Airway Flashcards
(153 cards)
1
Q
During a failed intubation, ______ is an acceptable alternative.
A
King LT, Combitube, LMA
2
Q
What two systems work together to ensure that constant supplies of oxygen and nutrients are delivered to every cell in the body and that carbon dioxide and other waste products are removed from every cell.
A
Respiratory
Cardiovascular
2
Q
To reduce the risk of aspiration from vomiting during neuromuscular blockage and tracheal intubation, you should:
A
perform a rapid sequence intubation
2
Q
The respiratory and cardiovascular systems work together to ensure that constant supplies of oxygen and nutrients are delivered to every cell in the body and that carbon dioxide and other waste products are removed from every cell. True or False
A
True
3
Q
Diffusion allows oxygen to transfer from the air into the:
A
Capillaries
3
Q
What is the relationship between the false vocal cords and the true vocal cords?
A
the true cords are inferior to the false cords
3
Q
In addition to observing the tube pass through the cords, observation of rise and fall of the chest, and auscultation of breath sounds, to verify correct tracheal tube placement, you should:
A
apply an end-tidal CO2 monitor
3
Q
You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?
A
tension pneumothorax to the left hemithorax
3
Q
You arrive on the scene and find a two-year-old patient sitting in his father’s lap. The child presents with a “seal-type bark” cough and appears to be in mild respiratory distress. The father states, “My son has been sick with a cold over the last few days but seems to get worse at night.”
In order to assess the child, you should:
Upon completing your initial assessment, you would immediately:
As you attempt to administer oxygen with a nonrebreather mask, the child becomes very agitated and begins to cry uncontrollably. Each time you apply the mask to the face of the child, he becomes very upset and cries. You should:
The child becomes increasingly more agitated as you continue with your treatment. The father continuously attempts to calm the child with no success. This may be an indication that the child is:
The condition this child is suffering from is most likely:
A
leave the child in the father’s lap and perform the assessment
Apply humidified oxygen via a nonrebreather mask
with the child in the father’s lap, have the father hold the nonrebreather mask near the child’s face
becoming more hypoxic
tracheolaryngobronchitis
3
Q
To prevent hypoxia from occurring during intubation attempts, each attempt should be limited to:
A
30 seconds
3
Q
Internal respiration is the exchange of gases between the ______ and the ______.
a. bronchiole, alveoli
b. blood cells, tissues
c. lungs, blood cells
d. pharynx, lungs
A
b. blood cells, tissues
3
Q
Diffusion allows oxygen to transfer from the air into the capillaries.
A
3
Q
The functions of the upper airway include:
A
warming
filtering
humidification of inhaled air
4
Q
Pulmonary gas exchange takes place at the:
A
alveolar level in the lungs
4
Q
You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?
A
tension pneumothorax to the left hemithorax
4
Q
The esophageal detector device is used for:
A
endotracheal tube placement
4
Q
The mechanics of inspiration is a(n):
A
active process due to contraction of the respiratory muscles
4
Q
When administering epinephrine for a respiratory emergency, which of the following properties would produce the most desirable effect?
A
beta 2
5
Q
Where does the upper airway begin?
A
Above the vocal cords
5
Q
Pulmonary gas exchange takes place at the:
A
alveolar level in the lungs
5
Q
The terminal end and the functional units of the lower airway are the:
A
alveolar sacs
6
Q
Jugular vein engorgement that occurs during inspiration is referred to as:
A
Kussmaul’s sign
7
Q
The upper airway consists of all structures above the vocal cords. There are the:
A
larynx
oropharynx
nasopharynx
tongue
7
Q
You encounter a patient suffering from a significant pneumothorax. You would expect a(n) _________ PaO2 and a(n) _________ PaCO2.
A
decreased, increased
7
The upper airway consists of all structures above the vocal cords. There are the:
larynx
oropharynx
nasopharynx
tongue
8
The tongue is a large muscle that is attached to the mandible and the:
hyoid bone
8
You encounter a patient suffering from a significant pneumothorax. You would expect a(n) _________ PaO2 and a(n) _________ PaCO2.
decreased, increased
9
Rapid sequence induction would be a helpful adjunct for advanced airway management for which type of patient?
