Respiratory Emergencies Flashcards
Which respiratory emergency causes the overdistention of the alveoli without alveolar destruction? A. Pulmonary embolus B. Chronic bronchitis C. Emphysema D. Asthma
Asthma causes overdistention of a patient’s alveoli but without the alveolar destruction that occurs with other respiratory conditions
this abnormal breathing pattern is identified by rapid, deep, labored breathing
Kussmaul
this abnormal breathing pattern is identified by breathing with varying periods of increased depth, interspersed with apnea
Cheyne-Stokes
this abnormal breathing pattern is identified by breathing with irregularly interspersed periods of apnea in a disorganized sequence of breaths
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.
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
Orthopnea
Partial pressure of carbon dioxide (PaO2) parameters
35 - 45
ABG parameters; bicarbonate
also, what is the chem abbreviation
HCO3-
22 to 26
Partial pressure of alveolar oxygen (PaO2+) = what
Partial pressure of alveolar oxygen (PaO2+) = 80 to 100
ABG values; Base excess arterial= what
+ 2.0 mEq/L, same for venous
true or false
hypotension can result in an inaccurate SpO2 reading
true
what are 6 types of viruses that can cause acute bronchitis
rhinovirus influenza adenovirus RSV parainfluenza coronavirus
viruses can cause bronchitis because…
they can cause an inflammatory process
common bacterial causes of bronchitis are (6)
mycoplasma pneumoniae chlamydia pneumoniae bordetella pertussis haemophilus influenzae moraxella streptococcus pneumoniae
what are come aggravating causes for bacterial bronchitis
smoking, talking, deep breathing, laughing
what are some S/S of bacterial bronchitis
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
name some treatments for bacterial bronchitis
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.
PNA typically presents with what?
fever, cough, malaise, hemoptysis, dyspnea, pleuritic chest pain
Medications that can trigger asthma are
aspirin, NSAIDS, Beta-blockers
PE development can be predicted with ____ triad. What are the three?
Virchow’s
Virchow’s triad; blood stasis, damage to wall epithelium, coagulation alterations
What are some risk factors for PE?
Risk factors include immobility, trauma, surgery, long bone fractures, pregnancy, cancer, heart failure, use of estrogen as in oral contraceptives, obesity, thrombophlebitis
what are 5 methods used to Dx PE?
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
what are some treatments for PE? (4)
Continuous Heparin infusion and bolus
Abbokinase, Activase
Prepare the patient for an embolectomy
Prepare the patient for inferior vena cava filter placement
what are some causes of pulmonary edema?
results from cardiac compromise, such as in MI or heart failure
Heart does not pull blood from pulmonary system
what are some symptoms of pulmonary edema?
Patient develops dyspnea and an increased respiratory rate in an effort to increase oxygenation, causing respiratory alkalosis
As pulmonary edema worsens, what are 7 things that happen to the body?
- 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
What are some respiratory methods used to treat pulmonary edema?
High flow O2
Administer bronchodilators
Provide PEEP when hypoxia continues despite aggressive O2 therapy
Anticipate Cpap or intubation
What are some medications used to treat pulmonary edema?
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
