Respiratory part 2 Flashcards

1
Q

Patients who are higher risk of upper airway obstruction?

A

altered mental status and level of consciousness, are dehydrated, are unable to communicate, are unable to cough effectively, or are at risk for aspiration.

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2
Q

What are sx of a partial obstruction of the airway?

A

diaphoresis, tachycardia, anxiety, decreased O2, elevated blood pressure, rising end tidal CO2 levels. Stridor or crowing. Drooling or an inability to swallow oral secretion.

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3
Q

What are sx of complete obstruction?

A

hypoxia and hypercarbia, restlessness, increasing anxiety, sternal retractions, a “seesawing” chest motion, abdominal movements, or a feeling of impending doom from air hunger.

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4
Q

Emergency procedures performed when obstruction cannot be removed quickly?

A

cricothyroidotomy or tracheotomy

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5
Q

Sx often seen as a result of chronic sleep apnea?

A

chronic excessive daytime sleepiness, an inability to concentrate, morning headache, and irritability

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6
Q

What are long-term effects of OSA?

A

risk for hypertension, stroke, cognitive deficits, weight gain, diabetes, and pulmonary and cardiovascular disease

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7
Q

Causes of OSA?

A

Obstruction by soft palate or tongue, obesity, large uvula, short neck, smoking, large tonsils or adenoids, and oropharyngeal edema

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8
Q

Physical findings of OSA?

A

retracted lower jaw, smaller chin, and shorter neck, swollen or enlarged oropharyngeal structure

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9
Q

What are some diagnostic tests for OSA?

A

sleep apnea questionnaires, “at home” sleep study, polysomnography, monitoring devices

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10
Q

What is the primary problem with OSA?

A

Poor gas exchange and hypoxia d/t abnormal sleep pattern

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11
Q

If you suspect a partial obstruction of the airway what should be your first priority?

A

Call Rapid Response team to prevent a complete obstruction

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12
Q

Why is posterior nasal bleeding an emergency?

A

Because the bleed cannot be reached with anterior packing and the patient may lose a lot of blood

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13
Q

What education should we teach the patients after tube or packing removal s/p epistaxis?

A
  • Apply petroleum jelly sparingly to the nares for comfort.
  • Use saline nasal sprays after healing to add moisture and prevent rebleeding.
  • Avoid vigorous nose blowing, the use of aspirin or other NSAIDs, and strenuous activities such as heavy lifting for at least 1 month.
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14
Q

How is COVID-19 spread?

A

Via droplet transmission

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15
Q

When is the contagious period of the flu?

A

24 hours before sx and up to 5 days after they begin

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16
Q

Which antivirals may be prescribed for the tx of flu?

A

Amantadine, rimantadine, and ribavirin

17
Q

Antivirals must begin within what time frame in order to be effective?

A

24-48 hours

18
Q

DKA, seizures, respiratory problems, starvation, and kidney failure all cause which acid base imbalance?

19
Q

How do pancreatitis, dehydration, kidney and liver failure affect acid base imbalance?

A

underproduce bases → acidosis

20
Q

Can you have respiratory and metabolic acidosis at the same time?

A

Yes; patient with DKA and COPD

21
Q

If your patient is at risk for acidosis which system do you assess first and why?

A

Cardiovascular because of the hyperkalemia that can lead to cardiac arrest

22
Q

What MSK changes may be seen in acidosis d/t hyperkalemia?

A

Msl weakness and reduced DTR’s

23
Q

Changes in what system may be the first sign of acidosis?

A

cognitive like confusion

24
Q

Is cyanosis in the nail beds and mucous membranes and early or late finding of acidosis?

25
TPN, blood transfusions, and thiazide diuretics can cause acidosis or alkalosis?
Metabolic alkalosis
26
Two common electrolyte imbalances associated with alkalosis?
low K and Ca
27
What is the first treatment for a patient with metabolic acidosis?
fluids first then reassess before giving bicarb
28
What imbalance does a high anion gap indicate?
Metabolic acidosis
29
What does a low anion gap indicate?
lab error or Lithium meds
30
Under what conditions do we give bicarb first?
if pH less than 6.9/base deficit