Respiratory Emergencies

Question 1

Which respiratory emergency causes the overdistention of the alveoli without alveolar destruction?
A. 	Pulmonary embolus
B. 	Chronic bronchitis
C. 	Emphysema
D. 	Asthma

Answer 1

Asthma causes overdistention of a patient’s alveoli but without the alveolar destruction that occurs with other respiratory conditions

Question 2

this abnormal breathing pattern is identified by rapid, deep, labored breathing

Answer 2

Kussmaul

Question 3

this abnormal breathing pattern is identified by breathing with varying periods of increased depth, interspersed with apnea

Answer 3

Cheyne-Stokes

Question 4

this abnormal breathing pattern is identified by breathing with irregularly interspersed periods of apnea in a disorganized sequence of breaths

Answer 4

Biot
It is caused by damage to the pons due to stroke, trauma, or uncal herniation. As the insult to the pons progresses, the pattern becomes irregular. At this point, the pattern deteriorates to ataxic breathing.

Question 5

an abnormal condition in which a person must sit or stand to breath deeply or comfortably. Occurs in conditions such as asthma, pulmonary edema, PNA, CHF, and angina. Patients often sleep in recliners

Answer 5

Orthopnea

Question 6

Partial pressure of carbon dioxide (PaO2) parameters

Answer 6

35 - 45

Question 7

ABG parameters; bicarbonate

also, what is the chem abbreviation

Answer 7

HCO3-

22 to 26

Question 8

Partial pressure of alveolar oxygen (PaO2+) = what

Answer 8

Partial pressure of alveolar oxygen (PaO2+) = 80 to 100

Question 9

ABG values; Base excess arterial= what

Answer 9

+ 2.0 mEq/L, same for venous

Question 10

true or false

hypotension can result in an inaccurate SpO2 reading

Answer 10

true

Question 11

what are 6 types of viruses that can cause acute bronchitis

Answer 11

rhinovirus
influenza
adenovirus
RSV
parainfluenza
coronavirus

Question 12

viruses can cause bronchitis because…

Answer 12

they can cause an inflammatory process

Question 13

common bacterial causes of bronchitis are (6)

Answer 13

mycoplasma pneumoniae
chlamydia pneumoniae
bordetella pertussis
haemophilus influenzae
moraxella 
streptococcus pneumoniae

Question 14

what are come aggravating causes for bacterial bronchitis

Answer 14

smoking, talking, deep breathing, laughing

Question 15

what are some S/S of bacterial bronchitis

Answer 15

sore throat, stuffy nose, cough (starts as non productive and leads to productive after a few days), wheezes (that often clear with coughing), low grade fever, chest discomfort, and fatigue

Question 16

name some treatments for bacterial bronchitis

Answer 16

Cough suppressants and expectorants
Administer an inhaled bronchodilator, if needed, for wheezing and bronchospasm
Encourage patient to increase fluids, avoid smoke and other irritants, use a vaporizer to add moisture to the air.

Question 17

PNA typically presents with what?

Answer 17

fever, cough, malaise, hemoptysis, dyspnea, pleuritic chest pain

Question 18

Medications that can trigger asthma are

Answer 18

aspirin, NSAIDS, Beta-blockers

Question 19

PE development can be predicted with ____ triad. What are the three?

Answer 19

Virchow’s

Virchow’s triad; blood stasis, damage to wall epithelium, coagulation alterations

Question 20

What are some risk factors for PE?

Answer 20

Risk factors include immobility, trauma, surgery, long bone fractures, pregnancy, cancer, heart failure, use of estrogen as in oral contraceptives, obesity, thrombophlebitis

Question 21

what are 5 methods used to Dx PE?

Answer 21

CXR - may be normal
Spiral CT chest, the primary diagnostic in many ED’s
Pulmonary Angiogram; the gold standard for Dx PE but poses the greatest risk
Lab tests, such as D-dimer
US of both legs to assess for DVT

Question 22

what are some treatments for PE? (4)

Answer 22

Continuous Heparin infusion and bolus
Abbokinase, Activase
Prepare the patient for an embolectomy
Prepare the patient for inferior vena cava filter placement

Question 23

what are some causes of pulmonary edema?

Answer 23

results from cardiac compromise, such as in MI or heart failure
Heart does not pull blood from pulmonary system

Question 24

what are some symptoms of pulmonary edema?

Answer 24

Patient develops dyspnea and an increased respiratory rate in an effort to increase oxygenation, causing respiratory alkalosis

Question 25

As pulmonary edema worsens, what are 7 things that happen to the body?

Answer 25

• Respiratory acidosis occurs when the lungs cannot remove all of the carbon dioxide the body produces
• The respiratory effort is labored as the patient tires from the breathing effort
• Fluid in the lungs causes crackles and a productive cough with frothy, white, sputum which may br pink tinged in fulminant pulmonary edema
• Cyanosis and decreased O2 saturation occur as hypoxia increases
• Bronchospasms may develop, causing wheezes
• CXR usually shows bilateral interstitial and alveolar infiltrates
• The left ventricle enlarges, giving the heart a water bottle shape

Question 26

What are some respiratory methods used to treat pulmonary edema?

Answer 26

High flow O2
Administer bronchodilators
Provide PEEP when hypoxia continues despite aggressive O2 therapy
Anticipate Cpap or intubation

Question 27

What are some medications used to treat pulmonary edema?

Answer 27

Medications
Diuretics to decrease cardiac workload by decreasing preload
Nitro bid to decrease preload by venous distension
Dobutamine increases cardiac contractility and reduces peripheral vascular resistance
Dopamine (intropin) increases the HR and causes increase in BP
Nitroprusside decreases afterload
Milrinone, phosphodiesterase inhibitors to increase contractility and cause vasodilation