Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

211 > TEST 2 > Flashcards

TEST 2 Flashcards

1
Q

What is the neurochemical control of ventilation?

A

Respiratory center
Central and peripheral chemoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the mechanics of breathing?

A

Major and accessory muscles
Lung elasticity
AIrway resistance
Alveolar surface tension
Work of breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Gas Transport for breathing

A

Distribution of ventilation and perfusion
Oxygen transport
Carbon dioxide transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is control of pulmonary circulation

A

Distribution of pulmonary blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is negative pressure breathing

A

Air moves from higher pressure to lower pressure

During inspiration: Diaphram and intercostal muscles contract expanding lungs. This creates an increase in volume and a decrease in pressure causing outside air to flow in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypoxemia

A

Low levels of 02 in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypoxia

A

Decreased tissue oxygenation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How many liters can a nasal cannula give

A

2-6L
After 4 make sure it is humidified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many liters can a simple face mask give?

A

6-10L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How many liters can a non-rebreather give?

A

10-15L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

**

Difference between a partial and full non-rebreather?

A

Partial - No one-way valves, allows patient to rebreathe some exhaled air which mixed with fresh oxygen, typically delivers 40-70% oxygen

**Non-rebreather **- one-way valves which prevent patient from inhaling exhaled air, delivering only fresh oxygen 60-100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a venturi mask?
O2 concentration ranging from?
Which allows?

A

Adjustable oxygen concentration - typically ranging from 24-60%
Mixes fresh 02 with room air in precise ratios allowing for accurate control of Fio2**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CPAP
Continuous Positive Airway Pressure

*primarily used for?

A

Provides 1 continuous pressure level into airway to keep it open during inspiration and expiration / Patient must be able to breathe independently

*Primarily used for Sleep apnea
**Goal is to prevent airway collapse and maintain regular breathing patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BiPap
Bilevel Positive Airway Pressure
*commonly used for?

A

2 levels of pressure - one for inhalation and a lower pressure for exhalation
The pressure changes between inhalation and exhalation

*Commonly used for COPD, central sleep apnea or resp failure

**Goal to assist both with inhaling more effectively and reducing effort required to exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define Ventilator Modes

A

How many breathes are delivered to the patient.

Many different modes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A/C Assist Control or CMV Continuous mandatory ventilation

A

Delivers a preset tidal volume or pressure at a preset rate of respirations
Every breath is the preset volume whether initiated by patient or machine

*pts who need total assistance from vent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SIMV
Synchronized intermittent mandatory ventilation

A

Delivers preset tidal and # of breaths per min
Patient can also breath spontaneously with no assistance from vent

*Pt doesnt need as much assistance from ventilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In what ways can a patient be weaned off ventilator?

A

CPAP
SIMV - rate slowly decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tidal volume
Vents give?

A

Amount of air delivered with each breath

Vents 10-15Ml/kg of body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fi02

A

Fraction of inspirated oxygen concentration / % of oxygen delivered to pt

Normal 21% / on vent close to 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PEEP

A

Positive End Expiratory Pressure

Like keeping a small amount of air in lungs to prevent them from collapsing after breathing out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pneumothorax
What to do?
Open-
Closed-

A

OPEN - Cover it immediately w/ occulsive dressing go to surgery or chest tube insertion
CLOSED - CHEST TUBE!
-Chest tubes are removed when lung is expanded (2-10days) or fluid is removed (3-4 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hemothorax

A

Blood accumulation between chest wall and lung; often associated with pneumothorax

Same treatment as pneumothorax - maybe surgery to control bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Empyema?

