Respiratory Conditions Flashcards
0
Q
What would the FEV1/FCV test be used to diagnose ?
A
COPD and asthma
1
Q
What is the FEV1/FCV test and what are the normal %’s
A
this stands for Volume that has been exhaled at the end of the first second of forced expiration
And Forced vital capacity: the determination of the vital capacity from a maximally forced expiratory effort
2
Q
What is the normal level for sodium
A
135 to 145
3
Q
What is the normal level for potassium
A
3.5-5
4
Q
With the normal one for calcium
A
8.8–10.5
5
Q
What is a normal GFR and what level would indicate liver failure
A
100–120
If it is below 60 is indicative of kidney failure
6
Q
What is gas transport
A
Delivery of O2 to cells and removal of CO2 from cells
7
Q
What three things is gas transport dependent on?
A
Ventilation
Diffusion
Perfusion
8
Q
Define ventilation
A
Minute volume equals respirations. Rate X’s tidal volume
9
Q
Describe diffusion
A
The movement of gases between air spaces in the Longs and The bloodstream
10
Q
Describe perfusion
A
the movement of blood into and out of the capillary beds of the lungs to body organs and tissues.
11
Q
Which stuck in gas transport is reliant on an intact cardiovascular system
A
Perfusion
12
Q
What are some factors that could negatively influence ventilation
A
Airway resistance
Noncompliance
Decreased mobility of the best wall
13
Q
How is parasympathetic stimulation affect ventilation
A
Bronchoconstriction which would cause airway resistance to increase
14
Q
How does sympathetic stimulation affect ventilation?
A
Bronchodilation would occur changing resistance in the airway
15
Q
What are some factors of ventilation compliance
A
Elasticity of the lung tissue
Mobility of the chest wall
16
Q
How is mobility of the chest wall affected by one’s age?
A
Chest wall compliance increases in children while chest wall compliance decreases with the elderly
17
Q
How much O2 transportation occurs in the plasma
A
3%
18
Q
How much O2 transport occurs on saturated hemoglobin?
A
97%
19
Q
PaO2 isn’t abbreviation for what?
A
The partial pressure of oxygen in arterial blood
20
Q
What is the definition of SaO2?
A
The oxygen saturation (Sao2) is the percentage of the available hemoglobin that is bound to oxygen and can be measured using a device called an oximeter.
21
Q
What is a normal hemoglobin concentration value
A
15g/dl of blood
22
Q
On the oxyhemoglobin dissociation curve a shift to the left would indicate what?
A
Increased affinity which means hemoglobin is holding onto O2
23
Q
On The Oxyhemoglobin dissociation curve a shift to the RIGHT would indicate what?
A
Shift to the right would indicate decreased affinity to O2 or in another words hemoglobin is releasing O2
24
In terms of ventilation with increased resistance but what happened to flow?
Flow of air in ventilation would be decreased
25
What are the major contributing factors that affect oxygen transport
PH of the blood
PCO2 (carbon dioxide partial pressure)
Temperature
26
How is CO2 transported
5 to 10% is transported in plasma as bicarbonate
27
What is the normal pH of blood
7.35–7.45
28
What is the normal level of PaCO2 in an adult
35–45 mmhg
29
In the adult what is the normal PaO2
80–100 mmHg
30
And a healthy adult what is a normal HCO3 value
22–26 Milliequivalent's/ liter
31
What is the normal SAT 02
95–100%
32
What are some major respiratory responses in the elderly population?
Decreased elasticity and recoil of lung tissue
Lung tissue expands easier but does not recoil as was well
Stiffer chest wall
Decreased vital capacity
Hypertrophy Of mucous glands
Decreased intercostal muscle tone
Decreased ciliary action and inability to cough
33
What is the definition of ventilatory compliance?
Ease of inflation related to elasticity of lung tissue and mobility of the chest wall
34
What are the major signs and symptoms of respiratory distress?
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Loss of consciousness and anxiety
Cyanosis
Posture(tripod position)
A/P 1:2 no barrel chest
Rate and depth of respirations
Use of accessory muscles
The change in breeding patterns
Dyspnea
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35
Describe dyspnea
Breathlessness
36
What are the major O2 delivery devices?
Nasal cannula
Mask
Rebreather mask
37
How many years of oxygen can be delivered via a nasal cannula
2–4 L
38
What is the technical term for a buildup of CO2?
