Respiratory Conditions (20 ques)

Question 1

PaCO2 < 35 – what is it?

Answer 1

respiratory alkalosis (loss of acid)
etiology: hyperventilation (anxiety disorders)

“if it’s coming out of your mouth, it’s alkalosis”

Question 2

HCO3 > 26 – what is it?

Answer 2

metabolic alkalosis (gain base/acid buffer)
etiology: vomiting (losing acid from stomach)

Question 3

ROME

Answer 3

Respiratory - Opposite

Metabolic - Equal (same)

Question 4

Prevention teaching for Otitis Media

Answer 4

• BF for first 6 months
• feed in upright
• d/c or reduce pacifier use after 6 mos
• avoid exposure to smoke
• give Prevnar (pneumococcal) vaccine

Question 5

Intervention for CO poisoning

Answer 5

100% O2 via nonrebreathing mask

Question 6

Bronchopulmonary Dysplasia (BPD)

Answer 6

• risk factors - born <30 wks, neonatal mechanical vent
• Can recover

Interventions:

• O2
• positive airway pressure (HFNC)
• small, frequent feedings
• high calorie
• meds: corticosteroids, bronchodilators, diuretics

Question 7

Laryngotracheobronchitis (LTB)?

Answer 7

Croup
caused by (Human) Parainfluenza virus (HPIV)

• barky, brassy cough
• inspiratory stridor
• IV fluid, as needed
• Racemic epi (lasts 6 hours)
• corticosteroids (IM, IV, PO)

Question 8

Epiglottitis

Answer 8

• prep for emergent tracheotomy or intubation
• monitor resp status
• IV corticosteroids, abx
• prevent w/Hib vaccine (Haemophilus influenzae type B)

Question 9

Tonsillitis

Answer 9

post op interventions

• side lying to promote drainage (on back w/HOB elevated)
• ice collar for comfort
• analgesics
• clear, cool fluids
• monitor for s/s of hemorrhaging – 1st 24 hrs and 7 days later [frequent swallowing, restlessness, fast, thready pulse, vomiting bright red blood]

Question 10

Cystic Fibrosis presentation

Answer 10

• steatorrhea (fatty stool)
• freq respiratory infection during infancy
• failure to thrive
• thick mucous that doesn’t move
• pseudomonas aeroginosa
• Burkholderia cepacia
• Staph aureus
• H. influenzae
• E. coli
• Klebsiella pna

Dx w/sweat test

Question 11

CF mngmt and preventing complications - respiratory

Answer 11

mechanical - CPT, deep breathing, coughing, flutter mucous clearance device

medication - aerosolized pulmozyme (helps reduce viscosity of mucous

Question 12

CF management of Pulmonary Infections

Answer 12

Treat infection promptly and aggressively

• IV abx
• airway clearance – mechanical and medications

Keep away from other CF patients due to colonization of bacterias

Question 13

CF clinical manifestations - GI

Answer 13

presentation - Meconium Illeus (blocks small intestine)
- if don’t pass meconium in 1st 72 hours, sign of CF

Pancreas - blockage of ducts -> reduction in enzymes for for digestion in duodenum; fibrosis and degeneration –> Type 1 diabetes develops

Liver – some biliary obstruction – increased LFTs, gall stones

Question 14

CF management of GI and nutrition

Answer 14

Pancreatic enzymes w/meals and snacks - give in applesauce immediately before meals and snacks
- goal is 2-3 stools/day

Diet – high protein, high calorie (up 150% of daily rec)

• multivitamins
• extra enzymes for high fat food

Question 15

CF affect on Reproductive System

Answer 15

Female - delayed puberty, viscous cervical secretions

Male - typically are sterile