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Year 2 Cardio > week 3 > Flashcards

week 3 Flashcards

1
Q

what is respiratory failure

A

respiratory failure occurs when the respiratory system fails top oxygenate arterial blood adequately (hypoxaemia) and consequently fails to provide the body with adequate amounts of oxygen (hypoxia) and/or the person fails to ventilate well enough to eliminate carbon dioxide

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2
Q

what is hypoxia

A

inability to provide oxygen to the tissues

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3
Q

what is hypoxaemia

A

lack of oxygen in arterial blood

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4
Q

How do we diagnose respiratory failure

A

take a sample of arterial blood and measure the partial pressure of O2 and CO2

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5
Q

what are the two main types of respiratory failure

A

type 1 and type 2

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6
Q

how long does it take for acute respiratory failure to develop

A

minutes to hours

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7
Q

whats an example of an acute respiratory failure

A

pneumonia

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8
Q

how long does chronic respiratory failure take to develop

A

over days

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9
Q

what is an example of chronic respiratory failure

A

COPD

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10
Q

what is type 1 respiratory failure

A

failure to maintain O2 levels in arterial blood
(hypoxaemia)

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11
Q

what is type 2 respiratory failure

A

failure of respiratory pump to ventilate adequately
(hypoxaemia and hypercapnia)

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12
Q

what is ischaemic hypoxaemia due to

A

inadequate blood flow through the lung

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13
Q

What is anaemic hypoxaemia

A

reduction in the carrying capacity of the blood e.g. anaemia/significant blood loss/sickle cell crisis

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14
Q

what is toxic hypoxaemia

A

difficulty utilising oxygen

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15
Q

what are some of the clinical signs of hypoxaemia

A

central cyanosis
peripheral shut down (cool to touch, cold and clammy)
tachypnoea
tachycardia
low oxygen saturations
confusion or agitation

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16
Q

Causes of type 2 respiratory failure

A

CNS depression/abnormalities with the respiratory drive centres
disorders of the spinal cord
abnormalities of the peripheral nerves
respiratory disease
neuromuscular disease
muscle weakness
loss of integrity of the chest wall/poor ventilatory mechanics

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17
Q

what can happen if patients with hypoxic drive are given large and unchecked amounts of additional oxygen

A

it can remove their drive to breathe

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18
Q

what is hypoxic drive

A

a condition associated with a small number of people with COPd and tends to be associated with more severe cases

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19
Q

what does CPAP stand for

A

continuous positive airway pressure

20
Q

what does CPAP do

A

delivers the same flow of gas throughout inspiration and expiration
increases functional residual capacity and primarily aimed at improving gas exchange and type 1 respiratory failure
splints open alveoli

21
Q

What does NIV stand for

A

non-invasive ventilation

22
Q

what does NIV do?

A

blows air into the lungs, via a nasal mask or a face mask, to ensure that the breathing remains supported and to prevent under-breathing
The NIV machine will recognise that the person using it has started to breathe in and assists with each breath

23
Q

what are the acute effects of NIPPV

A

reduced PaCO2
increase alveolar ventilation
rest respiratory muscles
decrease load on the respiratory muscles

24
Q

what are the contraindications for NIV

A

life threatening hypoxaemia
haemodynamic instability
confusion or agitation
upper gastrointestinal surgery or bowel obstruction
barotrauma
inability to protect airway
risk of vomiting
excessive secretions
facial trauma
haemoptysis

25
Q

what are the advantages of NIV

A

non invasive
no sedation
can be ward managed
low cost
easy to withdraw
easy to manage at home
allows communication, mobility, sleep

26
Q

why is severe hypoxaemia potentially dangerous

A

because it causes tissue hypoxia with insufficient oxygen available to tissues to meet metabolic needs

27
Q

what does an increase in PaCo2 cause

A

respiratory acidosis

28
Q

what does a decrease in PaCO2 cause

A

respiratory alkalosis

29
Q

what are some potential causes of respiratory acidosis

A

hypoventilation
exhaustion
drugs
cardiac arrest

30
Q

what are some potential causes of a respiratory alkalosis

A

excess mechanical ventilation
acute hyperventilation
anxiety/pain
stroke
anaemia
meningitis
acute asthma
SAH
altitude fever

31
Q

what does an increase in HCO3 cause

A

metabolic alkalosis

32
Q

what does a reduction in HCO3 cause

A

metabolic acidosis

33
Q

what are some causes of metabolic alkalosis

A

volume depletion
diuretics
excess vomiting
burns

34
Q

what are the causes of metabolic acidosis

A

diabetic ketoacidosis
diarrhoea
renal failure

35
Q

what two organs compensate for one another to maintain a relatively constant pH

A

lungs and kidneys

36
Q

name some indications for oxygen therapy

A

hypoxaemia
acute care situations in which hypoxaemia is suspected
severe trauma
acute MI
short term therapy (post anaesthesia recovery)

37
Q

name some complications of oxygen therapy

A

oxygen toxicity
depression of ventilation
absorption atelectasis
fire hazard

38
Q

what is the amount of oxygen delivered dependent on

A

oxygen flow rate
patients inspiratory volume
respiratory rate

39
Q

what are the types of oxygen delivery methods?

A

nasal cannula
simple face mask
reservoir mask

40
Q

what are the advantages of a nasal cannula

A

easy to fix
keeps hands free
not much interference with further airway care
low cost
compliant

41
Q

what are the disadvantages with nasal cannula

A

unstable
easily dislodges
high flow uncomfortable
nasal trauma
mucosal irritation
FiO2 can be inaccurate and inconsistent

42
Q

what are the advantages of a simple face mask

A

moderate but variable FiO2
good for patients with blocked nasal passages and mouth breathers
easy to apply

43
Q

what are the disadvantages of a simple face mask

A

uncomfortable
interfere with further airway care
proper fitting is required
risk of aspiration in unconscious patient
rebreathing

44
Q

name the variable flow devices for prescribing oxygen

A

nasal cannula
face mask
reservoir mask/non rebreathe

45
Q

name the fixed flow devices for prescribing oxygen

A

venturi system via simple face mask or humidified system
nasal high flow

46
Q

what is the aim of oxygen therapy

A

to help manage type 1 respiratory failure

47
Q
A

Year 2 Cardio (10 decks)

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