Respiratory Distress

Question 0

Respiratory Distress -
A- ______ distress - Pt is able to speak full sentences; pt may have an elevated ______ and ______. pt may be diaphoretic and weak; mental status is unaffected; no cyanosis present

Answer 0

Mild
pulse
blood pressure

Question 1

Respiratory Distress -
B_________ Distress. Pt is able to speak a few words; pt may have an elevated pulse and blood pressure’ pt may be ________ and weak; mental status is ______; mild cyanosis of lips and digits may be present.

Answer 1

Moderate
diaphoretic
unaffected

Question 2

Respiratory distress-
C. ________ distress-pt is ______ to speak; pt may have decreased/elevated pulse and/or decreased /elevated blood pressure’ mental status is altered; more _____ and profound cyanosis is present

Answer 2

Severe
Unable
Central

Question 3

Respiratory Distress -
Pt may have several disease process together producing shortness of breath. ______ may occur in diseases other than asthma and _________ may occur in setting other than CHF. Assessment should usually yield a single treatment plan. In general, commit yourself to a single assessment- you may modify this assessment based on _____ to therapy and as additional info becomes available .

Answer 3

Wheezing

Peripheral edema

Question 4

Pulmonary Edema in the setting of CHF will usually have collaborating signs such as: 1-4

Answer 4

1) HX of CHF and meds such as diuretics and or angiotensin converting Enzyme inhibitors
2) Peripheral edema
3) JVD
4) Frothy pulmonary secretions

Question 5

Respiratory Distress - Initial Box

Answer 5

ABC - limit exertion, reduce anxiety
O therapy as appropriate, protect airway with position, assist vent, advanced airway

ECG, pulse Ox, ETCO2

Question 6

Respiratory Distress - Asthma/COPD-Mild distress consists of

Answer 6

mild wheezing sob cough

Question 7

Respiratory Distress - Asthma/COPD- mild treatment

Answer 7

Albuterol

2.5-5mg via HHN, mask or inline neb. May repeat

Question 8

Respiratory Distress - Asthma/COPD- Moderate/Severe Definitions

Answer 8

Cyanosis
Accessory muscle use
inability to speak >3 wds/sent
Severe wheezing/sob

Question 9

Respiratory Distress - Asthma/COPD- Moderate - Severe Treatment

Answer 9

Albuterol 5mg via HHN mask or inline neb. Continuous albuterol

CPAP

IV

EPI - for pt with severe asthma/bronchospasm only:
epi 1:1000 - 0.3mg IM
base hospital order if** pt > or equal to 40 years old and/or BP>or equal to 180 mmhg

Question 10

Respiratory Distress - CHF/Pulmonary Edema - Mild Distress - definition

Answer 10

mild wheezing
sob
cough

Question 11

Respiratory Distress - CHF/Pulmonary Edema - Mild Distress - treatment

Answer 11

Albuterol 2.5mg-5mg HHN repeat PRN

Nitro 0.4mg SL (q5) **hold of SBP <90

IV access

Question 12

Respiratory Distress - CHF/Pulmonary Edema - Moderate/Severe Distress- Definition

Answer 12

Cyanosis 
Accessory muscle use 
inability to speak > 3wds/sent
Rales/ronchi JVD 
Diaphoresis, pedal edema

Question 13

Respiratory Distress - CHF/Pulmonary Edema - Moderate/Severe Distress- Treatment path

Answer 13

Albuterol 2.5mg-5mg via HHN - repeat PRN

Nitro - (may repeat q5 based on BP....hold if BP 200 - 1.2mg SL 
-SBP 150-200 - 0.8mg SL 
-SBP 90-150 - 0.4mg SL 
1" of NTP with CPAP use 
-remove paste if SBP <90
-dose 10mcg/kg/min

Question 14

Respiratory Distress - If pt took PDE - 5 inhibitor within ______ do not give nitro.

Answer 14

48hours

Question 15

Respiratory Distress - Quick recall Moderate severe distress CHF

Answer 15

Albuterol 
Nitro - BP based 
CPAP - with paste 
IV
Morphine
Dopamine

Question 16

Respiratory Distress -Quick recall - Asthma Copd- severe

Answer 16

Albuterol
CPAP
IV
Epi