Respiratory

Question 1

Acute respiratory failure

Answer 1

Patient can no longer compensate for the underlying patho or anatomical problem by increased WOB.
Decreased or absent retractions, hypoxia, low RR

Question 2

Aspiration

Answer 2

Could also refer to as FBAO. Can also destroy bronchiole tissue, introduces pathogens, decreases ability for ventilation

Question 3

Acute respiratory distress syndrome

Answer 3

Respiratory insufficiency and hypoxemia, diffuse damage to alveoli. Alveoli become stiff and difficult to ventilate. Avoid high pressures and supraphysiologic volumes while treating.

Question 4

COPD

Answer 4

Emphysema and chronic bronchitis. Loss of alveolar surface area. Can result in hypoxic drive.

Question 5

Hyperventilation disorder

Answer 5

Occurs when people breathe in excess of metabolic needs. Can be generalized anxiety, or acidosis. Can result in respiratory alkalosis, resulting in tingling, numbness, loss of consciousness.

Question 6

Pleural effusion

Answer 6

Excess accumulation of fluid in the pleural space. Can be caused by infection, tumour, CHF, trauma. Can result in rubbing sound on ausc, pain while breathing.

Question 7

Pulmonary edema

Answer 7

Swelling of the lungs occurs when fluid migrated into lungs. Compromises gas exchange.
Hear crackles @ bases on end inspiration, which can migrate up to apices as it progresses. Pt can cough up pink and foamy sputum.

Question 8

Pulmonary embolism

Answer 8

Blood clot (common with DVT), fat, broken bone, foreign object, air, or amniotic fluid blocking pulmonary circulation. Inhibits gas exchange. Usually sudden onset, cyanosis despite good ventilation.

Question 9

Reactive airway disease (asthma)

Answer 9

Inflammation of the bronchiole due to a variety of stimuli (smoke, pollen, dust, etc).
Potentially fatal asthma: status asthmaticus, previous ET, previous ICU, AMS, hypoxia, silent chest.

Question 10

Severe acute respiratory syndrome

Answer 10

An infectious disease caused by a virus that presented as atypical pneumonia. Spread by close contact droplets. Incubation approx 10 days. S/S fever>38C, headache, flu-like symptoms. Dry cough after 2-7 days, pneumonia in severe cases.

Question 11

Simple pneumothorax

Answer 11

Frequent occurrence in trauma patients. Allows air to escape into the pleural space causing a pneumothorax

Question 12

Open pneumothorax

Answer 12

Occurs when a defect in the chest wall caused by penetrating trauma allows air to enter the thoracic space. Causes collapsing of the lung.

Question 13

Tension pneumothorax

Answer 13

Air accumulation within the intrapleural space due to open or simple injury. Air exerts pressure on the lung, heart, and great vessels.

Question 14

Hemothorax

Answer 14

Blood accumulation in the pleural space, limiting lung expansion and ultimately causing an increase of thoracic pressure. Hemopneumothorax is when blood and air get trapped in the pleural space.

Question 15

Pulmonary contusion

Answer 15

Local tissue injury to lungs, resulting in inflammation. Inflammation leads to edema, reduction in surfactant, reduced compliance, and atelectasis.

Question 16

Flail chest

Answer 16

2 or more adjacent ribs fractured in 2 or more places. Seen with paradoxical movement. Can result in pulmonary contusion, pneumothorax, hemothorax.

Question 17

Diaphragmatic injuries

Answer 17

Injury to the diaphragm. Can result in hypotension, tachypnea, bowel sounds in the chest, C/P, absent breath sound in acute phase. Nausea, vomit, abdo pn, dyspnea, abdo distension in obstructive phase.

Question 18

Normal respiration rates

Answer 18

Adults: 12-20 breaths/min
Children: 15-30 breaths/min
Infants: 25-50 breaths/min

Question 19

Signs of inadequate breathing

Answer 19

Slow or fast respirations. 
Shallow breathing
Adventitious (abnormal) sounds
AMS
Cyanosis

Question 20

Signs of consolidation

Answer 20

Bonchophony: consolidation or atelectasis.
Egophony: pleural effusion
Whispered pectoriloquy: consolidation

Question 21

Adult male total lung capacity

Answer 21

Approximately 6 litres

Question 22

Situations that can affect pulse oximetry readings

Answer 22

Bright ambient light
Patient motion
Poor perfusion
Nail polish
Venous pulsation
Abnormal hemoglobin

Question 23

Recovery (lateral recumbent position) indication

Answer 23

All non trauma patients who are unconscious or have a decreased LOC who are able to maintain their own airway spontaneously and are breathing adequately

Question 24

Cricoid pressure (Sellick maneuver)

Answer 24

Pressure to cricoid cartilage to prevent aspiration, allow more air to enter the lungs during PPV, and can help visual vocal cords during intubation

Question 25

Normal tidal volume

Answer 25

Approximately 500ml of air inhaled or exhaled per respiratory cycle. Average adult man = 5 to 7ml/kg.
Children = 6 to 8ml/kg

Question 26

Neural control of ventilation

Answer 26

Phrenic nerve: diaphragm
Intercostal nerves: intercostals.
Controlled by pons and medulla