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Flashcards in Respiratory Emergencies Deck (33)
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1
Q

What are two potential causes of cardiogenic pulmonary edema?

A

Myocardial infarction and congestive heart failure

2
Q

Permanent abnormal enlargement of the air spaces distal to the terminal bronchioles and associated destructive changes of the alveolar wall is known as what respiratory illness?

A

Emphysema

3
Q

The presence of a barrel chest and clubbing of the fingers is suggestive of what respiratory condition?

A

Chronic obstructive pulmonary disease (COPD)

4
Q

The classic signs and symptoms of fever, sputum production, productive cough, dyspnea, tachycardia and pleuritic chest pain are indicative of what respiratory illness?

A

Pneumonia

5
Q

What is the most definitive diagnostic tool in asthma?

A

Peak flow

6
Q

What is Ipratropium bromide (Atrovent) and why is it given with beta2 agonists?

A

Anticholinergic used to reverse cholinergically mediated bronchospasm, blocks vagal tone to larger airways, dries secretions and when given with beta2 agonists, provides additive effects

7
Q

Male smokers in their twenties with tall stature are at greatest risk for what pulmonary emergency?

A

Primary spontaneous pneumothorax

8
Q

What are normal arterial blood gas values?

A

pH 7.35-7.45, PaO2 80-100 mmHg, PaCO2 35-45 mmHg, HCO3- 22-26 mEq/L

9
Q

What are the accepted arterial blood gas values indicative of acute respiratory failure?

A

PaO2 less than 60 mmHg and PaCO2 greater than 50 mmHg and arterial pH less than 7.30 on room air

10
Q

Interpret the following arterial blood gas and provide a cause: pH 7.28, PaO2 88 mmHg, PaCO2 51 mmHg, HCO3- 24 mEq/L

A

Acute uncompensated respiratory acidosis potentially from hypoventilation secondary to drug ingestion, COPD, pulmonary edema, respiratory arrest

11
Q

Interpret the following arterial blood gas and provide a cause: pH 7.49, PaO2 98 mmHg, PaCO2 20 mmHg, HCO3- 24 mEq/L

A

Acute uncompensated respiratory alkalosis potentially from hyperventilation, CNS infection/trauma, carbon monoxide poisoning

12
Q

What are the clinical manifestations of asthma?

A

Dyspnea, cough, wheezing, prolonged expiratory time, reduced peak flow

13
Q

What mechanical ventilator settings are frequently adjusted specifically for the treatment of adult respiratory distress syndrome (ARDS)?

A

Incrementally elevated levels of positive end expiratory pressure (PEEP), inversion of inspiratory/expiratory (I:E) ratio, limited peak inspiratory pressures (PIP), reduced tidal volume delivery

14
Q

A patient presents with an elevated end tidal CO2 what should the critical care paramedic consider as a cause?

A

Any condition that elevates carbon dioxide, decreases alveolar ventilation, or equipment malfunction

15
Q

Corticosteroids work on what portion of the asthma cascade?

A

Inflammation and edema

16
Q

What is the most recognizable and reversible cause of hypoventilation?

A

Foreign body airway obstruction

17
Q

If the chronic bronchitis patient produces more sputum then they are able to eliminate, what adventitious lung sound will be auscultated?

A

Rhonchi

18
Q

Pulmonary edema is a direct result of failure of which heart chamber?

A

Left ventricle

19
Q

COPD patients that breathe with pursed lips are essentially mimicking what mechanical ventilator setting?

A

Positive end expiratory pressure (PEEP)

20
Q

What type of medication is primarily used for the treatment of pneumonia?

A

Antibiotics

21
Q

What are the classic early signs of asthma?

A

Dyspnea, expiratory wheezing, cough, tachycardia, and chest tightness

22
Q

What should be evaluated when assessing a patient with a respiratory complaint?

A

Level of consciousness, pallor, cyanosis, vital signs, breath sounds and work of breathing to include nasal flaring, grunting, accessory muscle use

23
Q

In what instance would fluctuations in pulse oximetry, capnography, and auscultation of lung sounds be minimal with pneumothorax?

A

When the degree of lung collapse is minimal

24
Q

Interpret the following arterial blood gas and provide a cause: pH 7.58, PaO2 92 mmHg, PaCO2 33 mmHg, HCO3- 30 mEq/L

A

Acute uncompensated metabolic alkalosis potentially from severe vomiting, diarrhea, gastric suction, diuretics

25
Q

What is the purpose of administration of magnesium sulfate in patients with acute bronchospasm?

A

Bronchial smooth muscle relaxation

26
Q

Interpret the following arterial blood gas and provide a cause: pH 7.14, PaO2 89 mmHg, PaCO2 35 mmHg, HCO3- 16 mEq/L

A

Acute uncompensated metabolic acidosis potentially from diabetic ketoacidosis, renal failure, lactic acidosis

27
Q

What are the ominous signs of the need to intubate?

A

Near exhaustion, lethargy, somulence, apnea, shallow or irregular respirations; limited air movement (decreased tidal volume)

28
Q

What is the next course of action in the respiratory distress patient that does not respond to oxygen delivery and pharmacology?

A

Intubation and mechanical ventilation

29
Q

What are the six causes of oxygenation failure resulting in hypoxemia?

A

Hypoventilation, ventilation/perfusion mismatch, intrapulmonary shunting, cardiogenic shock, diffusion defects, and low FiO2

30
Q

Why are beta2 agonists beneficial in asthma?

A

Relaxation of bronchial smooth muscle, inhibition of chemical mediator response, and promotion of mucociliary clearance

31
Q

Pulmonary emboli results in hypoxemia through what mechanism?

A

Ventilation/perfusion mismatch

32
Q

What medications are commonly used in the treatment of pulmonary embolus?

A

Heparin. Also LMWH (e.g. Lovenox) and warfarin. Fibrinolytic therapy may be used in critically ill patients with acute PE.

33
Q

A pulse oximetry of 90% correlates with an approximate arterial oxygenation level of?

A

PaO2 60mmHg