Hypercapnia
39
How would you define hypo ventilation
Decreased rate or depth of respirations
Buildup of CO2
PCO2 greater than 45 mm HG
40
How do you define hyperventilation
Increased minute volume
Frequent sighing
Too much CO2 a blown off (CO2 greater than 35 mm of hemoglobin)
41
How would you define hypercapnia
PCO2 greater than 45 mm HG
42
What is the common etiologies of hypercapnia?
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Respiratory depression(drugs)
Problems in the mid Dula due to infection or injury
Neuromuscular disease
COPD
Sleep apnea
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43
What is the main clinical manifestation of hypercapnia?
Decreased level of consciousness
44
What is hypoxemia
Lack of O2 in blood (satO2 less than 95%)
45
What are the common etiologies of hypoxemia ?
Decreased O2 delivery to the Alveoli
Change in 02 carrying capacity
Problems with the diffusion into Alveolar capillaries
Imbalance of ventilation and perfusion (V/Q RATIO)
46
What is the V /Q ratio ? And it's normal value ?
Ventilation to perfusion ratio in regards to air that reaches the alveoli versus blood that reaches the alveoli
4 L alveolar ventilation/5 L blood flow
47
What does a high V/Q value mean? And what is the value ?
Hi ventilation without perfusion this is indicative of a pulmonary embolus
4 L of your ventilation /5 L blood flow
48
What does a lower VQ ratio mean? And what would be the lab value ?
Poor ventilation with moderate perfusion.
Pneumonia, asthma, COPD, (responds to O2 therapy as some ventilation is occurring)
2 L of your ventilation/5 L blood flow
49
What is the treatment for hypoxemia ?
Give the patient O2 and fix the underlying cause of hypoxemia.
50
In regards to the VA/Q shunt what is happening
No ventilation/ ok perfusion.
| this will not respond O2 therapy and is known as acute respiratory distress syndrome or ARDS
51
How is acute respiratory failure defined?
But in adequate gas exchange. PaO2 greater than 50 and PaCO2 less than 50
52
What are the 4 most common etiologies of acute respiratory failure
Pneumonia,
surgery,
trauma,
pulmonary edema.
53
How do you treat acute respiratory failure
Ultimately you need to reverse the cause and support respirations
54
What are the clinical manifestations of acute respiratory distress syndrome
The classic signs and symptoms of ARDS are marked dyspnea; rapid, shallow breathing; inspiratory crackles; respiratory alkalosis; decreased lung compliance; hypoxemia unresponsive to oxygen therapy (refractory hypoxemia); and diffuse alveolar infiltrates seen on chest radiographs, without
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evidence of cardiac disease. Symptoms develop progressively, as follows:
Dyspnea and hypoxemia ↓ Hyperventilation and respiratory alkalosis ↓ Decreased tissue perfusion, organ dysfunction, and metabolic acidosis ↓ Increased work of breathing, decreased tidal volume, and hypoventilation ↓ Respiratory acidosis and worsening hypoxemia ↓ Hypotension, decreased cardiac output, death
55
What is chronic obstructive pulmonary disease (COPD)
It is the coexistence of chronic bronchitis and emphysema and is an important cause of hypoxemic and hypercapnic respiratory failure.
This is an obstructive disorder of the Lungs
56
What are the three types of obstructive lung disease
Asthma chronic bronchitis chronic emphysema COPD
57
What are some common triggers for an asthma attack
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Air pollution
medication
cigarette smoke
woodsmoke
stress
exercise
upper respiratory infections
menstruation
GERD
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58
With the pathogenesis of asthma?
Inflammation
59
What is the early response of an asthma attack
Type one hypersensitivity. Release of inflammatory mediators leads to vasodilation and increased capillary. Ability. Adema, bronchoconstriction, and increased mucus production obstruct the airflow
60
What are some clinical manifestations of an asthma attack
Coughing, wheezing, anxiety, tachycardia, cyanosis, level of consciousness
61
What is the first-line treatment for an asthma attack
Inhaled corticosteroid (Flovent and Asthmacort)
62
What is a long-term treatment for asthma
Long acting beta agonist Lucot trying modifiers, singular.
63
In terms of an asthma action plan green indicates what?
Patient is doing well/controlled symptoms
64
In terms of an asthma patient yellow indicates what?
Trouble with activity/added medication
65
In regards to an asthma patient and their action plan read indicates what
The patient should seek medical attention
66
What is the leading cause of COPD
Smoking and a genetic component
67
What is the fourth leading cause of death
COPD
68
Chronic bronchitis is characterized by what
Excessive mucus secretions, cough producing sputum, at least three months to two years. Sputum is Thick and obstructs airflow
69
What are the pathophysiology behind chronic bronchitis?
