Respiratory Disorders

Question 1

Risk factors for development of venous thrombosis or pulmonary embolus?

Answer 1

1. Use of oral contraceptives.
2. Obesity.
3. Smoking.
4. Sedentary lifestyle.

Question 2

Some indicators of impending respiratory failure (8):

Answer 2

1. Respiratory rate >30 or <6 breaths/min.
2. O2 Sat <90.
3. Use of multiple accessory muscle groups.
4. Inability to lie supine.
5. Tachycardia with rate >140 beat/min.
6. Mental status changes.
7. Inability to clear oral secretions.
8. Cyanosis of nail beds or lips.

Question 3

Adequate respiratory rate vs depth; why is this important?

Answer 3

A pt with an adequate rate and low volume will have inadequate minute volume. Depth is even more commonly misjudged.

Question 4

Minute volume =

Answer 4

Minute volume = respiratory rate x tidal volume.

Important for determining adequacy of ventilation.

Question 5

Key findings in pt’s with dyspnea:

Duration - acute and chronic -

Answer 5

Chronic or progressive dyspnea is usually related to cardiac disease, asthma, COPD, or neuromuscular disease (multiple sclerosis).

An acute dyspnea spell may be due to exacerbation of asthma, infection, pulmonary embolus, intermittent cardiac dysfunction, a psychogenic cause, or inhalation of a toxic substance, allergen, or foreign body.

Question 6

Key findings in pt’s with dyspnea:

Onset - sudden and slow progression.

Answer 6

Sudden onset of dyspnea should raise suspicion of pulmonary embolism or spontaneous pneumothorax.

Dyspnea that develops slowly (hours to days) points towards pneumonia, congestive heart failure, or malignancy.

Question 7

Key findings in pt’s with dyspnea:

Patient position -

Answer 7

Orthopnea (diff breathing when lying flat) can be attributed to congestive heart failure, COPD, or a neuromuscular disorder.

Paroxysmal nocturnal dyspnea is most common in those with left heart failure.

Exertional dyspnea is associated with COPD, myocardial ischemia, and with the abdominal loading that occurs in obesity, ascites, and pregnancy.