Respiratory Flashcards
The presence of a barrel chest and clubbing of the fingers is suggestive of what respiratory condition?
Chronic obstructive pulmonary disease (COPD)
Why are beta2 agonists beneficial in asthma?
Relaxation of bronchial smooth muscle, inhibition of chemical mediator response, and promotion of mucociliary clearance
What should be evaluated when assessing a patient with a respiratory complaint?
Level of consciousness, pallor, cyanosis, vital signs, breath sounds and work of breathing to include nasal flaring, grunting, and accessory muscle use
What type of medication is primarily used in the treatment of pneumonia?
Antibiotics
What is the next course of action in the respiratory distress patient that does not respond to oxygen therapy and pharmacology?
Intubation and mechanical ventilation
What are the six causes of oxygenation failure resulting in hypoxemia?
Hypoventilation, ventilation/perfusion mismatch, intrapulmonary shunting, cardiogenic shock, diffusion defects, and low FiO2
What are the clinical manifestations of asthma?
Dyspnea, cough, wheezing, prolonged expiratory time, reduced peak flow
Interpret the following arterial blood gas and provide a cause: pH 7.49, PaO2 98 mmHg, PaCO2 20 mmHg, HCO3- 24 mEq/L
Acute uncompensated respiratory alkalosis potentially from hyperventilation, CNS infection/trauma, carbon monoxide poisoning
Male smokers in their twenties with tall stature are at greatest risk for what pulmonary emergency?
Primary spontaneous pneumothorax
Corticosteroids work on what portion of the asthma cascade?
Inflammation and edema
Pulmonary emboli results in hypoxemia through what mechanism?
Ventilation/perfusion mismatch
Interpret the following arterial blood gas and provide a cause: pH 7.58, PaO2 92 mmHg, PaCO2 33 mmHg, HCO3- 30 mEq/L
Acute uncompensated metabolic alkalosis potentially from severe vomited, diarrhea, gastric suction, diuretics
COPD patients that breathe with pursed lips are essentially mimicking what mechanical ventilator setting?
Positive end expiratory pressure (PEEP)
What are the ominous signs of the need to intubate?
Near exhaustion, lethargy, somulence, apnea, shallow or irregular respirations; limited air movement (decreased tidal volume)
Permanent abnormal enlargement of the air spaces distal to the terminal bronchioles and associated destructive changes of the alveolar wall is known as what respiratory illness?
Emphysema
What is the most recognizable and reversible cause of hypoventilation?
Foreign body airway obstruction
A pulse oximetry of 90% correlates with an approximate arterial oxygen level of?
PaO2 60 mmHg
Interpret the following arterial blood gas and provide a cause: pH 7.28, PaO2 88 mmHg, PaCO2 51 mmHg, HCO3- 24 mEq/L
Acute uncompensated respiratory acidosis potentially from hypoventilation secondary to drug ingestion, COPD, pulmonary edema, respiratory arrest
What are the accepted arterial blood gas values indicative of acute respiratory failure?
PaO2 < 60 mmHg
PaCO2 > 50 mmHg
ABG: pH < 7.3 (room air)
What are normal arterial blood gas values?
pH 7.35-7.45
PaO2 80-100 mmHg
PaCO2 35-45 mmHg
HCO3- 22-26 mEq/L
What are two potential causes of cardiogenic pulmonary edema?
Myocardial infarction and congestive heart failure
Pulmonary edema is a direct result of failure of which heart chamber?
Left ventricle
If the chronic bronchitis patient produces more sputum than they are able to eliminate, which adventitious lung sound will be auscultated?
Rhonchi
What is the most definitive diagnostic tool in asthma?
Peak flow
What medications are commonly used in the treatment of pulmonary embolus?
Heparin. Also LMWH (e.g. Lovenox) and warfarin. Fibrinolytic therapy may be used in critically ill patients with PE.
Interpret the following arterial blood gas and provide a cause: pH 7.14, PaO2 89 mmHg, PaCO2 35 mmHg, HCO3- 16 mEq/L
Acute uncompensated metabolic acidosis potentially from diabetic ketoacidosis, renal failure, lactic acidosis
In what instance would fluctuations in pulse oximetry, capnography, and auscultation of lung sounds be minimal with pneumothorax?
When the degree of lung collapse is minimal
What are the classic early signs of asthma?
Dyspnea, expiratory wheezing, cough, tachycardia, and chest tightness
What is ipratropium bromide (Atrovent) and why is it given with beta2 agonists?
Anticholinergic used to reverse cholinergically mediated bronchospasm, blocks vagal tone to larger airways, dries secretions, and when given with beta2 agonists, provides additive effects
A patient presents with an elevated end tidal CO2. What should the critical care paramedic consider a cause?
Any condition that elevates carbon dioxide, decreased alveolar ventilation, or equipment malfunction
What is the purpose of administration of magnesium sulfate in patients with acute bronchospasm?
Bronchial smooth muscle relaxation
What mechanical ventilator settlings are frequently adjusted specifically for the treatment of adult respiratory distress syndrome (ARDS)?
Incrementally elevated levels of positive end expiratory pressure (PEEP), inversion of inspiratory/expiratory (I:E) ratio, limited peak inspiratory pressures (PIP), limited plateau pressures (Pplat), and reduced tidal volumes
The classic signs and symptoms of fever, sputum production, productive cough, dyspnea, tachycardia, and pleuritic chest pain are indicative of what respiratory illness?
Pneumonia
