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Adult 2 Pulmonary Flashcards | StudBud
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Adult 2 Pulmonary
Adult 2 Pulmonary
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Answers
1
P/F ratio: Moderate (ARDS)
200-300
100-200
<100
2
Oxygenation Failure: What is impaired, what is normal, what is it called?
Dead Space (V>Q)
Shunt (V<Q)
Ventilation Normal
Perfusion Normal
Perfusion Impaired
Ventilation Impaired
3
Ventilatory Failure Causes:
Intra
pulmonary
Brain defect (medulla oblongata)
Collection of fluid, reducing diffusion (pulmonary edema, PNA, ARDS)
Chemical depression (Opioid, sedative)
Neuromuscular disorders (MG, GB, CVA)
Destructive lung disease (COPD)
Collapse of alveoli (pleural effusion, pnuemothorax)
4
V/Q Match is normal adequate gas exchange
True
False
5
Acute Respiratory Failure Causes:
Combined ventilatory and oxygenation failure
Oxygenation (gas exchange) failure
Ventilators
Ventilatory Failure
Weaning
Compliance
6
ARF diagnostic criteria:
ABG O2<60, CO2>45, pH<7.35
Chest X-ray white fluffy infiltrates (LL, uni or bilat)
Pulse Ox < 90%
Pulse Ox > 90%
Chest X-ray black dull infiltrates (UL, bilaterally)
ABG pH >7.45, CO2 <35, O2 >80
7
AMS, irritability, agitation, and confusion are the
first
cues of respiratory distress!!!
False
True
8
Combined Vent/O2 Failure: What is impaired, what is normal, what is it called?
Perfusion Impaired
Rhonchi
Silent Chest (V/=/Q)
Ventilation Normal
Perfusion Normal
Ventilation Impaired
9
ARDS
early
CV assessment shows bradycardia, weak pulses, hypotension
True
False
10
Vent mode: Full support, preset TV/RR, risk for hyperventilation-Resp Alkalosis
Assist-Control (AC)
Pressure Support
Synchronized intermittent mandatory ventilation (SIMV)
11
P/F ratio= PaO2/FiO2
True
False
12
Vent Mode: Spontaneous Breathing, no preset TV, preset pressure and PEEP, good for weaning
Assist Control (AC)
Pressure Support
Synchronized intermittent mandatory ventilation (SIMV)
13
Hypercapnic failure r/t alveolar hypoventilation causes hypoxemia (pH <7.35, PaCO2 >45)
False
True
14
Positive-Pressure Ventilation settings determined by:
Gas Delivery (Set TV or target pressure
Termination (of inspiration by set volume, pressure, time, or flow)
Trigger (inspiration by pt or is set)
15
Common causes of COMBINED ventilatory/oxygenation failure:
Cystic Fibrosis
Emphysema
Moderate obesity
Hang nail
Asthma attack
Chronic bronchitis
16
Oxygenation Failure Causes (aka gas exchange failure):
Hyperinflation of alveoli (causes compression of pulm vasculature)
Reduction of perfusion through pulmonary vessels
Increased perfusion through pulmonary vessels
17
Oxygenation Failure Common Causes:
Non-Pulmonary
Low Hemoglobin Level
Pulmonary Embolism
Low Cardiac Output
Hypovolemic Shock
18
Ventilation Failure: What is impaired, what is normal, what is it called?
Ventilation Normal
Dead Space (V>Q)
Perfusion Impaired
Ventilation Impaired
Perfusion Normal
Shunt (V<Q)
19
ARDS
late
CV assessment shows bradycardia, weak pulses, hypotension
False
True
20
Vent alarms: HIGH pressure
Cuff leak
Displaces, kinked, obstructed ETT
Mucus Plugs
Anxious, fighting vent
Pt stops breathing
Pneumothorax
21
Refractory hypoxemia: PaO2 does not improve despite supplemental O2
True
False
22
CO2 is 20x more diffusible than O2
True
False
23
Ventilatory Failure Causes:
Extra
pulmonary
Upper airway obstruction (asthma)
Chemical depression (opioid OD, sedatives, anesthetics)
Collapse of the alveoli (atelectasis)
Neuromuscular disorders (MG, GB, CVA)
Defect in resp control center in brain (medulla oblongata)
Chest wall rigidity/injury (OSA, morbid obesity)
24
ARDS is characterized by:
Refractory hypoxemia
Early Stage Resp Acidosis
Early Stage Resp Alkalosis
Late Stage Resp Alkalosis
Decreased lung compliance, increased lung recoil
Late Stage Resp Acidosis
25
Vent alarms: LOW pressure
Cuff leak
Disconnected circuit
Secretions or water build up
Pt stops breathing
Leak in tubing/circuit
Coughing, gagging, pain
26
ARDS triad:
Systemic inflammatory response (cytokine storm)
Permeable capillaries (large debris cross the ACM)
Pulmonary Edema (decreased lung compliance)
Localized inflammatory response (histamines)
27
Subcategories of pneumothorax include: open (traumatic), closed (blunt trauma), spontaneous + tension(mediastinal shift)
False
True
28
P/F ratio: Severe
200-300
<100
100-200
29
Acute lung injury:
Shock/Trauma
Drowning/aspiration
Burns, smoke inhalation
Multiple blood transfusions/any embolisms
COPD
Asthma
30
V/Q MISMATCH: Adequate gas exchange?
False
True
31
Oxygenation Failure Common Causes:
Pulmonary
High altitudes
Congestive Heart Failure
ARF, ARDS, Sepsis
Carbon Monoxide Poisoning
PNA, Flu, RSV, PE
Closed Spaces
32
Vent Mode: Set TV/RR (if pt does not breath, vent will set a pattern), can be used in vent or weaning mode
Pressure Support
Synchronized intermittent mandatory ventilation (SIMV)
Assist Control (AC)
33
P/F ratio: Mild (ARF)
200-300
<100
100-200
