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Flashcards in Respiratory Emergencies Deck (99):
1

Lungs fail to work

Carbon Dioxide accumulates in the blood. Co2 combines with water to form hydrogen ions. Resulting in acidosis.

2

Impaired Bentilation Causes

Upper Airway Obstruction- foreign body, infection, trauma
Lower Airway Obstruction- disease, mucus, edema
Chest Wall Impairment- flail chest, pneumonia, restrictive (scoliosis)
Neuromuscular Impairment- Lou Gehrig disease, OD

3

Guillain Barre Syndrome

Progressive muscle weakness and paralysis move from the feet up.

4

Pickwickian Syndrome

Obesity hypoventilation syndrome

5

Serious injury to the spinal cord above _____ may...

above C5 may block the nerve impulses that stimulate breathing

6

Botulism

Rare.
Acquired by giving infants raw honey.
Can cause muscle paralysis and ultimately hinder breathing

7

Alcohol, Narcotics and Opiates

Reduce the respiratory drive

8

Hyperventilation

Creates alkolosis

9

Hypoventilation

Creates acidosis

10

Respiratory Alkolosis

Cause numbness and tingling in the hands, feet and mouth

11

Carpopedal Spasm

Hands and feet clinch like a claw due to hyperventilation

12

Why breathing into bag is bad

1) rebreathing too much carbon dioxide can cause hypoxia
2) may be compensatory and does not need to be fixed

13

Causes for hyperventilation

Stressor such as a family fight, or bad news.

14

Psychological Support for hyperventilation

Breathing with the patient
Count to two between breaths
Talk to the patient
Sing a song

15

Turbinates

Highly vascular
Mucus covered that traps particulate matter
Large surface area allows air to be warmed and humidified

16

Angiodema

Vascular reaction characterized by swelling of eyes, lips, rounded and mouth

17

Hypopharynx

Where Oro and nasopharynx meets
Gag reflex
Vagus nerve

18

Larynx

Voice box

19

Glottis

Vocal cords

20

Arytenoid cartilage

Two pearly white lumps at distal end of vocal cords

21

Pyriform Fossa

Pockets of tissue on sides of glottis

22

Cilia

Small hairlike structures that wave in a pattern to move particulate matter up and out of the airway

23

Block Spots in lungs

Food or objects that were inhaled and become permanently lodged within lung

24

Goblet cells

Line the irways
Produce mucus that blankets lining of airway

25

Gas Exchange

Process by which deoxygenated blood from the pulmonary circulation releases carbon dioxide and is resupplied with oxygen before entering cardiac circulation

26

Alveolar Cell Types I and II

Type 1- (pneumocystis) are empty and allow for better gas exchange
Type 2-make new type 1 cells and produce surfactant

27

Surfactant

Reduces surface tension and helps keep alveoli expanded

28

Shunt

Collapsed alveoli do not participate in gas exchange. Blood from right side of heart bypasses alveoli and returns to left side unoxygenated resulting in hypoxemia.

29

Polycythemia

Thick blood
COPD patients generate a surplus of RBC's that cause strain on right side of heart due to the blood trying to push through tiny capillaries

30

Cor Pulmonale

Right sided heart failure because of chronic lung disease

31

Dead Space

Left over gas in airway. (1ml of dead space per pound)

32

Restrictive Lung Diseas

E.g kiphosis, loridosis, scoliosis
Limits air movement

33

Respiration

Oxygen is taken into the body, distributed to the cells, and used by cells to make energy

34

Ventilation

Movement of air in and out of the lungs

35

Diffusion

Movement of oxygen from interstitial to alveoli for use

36

Perfusion

Circulatory component of respiratory system

37

Hearing Breuer Reflex

Regulates depth of inspiration to not overinflated the lungs

38

Negative Pressure

Air sucked into lungs and then pushed out

39

Exhalation

Passive process

40

Sternum Rib retrations

Often present in children and infants causing bony retrations

41

Wheezing

High pitched whistling made by air forced through narrow airway (asthma, CHF, or foreign body)

42

Crackles

Popping open of alveoli and caused by increased fluid in the lungs

43

Rales

High pitched crackles

44

Rhonchi

Low pitched crackles

45

Stridor

Airway obstruction

46

Blood tinged sputum

Tuberculosis or small airway vessel rupture from excessive coughing

47

Purulent

Pus like fluid

48

Sputum Color Meaning

Frothy, pink- CHF
Thick- dehydration
Purulent- infection
Yellow, green, brown- old secretions
Clear or white- bronchitis
Blood streaked- tumor, tuberculosis, pulmonary edema, trauma from coughing

49

Agonal Breathing

Irregular gasps widely spaced. Not actual breathing

50

Apneuistic Breathing

Prolonged inspiratory "fish breathing"
Indicitave of severe damage to the brain

51

Ataxic Breathing

Chaotically irregular indicate severe brain injury

52

Biot Respirations

Irregular pattern, rate and depth with patterns of apnea
Indicates brain injury or herniation