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Inhaled Particles and gases
Bronchial edema and goblet cell hypertrophy
Excessive mucus
Low V/Q
Increased CO2
Central chemoreceptors/hypercapnia
Cyanosis
Congestive heart failure or
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70
What are the four classifications of asthma
Intermittent
Mild persistent
Moderate persistent
Severe
71
What would my FEV be if I were an asthma patient in the green zone
80 to 100%
72
FEV if in yellow zone ?
50–80%
73
Red zone FEV ?
Less than 50%
74
Was the primary cause of a pneumothorax
Spontaneous
75
What is a secondary causes of a pneumothorax
Traumatic events and diseases
76
Name some clinical manifestations of emphysema
Decreased activity tolerance and dyspnea
77
Define emphysema
Enlargement of gas that exchange airways company but instruction of the walls and without obvious fibrosis, air trapping, prolonged expiration, impaired gas exchange
78
What are some clinical manifestations of pneumothorax
Chest pain and dyspnea
Breath sounds are unequal or absence on one side
Subcutaneous emphysema air under the skin
Jugular vein distention would be seen with a tension pneumothorax
CXR is definitive
79
What is a pneumothorax
Collapse of the lungs
80
What is atelectasis
Collapse of the alveoli due to compression absorption or surfactant impairment
81
What are the clinical manifestations of atelectasis
Coughing fever leukocytosis coughing.
82
In regards to post op patients what can we do to prevent atelectasis
Encourage the patient to cough and use incentive spirometry.
83
What is Marfan syndrome
Tall skinny emails that have pulmonary lack both at rest and during exercise
84
Where's the secondary causes pulmonary pneumothorax
Genetic diseases such as Cushing syndrome, or gunshot and knife wounds, cancer and tumors may also cause this
85
How do you treat ARDS
I see you, ventilator long-term, treat the underlying cause of ARDS, please patient in the prone position, inhale nitric oxide
86
Who is at risk for infant respiratory distress syndrome
Premature neonates born 25 weeks or less
87
What causes infant respiratory distress syndrome
Lack of surfactant leaves the pulmonary edema, Atelectasis and profound hypoxemia
88
What are some clinical manifestations of the tension pneumothorax
Tracheal deviation
Chest pain and dyspnea
Plearle pain that changes with the cough
Jugular vein distention
89
What is pleural effusion
Fluid in the plural space
90
What are the three types of pleural effusion
Empyema
Transudative
Hemorrhagic
91
How do you treat a pleural effusion
Drain off the fluid with a thoracentesis or chest tube normal you should see 10–20 L of fluid
92
What are some clinical manifestations of atelectasis
Cough and fever with increased white blood cell count and leukocytosis
Which may lead to pneumonia
93
What is pulmonary Adema
Excess fluid buildup in The Alveoli leading to impaired ventilation and gas exchange
94
What is the main clinical manifestation of pulmonary edema and the leading cause
Pink frothy sputum, left sided heart failure or leads to backflow into lungs
95
What is the pathogenesis of ARDS
Massive pulmonary inflammation, widespread pulmonary edema, ventilation and perfusion a mismatch V/Q 0/5, acute respiratory failure, pulmonary fibrosis,SRIS, multiple organ failure or mods
96
What is the most common cause of death from an infection
Pneumonia
97
What is the etiology of pneumonia
Viral; influenza bacterial; strep pneumonia
98
What are the 3 pathogenesis of pneumonia
Aspiration,
inhalation of infectious agents,
contamination from systemic circulation
99
How will pneumonia represent the elderly
Hey symptomatic or changes in level of consciousness
100
How is pneumonia treated
Vaccines are given to the elderly, younger with asthma, and Those with autoimmune diseases
101
How much money you spend annually on tuberculosis
9 million
102
What is epidemiology of tuberculosis
One third of the worlds population
103
What is the cause of tuberculosis
Mycobacterium tuberculosis
104
Clinical manifestations of tuberculosis
Persistent cough, profuse night sweats, Progressive weight loss
105
Evaluation of tuberculosis
Tuberculin skin test
For acid-fast bacilli
And treatment for 6 to 9 months
106
Most common site of DVT
Lungs pulmonary embolism
107
How do you diagnose a pulmonary embolism
Lung scan or CT scan