S/S
Treatment

A

Pus collected in pleural space

*Fever, chest pain, cough, SOB
Chest tube, surgery, antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Steps for chest tube removal?
Tell pt to take deep breath IN and bear down slightly on inspiration. so no air enters the pleural space
26
Hemopneumothorax
Both blood and air in chest cavity
27
Open pneumothorax
wound is large enough to allow air to pass freely in and out of thoracic cavity with each attempted respiration. **"Sucking chest wounds"** *Lungs collapse, heart and vessels shift toward noninjured side with each inspiration and opposite side with each expiration **"mediastinal flutter or swing"** causes major circulatory problems
28
Nursing assessment of pneumothorax
**Simple** - Trachea midline, expansion of chest is decreased, breath sounds diminished, percussion may reveal normal or hyperresonance **Tension** - trachea is shifted away from affected side, Chest expansion increased or decreased, breath sounds diminished, percussion on affected side is hyperresonant
29
Small chest tube is inserted where? Large? Suction?
**Small** - 28 french, 2nd intercostal space **Large** - 32 french, 4th or 5th intercostal at midaxillary line **Suction** - 20mmHg
30
When is a thoracotomy performed?
If more than 1500 ML blood aspirated by thoracentesis or chest tube output is greater than 200mL/H
31
ARDS classification MILD MODERATE SEVERE
**Mild** - Pa02/FIO2 >200mmHg but <=300nnHg **Moderate** - Pa02/FIO2 - >100mmHg but <=200mmHg **Severe** = Pa02/FIO2 - <=100mmHg
32
BNP level is helpful in distinguishing ARDS from
Cardiogenic pulmonary edema
33
What could be some causes of ARDS?
Trauma Pulm infection Prolonged cardiopulmonary bypass Shock Fat emboli Sepsis
34
What are ABGS for ARDS
Decreased P02 increased dyspnea *pt not getting better even with higher FIO2
35
If the rhythm starts with a P wave then its?
Sinus
36
Inappropriate sinus tachycardia?
Enhanced automaticity of SA node or excessive sympathetic tone with reduces parasympathetic tone that is out of porportion to physiologic demands
37
What is POTS Postural Orthostatic Tachycardia Syndrome
Tachycardia without hypotension and by presyncopal symptoms such as palpitations, lightheadedness, weakness and blurred vision that occur with sudden postural changes
38
AFIB Classification Paroxysmal
Sudden onset w/ termination that occurs spontaneously or after treatment Last less than 7 days but may reoccur
39
**AFIB Classification** Persistent Long-standing persistent Permanent Nonvalvular
**Persistent** - Lasting more than 7 days **Long-standing persistent ** - Lasting more than 12 mo **Permanent** - Persistent, but decision made not to restore sinus rhythm **Nonvalvular**- Absence of mod-severe mitral stenosis or mechanical heart valve
40
**Preload** Define Increased in:
Amount of blood remaining in ventricles at end of diastole. *degree of stretch the heart muscle fibers at end of diastole **Increased in**: hypervolemia, regurgitation of cardiac valves, heart failure
41
**Afterload** Define Increased in
Resistance or pressure that the heart muscle must overcome to eject blood from ventricles during systole (contraction) *The force that the ventricles need to generate to push blood into circulation **Increased in:** Hypertension, vasoconstriction
42
Contractility Factors affecting?
Intrinsic ability of the heart muscle to contract, independent of preload and afterload **Factors affecting:** Symoathetic nervous system, Inotropic agents, Oxygen supply
43
How much 02 does the myocardium need?
70-75% of what is delivered by coronary arteries
44
Echocardiogram
Apical 4 chamber view / front of heart Visualizes structure, looks at valves and can get ejection fraction
45
ETT
More invasive than echocardiogram Looks at back of heart
46
Stress test What are they looking for? What do they give?
CAD Thallium - it does not enter infarcted or scared areas
47
CBK Troponin
biomarker to diagnose heart damage **CPK** - Elevated, suggest cardiac muscle damage. Rise 4-6hrs after & return to normal 48-72hrs **Troponin** - Proteins specific to cardiac muscle. Elevate when injury or stress to heart. Rise within 3-4 hours and may remain elevated 1-2weeks CPK can also be found in skeletal muscles and brain and troponin is highly specific to heart.
48
In cardioversion what wave are we trying to synchronize?
R wave
49
What is CABG?
Surgical procedure taking a blood vessel from another part of the body (leg or chest) and grafting it to bypass the blocked coronary artery
50
Colladeral circulation
as we age we develop 'Shunts" away from the blockage in heart to continue to get blood flow Not in younger patients
51
What would we ask in patients with heart issues? P Q R S T
P - What were they doing? Q - How does it feel? R - Where does pain go S - 1-10 T- How long has this been going on?
52
Unstable angina
The patient has clinical manifestations of coronary ischemia but ECG and biomarkers show no evidence of MI
53
STEMI