53

Cheyenne-Stokes Respirations

Crescendo-decrescendo with period of apnea inbetween
Indicates brain injury

54

Eupnea

Normal breathing

55

Hyperpnea

Increased rate and death of breathing (overdose)

56

Hypopnea

Decreased rate and death

57

Kussmaul

Deep respirations
Caused by body's attempt to rid body of metabolic acidosis
Seen with DKA patients
Accompanied

58

Cerebellum Injury

Hyperpnea
Cheyenne Stokes
Apnea

59

Brain stem Injury

Apneuistic
Biot
Ataxic
Agonal

60

Anitussive

Suppresses cough.
Can be bad because coughing naturally clears secretions from the airway

61

Pulse Oximetry

Measures percentage of hemoglobin that has oxygen attached to it
Keep saturation abover 93% saturation

62

Capnography ROCS

Increase in 10 to 35 mmHg

63

Aerosol Therapy

Delivers liquid medications by smaller particles to facilitate the delivery of medication into the lower airway at 6lpm
Larger particles may be formed at lower oxygen setting and won't reach the lower airway

64

Aerosol for burns and croup

Can greatly humidify and "cool" the airway of a burn patient with aerosoling normal saline

65

Spacer

Collects medication and allows higher concentration of medication to be delivered and will lose less to the environement

66

Oxygen in Body

97% bound to hemoglobin and 3% bound in plasma

67

Orthopnea

Difficulty breathing laying down

68

CPAP

Contraindications are hypotension (increase thoracic pressure decreasing perload)
AMS
Vomiting

69

Settings CPAP

5 to 15cm of water and 5 to 10lpm of oxygen

70

Poiseuille's Law

The diameter of a tube decreases, resistance to flow decrease exponentially

71

Laryngotracheobronchitis

EXAMPLE is croup
Inflammation of larynx, trachea, and bronchi

72

Upper Airway Inflammation

Croup
Epiglottitis
Peritonsillar Abscess
Diphtheria
Enlarged Tonsils

73

Croup

Usually between 6months to 3 years
Barking or seal cough
May be caused by laryngotracheobronchitis

74

Epiglottitis

Inflammation of epiglottitis usually by infection
Sore throat, fever, hoarseness, and hyper extension of the neck

75

Aspiration

Inhalation of anything other than air
Can cause pnuemoitis and pneumonia
Aspiration of stomach contents increase mortality significantly

76

Obstructive Lower Airway Disease

*Asthma*
Findings include pursed lips, increased I/E ratio, abdominal muscle use, and JVD.

77

Asthma

Increased reactivity of the trachea and bronchi to a variety of stimuli
TRIANGLE of Asthma *edema, bronchospasm, and mucus production*

78

Status Asthmaticus

Severe, prolonged asthmatic attack that cannot be stopped with traditional treatment

79

Bronchospasm

Caused by constriction of the smooth muscle that surrounds larger bronchi in the lungs
-can occur from allergen, dust, perfume, animal dander, or change in temperatures-

80

Bronchial Edema

Swelling of bronchial and bronchi
Creates turbulent air flow, wheezing, and air trapping
(Corticosteroids)

81

Mucus Production

Thick secretions may plug distal airway and contibute air trapping

82

COPD

Empheseyma and Chronic Bronchitits
When the tracheobronchial tree becomes so weak it collapses

83

Chronic Bronchitis

Sputum production most days of month for 3 or more months out of the year for more than 2 years
Chronic and reoccurrence cough
Almost always a smoker

84

Assessment of Chronic Bronchitis

Crackles, Edema, infections, sputum production

85

Hypoxia Drive

Body stimulates breathing from a decrease in partial prsssure of oxygen

86

Atelactisis

When alveoli completely collapse eventually including entire lung segments

87

Lung Cancer

Tumors in large airways causing hemoptysis
Common site for metastasis (cancer formation from other sites)

88

Pulmonary Edema

Fluid build up in lung tissue
Assessment revealed rales or rhonchi

89

ARDS (Acute Respiratory Distress Syndrome)

Shock lung, Da Nang lung, hyaline membrane in neonates

90

Pneumothorax

Air collects between visceral and parietal pleura

91

Bleb

Weak spot in the lung causing spontaneous pneumothorax
(Coughing or lifting)

92

Pleural Effusion

Fluid collects between visceral and parietal pleura

93

Pulmonary Embolism

Blood clot in the lungs
S1Q3T3 on ECG
SUDDEN dyspnea, cyanosis, sharp pain in chest

94

PE causes

Clot forms in the greater saphenous vein
Thrombophlebitis

95

Holman Sign for PE

Calf pain from thrombophlebitis

96

Greenfield Filter

Filter placed in placed with patients that have a history of DVT's that help trap clots or coagulated blood (basically a net)

97

Cape cyanosis

Deep cyanosis of the face, neck, chest and back despite good-quality CPR and ventilation with 100% oxygen

98

Cystic Fibrosis

Produce copious amounts of thick mucus in respiratory and digestive tracts

99

Pertussis

"Whooping Cough" contagious bacterial disease "the 100 day cough"
Can cause vomiting, hypoxia, conjuctivial hemmorage