week 5

Question 1

what is an anaesthetic

Answer 1

a drug to prevent patients from feeling pain and having any awareness during procedures

Question 2

how does general anaesthetic cause FRC to reduce?

Answer 2

impaired CNS regulation of breathing -> hypoventilation
loss of muscle tone and periodic sighing
patient position (supine)

Question 3

name some effects of major surgery on the respiratory system

Answer 3

immobility and drowsiness -> prevents normal oscillations in tidal volume -> decreased FRC
recumbency -> decreased FRC

Question 4

name some post-op pulmonary complications

Answer 4

atelectasis
hypoxaemia
chest infection/pneumonia

Question 5

what are some risk factors for post-op pulmonary complications

Answer 5

prolonged surgery
current smoker
presence of pre-op respiratory problems/disease
reduced level of pre-op activity/functional dependence
pain
anaemia
congestive heart failure
obstructive sleep apnoea

Question 6

what is a haemothorax

Answer 6

blood in the pleural space

Question 7

what is empyema

Answer 7

pus in the pleural space

Question 8

what is pneumothorax

Answer 8

air in the pleural space

Question 9

what respiratory complications can occur after general anaesthetic and/or major surgery

Answer 9

impairs mucociliary clearance and decrease cough efficacy
increased viscosity and volume of secretions
FRC is reduced
dependent lung collapse
atelectasis

Question 10

name some post pulmonary complications after cardiac surgery

Answer 10

atelectasis
respiratory infection
respiratory failure
pleural effusion
pneumothorax
bronchospasm
pneumonia
aspiration pneumonitis
acute respiratory distress syndrome
pulmonary embolus

Question 11

name some risk factors for developing postoperative pulmonary complications after cardiac surgery

Answer 11

chronic heart failure
increased BMI
increased age
long duration surgery
poor activity levels
poor nutrition
smoking habits

Question 12

what do you need to watch out for when mobilising/walking a post-operative patient

Answer 12

do you need assistance for drips/drains/catheter etc
does the patient require pain relief administering
check lower limb strength to ensure no motor block
check observations

Question 13

how are normal lung volumes maintained

Answer 13

by regular position changes, ambulating (moving about), sighing 9-10 times a day

Question 14

what is closing volume

Answer 14

a critical level during exhalation above residual volume where there is insufficient air in the lungs to maintain inflation and small airway collapse occurs during expiration

Question 15

what two diseases can impact closing volumes

Answer 15

emphysema and pulmonary fibrosis

Question 16

name some factors that affect lung volumes

Answer 16

body size
age
gender
respiratory disease

Question 17

what is inspiratory reserve volume

Answer 17

the total volume of air that can be inspired beyond a normal tidal inspiration volume

Question 18

what affects inspiratory reserve volume

Answer 18

anything that influences the ability of the thoracic cage to expand during inspiration

Question 19

what is functional residual capacity

Answer 19

the volume of air that remains in the lung after a normal tidal exhalation

Question 20

what can FRC be influenced by

Answer 20

body position