Respiratory Distress

Question 1

In what lung conditions might increased O2 delivery (and SpO2) cause decreased respiratory drive?

Answer 1

COPD

MOA:

Question 2

For wheezing or diminished lung sounds, what is administered?

Answer 2

2.5 mg albuterol and 0.5 mg ipratropium (“Duo-Neb”)

Question 3

In the status asthmaticus patient, what medication should be administered IM?

A. 125 mg methylprednisolone
B. 0.3 mg 1:1,000 epinephrine
C. 0.2 mg atropine

Answer 3

B. 0.3 mg 1:1,000 epinephrine

Question 4

List the “cautions” for IM epinephrine

Answer 4

• patient > 40 years old
• irregular heart rate
• heart rate > 150 BPM
• heart disease/HTN
• contact medical control for orders for these patients

Question 5

In patients with asthma, COPD, pulmonary edema, what systolic BP is the minimum required for CPAP?

A. 70 mmHg
B. 80 mmHg
C. 90 mmHg
D. 100 mmHg

Answer 5

C. 90 mmHg

Question 6

In addition to the “normal” respiratory distress medications/procedures (CPAP, Duo-Neb, etc.), what is also given in pulmonary edema care?

Answer 6

• 12-lead EKG (electrical disturbance may result in increased capillary hydrostatic pressure, and filters fluid out into alveoli)
• Nitroglycerin (vasodilation causes decreased capillary hydrostatic pressure, slowing plasma filtration, and allowing increased fluid pressure in alveoli to flow back into vasculature)

Question 7

Max dose of NTG, as long as SBP > 90 mmHg.

Answer 7

(3) doses of 0.4 mg

Question 8

Oxygen levels should be titrated to obtain an SpO2 level greater than ____.

A. 90%
B. 92%
C. 94%
D. 96%

Answer 8

C. 94%