Respiratory

Question 1

What respiratory measurement is used for differentiating between obstructive and restrictive pulmonary dysfunction?

What helps in monitoring bronchoconstricion in asthma

What is forced vital capacity

What is forced mid expiratory flow rate indicator of.

Answer 1

What respiratory measurement is used for differentiating between obstructive and restrictive pulmonary dysfunction?
• forced expiratory volume / forced vital capacity ratio

What helps in monitoring bronchoconstricion in asthma
• peak expiratory flow rate

What is forced vital capacity
• amount of air that can be wuickly and forcefully exhaled after maximum inspiration

What is forced mid expiratory flow rate indicator of.
• disease of small airways

Question 2

What is a fat embolism

Answer 2

• a piece of fat that develops after fractures of long bone in the lower body (femur, tibia, pelvis)
• Fat lodges on a bv and block blood flow
• Resolves on own bug can lad to FES fat embolsim syndromd which causes inflammation, multiple organ dysfuction and neurologic changes
• Symptoms
• tachycardia
• Petechiae often on chest, head, neck
• Tachypnea
• Mental status change

Question 3

Copd with pneumonia meds

Answer 3

1. Ampicillin-sulbactam - a broad spectrum antibiotic. Sputum culture must be obtained prior to first dose coz a specific antibiotic needs to be admind after the broad spectrum
2. Albuterol (ventolin) - bronchodilator. Usually used for acute asthma attacks. A beta andrenergic agonist thus mimic sympathetic stimulation - monitor for arrhythmia, HTN, nervoussness and restlessness. For inhalers. Wait at least 1 minute between each puff and 5 minutes before using a second inhaler
3. Beclomethasone (vanceril) a glucocorticoid with antiinflammatory effect. Used for long term prevention in asthma not useful during acute episodes
4. Methylprednisolone (solu-medrol) - a type of steroid. Steroids usually admind with bronchodilators. Steroids reduce inflammation in lungs due to COPD flare ups

Question 4

Copd and oxygenation

Answer 4

Pts with COPD should be maintained on low doses of O2 (2L) because their drive to breath is based on hypoxia rather than hypercapnia. Ideally their normal 02 sat is between 88-92. These pts stimulus to breath is the lack of O2 not increase in CO2 like normal . If f you give more O2. They won’t have stimulus to breath. They will retain CO2. Increasing the O2 sat in a pt with a lot of retained CO2 dt COPD can lead to respiratory acidosis and death
Hypoxia - O2 cannot cannot pass through the lungs due to damaged air sacs from COPD
Hypoxemia - dt to hypoxia O2 cannot be transferred to blood and rest of the body
If pt with COPD’s o2 sat must be positioned in high fowlers to to allow opening of airway not increasing the O2 to higher rate
Septic shock
First theres a local infection then systemic infection (early sepsis) — SIRS (systemic inflammatory response syndrome) — organ failure (severe sepsis) — septic shock — death
RR very high, O2 very low, pulse high and weak, BP is low
Priority is to place rescusitation equipment in the room right away