ECG evidence of acute MI with characteristics changes in two contiguous leads on a 12 lead ECG. There is significant damage to myocardium
54
NSTEMI
Elevated cardiac biomarkers but no definite ECG evidence of acute MT. May be less damage
55
What does it mean when ECG shows inverted T wave
ISCHEMIA
56
INJURY
57
INFARCTION
58
Acute inferior MI
59
How much Aspirin would you give if a pt comes in for MI
325mg
60
What is happening in the P wave? QRS? T?
P wave - atrial depolarization / Atrial contraction QRS - Ventricle depolariztion / ventricle contraction T - Ventricle repolarization /
61
Difference between synchronized cardioversion vs defibrillation?
**Synchronized** - hit on R wave, Done when they have a pulse Afib, pSVT, Vtach, --less life threatening confitions **Defibrillation** - Delivered immediately without syndronizing to hearts rhythm Life threatening arrhythmias that can lead to sudden cardiac arrest Vent fib, Pulseless vent tach, Torsades de pointes
62
what do hormones do?
Fluid and electrolyte balance Host defenses Response to injury and stress Energy metabolism Growth and development Reproduction
63
Hormones are apart of what system
Endocrine
64
What is antidiuretic hormone? Aka vasopressin
Produced by hypothalamus and released by post pit **Role**: Regulating water balance / retain fluids Maintainin blood pressure, fluid balance, blood volume
65
What two disorders happen from issues with ADH?
Diabetes insipidus Syndrome of inappropriate antidiuretic hormone secretion
66
What is the process of SIADH to water intox?
ADH elevated Kidneys retain water / plasma volume expands BP rises Body sodium diluted Water intox!
67
Differences between ICP and Shock
**ICP** BP -up PULSE - down RESP - down **SHOCK** BP -down PULSE -up RESP- up
68
What is occipital lobe responsible for?
Analyzes visual input Helps recognize objects, faces, written Depth perception Stores info and helps with recognition
69
What is Temporal lobe responsible for?
**Process sounds** - speech, music, environmental noise **Language comprehension **- Wernickes area (understanding spoken/written) **Memory formation **- **Emotional processing** **Recognition** - faces, objects, scenes, visual memory
70
What is frontal lobe responsible for?
Decision making, problem solving, planning, reasoning, judgement Motor control Speech production - Broca's area (speech production) Personality Attention/focus Short term memory functions
71
What is parietal lobe responsible for?
sensory perception (touch, temp, pain, pressure) Depth perception, hand-eye Sense of body position and mvmt Mathematical and analytical skills Language processing
72
Autoregulation
brains ability to change the diameter of its blood vesssels to maintain constant cerebral blood flow during alterations in systemic blood pressure
73
EPIDURAL - above dura mater, between skull and dura mater
74
SUBDURAL - Between dura mater and brain
75
What does CSF do?
Acts as shock absorber to brain and spinal cord Bathes neurons Decreases when brain tissue or blood flow increases to compensate
76
What % of brain is CSF Intravascular blood Brain tissue
CSF - 10% Intravascular blood - 12% Brain tissue - 78% Any increase is ICP
77
Super ventricular Epidural Subdural
**Super ventricular** - nost accurate, highest rate of infection **Epidural** - least invasive, least accurate **Subdural** - Decreased accuracy at high pressures
78
What is formular for CPP? Ideal number?> No autoregulation between?
Cerebral perfusion pressure = MAP-ICP Ideally 70-80 We dont get autoregulation when ICP falls below 50 or above 150
79
What is Cushings triad?
Icreased in BP Bradycardia irregular Respiratory +Some add Wide pulse pressure *this is a LATE sign
80
What is Decorticate posturing Decerebrate Pressure where?
**Decorticate** - pressure on cortical structures. Towards core **Decerebrate** - Pressure on cerebellum. at sides
81
If someone has complete spinal cord damage what are symptoms?
Total loss of motor, sensory and reflex activity below area of damage
82
Relay activity
Signal goes up spinal cord, information is processed and impulses down decending tracts to signal movement
83
RESPIRATORY IMPAIRMENT in spinal injuries
Injury at or above C5 may result in instant death Below C4 spare diaphragm but can involve impairment of intercostal and abdominal muscles
84
Spinal Shock
Temporary - sympathetic function impaired. Parasympathetic take over Hypoxia, hypotension, bradycardia, temp flucations Vasodilation, venous pooling, decreased C/o, loss of reflexes and sensation *Could mask the extent of injury. This is caused by swelling. **Sign its over:** get reflexes back
85
Side effects of Nitro
Headache, Flushing, dizziness Postural hypotension, tachycardia, collapse, palpitations Nausea, vomit, Pallor, sweating, rash NEVER TAKE WITH VIAGRA
86
GCS - What does score mean? 15 9-12 8 3
15 - Good 9-12 - Maybe hospitalization, freq orientation 8 = intubate and ventilation 3 = Severe TBI. Must be kept artificially alive

211 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions