9

SIMV

Answer 9

-synchronized intermittent mandatory ventilation
-if you take a breath at the same time the machine is giving a breath -> the machine senses it and turns off
-synchronized to effect of breathing
-pt can breath on their own without stacking
-still still kick in with preset tidal volume, RR, and pressure
-best choice
-post op
-pt can be awake or not
-if pt is alseep = CMV -> works the same

Question 10

CPAP

Answer 10

-liberation setting
-getting ready to take off ventilator
-providing continuous positive airway pressure
-alveoli has a PEEP of 5 (standard)
-if pt stops breathing the ventilator kicks in
-alarm

Question 11

T piece

Answer 11

-ET tube connected to O2 on the wall
-breaths completely on without any assistance -> no alarm
-like breathing through a straw
-see if you can take the pt off ventilator
-rarely used

Question 12

BPAP

Answer 12

-set a inspiratory and expiratory pressure

Question 13

classic settings

Answer 13

-vent AC
-100% FIO2 (max 48 hrs)
-kg x 10cc
-RR- 12-20
-PEEP =5

Question 14

capnography

Answer 14

-shark tooth- obstruction (asthma, COPD)
-no plateau- incomplete alveolar emptying or early obstruction
-flat line- No CO₂ detection, possibly due to apnea, circuit disconnection, or esophageal intubation.

Question 15

ETT

Answer 15

-2-6 cm above carina
-20-22- females
-22-24- males

Question 16

pulmonary embolism

Answer 16

-tachypnea
-tachycardia
-respiratory alkalosis with hypocapnia- hyperventilation
-hypotension
-chest pain, coughing, hemoptysis
-obstruct pulmonary artery -> right heart strain

-dx-
-unstable- ECG, echo, POCUS if DVT, CTA or V/Q if stable enoguh
-stable- D-dimer -> CTA or V/Q -> ECG, echo, cardio biomarkers for severity
-x-ray- hamptom hump, westermark sign

-tx-
-O2
-anagelsics (not NSAIDs)
-low bleeding risk- anticoagulation, thrombolysis is massive
-high bleeding risk- VC filter, embolectomy if massive
-DO NOT fluid overload -> strain RV
-stable- LMWH -parin
-unstable- unfractionated heparin -aban

Question 17

respiratory failure

Answer 17

-type 1- hypoxemic
-failure to oxygenate
-Acute respiratory distress syndrome (ARDS)
-Pneumonia
-Pulmonary edema
-Pulmonary embolism
-Atelectasis
-Pulmonary fibrosis
-sepsis
-O2 < 60
-tx- increase FiO2, increase PEEP
-CPAP

-type 2- hypercapnic
-failure to ventilate
-Central nervous system depression (e.g., opioid overdose)
-Neuromuscular diseases (e.g., Guillain-Barré syndrome, myasthenia gravis)
-Airway obstruction (e.g., asthma, COPD exacerbation)
-Chest wall disorders (e.g., kyphoscoliosis, obesity hypoventilation syndrome)
-CO2 > 45
-tx- increase MV (RR)

Question 18

CPAP and BiPAP

Answer 18

-CPAP
-keeps alveoli open and decrease work of breath
-good for type 1 respiratory failure
-good for CHF -> increase CO

-BiPAP
-good for type 2 respiratory failure (ventilation) or mixed
-COPD and HF
-good for weening off intubation