21-year-old combative male with severe head injuries
9
You arrive on the scene and find a two-year-old patient sitting in his father’s lap. The child presents with a “seal-type bark” cough and appears to be in mild respiratory distress. The father states, “My son has been sick with a cold over the last few days but seems to get worse at night.”
In order to assess the child, you should:
leave the child in the father’s lap and perform the assessment
10
You are treating a 40-pound-child and medical direction has requested that you administer a bolus of lidocaine for a cardiac dysrhythmia, followed by an infusion. Which dose of lidocaine should this patient receive?
18 milligrams IV push followed by 360 mcg/minute infusion
10
Rapid sequence induction would be a helpful adjunct for advanced airway management for which type of patient?
21-year-old combative male with severe head injuries
11
When assessing a 14-month-old, you would consider which of the following respiratory rates to be within the normal rate range for this patient?
20-30 breaths per minute
11
You are treating a 40-pound-child and medical direction has requested that you administer a bolus of lidocaine for a cardiac dysrhythmia, followed by an infusion. Which dose of lidocaine should this patient receive?
18 milligrams IV push followed by 360 mcg/minute infusion
12
Upon identification of the sonorous sounds in the patient, you should immediately:
perform a head-tilt chin-lift maneuver to open the airway
12
When assessing a 14-month-old, you would consider which of the following respiratory rates to be within the normal rate range for this patient?
20-30 breaths per minute
13
Indication of terminal bronchiole and alveolar atelectasis in the neonate may be evident clinically by:
grunting on exhalation
13
Upon identification of the sonorous sounds in the patient, you should immediately:
perform a head-tilt chin-lift maneuver to open the airway
14
You find an unresponsive and apneic patient in a local restaurant. You attempt to ventilate and are unable to move any air. You should immediately:
perform a laryngoscopy and remove the object with Magill forceps
14
Indication of terminal bronchiole and alveolar atelectasis in the neonate may be evident clinically by:
grunting on exhalation
15
An acute bronchial rupture should be suspected in the field when:
a tension pneumothorax does not respond to chest decompression
15
You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?
Your treatment for the patient in sequence of priority would include:
After you have successfully carried out your treatment, the patient continues to deteriorate and the signs and symptoms remain the same and begin to worsen. You have performed all the procedures correctly. At this point you suspect the patient may be suffering from:
tension pneumothorax to the left hemithorax
1. assist ventilation with supplemental oxygen attached to the ventilation device
2. needle decompression of the left thorax
a rupture of the left bronchus
15
You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
After you have successfully carried out your treatment, the patient continues to deteriorate and the signs and symptoms remain the same and begin to worsen. You have performed all the procedures correctly. At this point you suspect the patient may be suffering from:
a rupture of the left bronchus
16
The lower airway consists of all structures below the vocal cords and consist of the:
trachea
mainstem bronchi
bronchioles
pulmonary capillaries
alveoli.
16
An acute bronchial rupture should be suspected in the field when:
a tension pneumothorax does not respond to chest decompression
17
After successfully placing the endotracheal tube, you should secure the tube in place by:
applying a commercial tracheal tube holder
17
You arrive on the scene and find a patient experiencing hyperventilation syndrome due to an emotionally charged situation. You would expect this patient to initially be in:
respiratory alkalosis
17
You arrive on the scene at the local bar and find a 22-year-old female patient who is agitated and confused. Her airway is open and she is breathing. Her blood pressure is 240/180 mmHg. Her radial pulse is present and bounding and the respiratory rate is 32 breaths per minute. Her blood glucose reading is 82 mg/dl. Her skin is slightly pale, cool, and clammy. Her pupils are equal and reactive but sluggish to respond to light. The pulse oximeter reading is 86%. The monitor shows a sinus tachycardia at 128 bpm. Your priority treatment for this patient should be:
administration of oxygen via a nonrebreather mask
17
You arrive on the scene at the local bar and find a 22-year-old female patient who is agitated and confused. Her airway is open and she is breathing. Her blood pressure is 240/180 mmHg. Her radial pulse is present and bounding and the respiratory rate is 32 breaths per minute. Her blood glucose reading is 82 mg/dl. Her skin is slightly pale, cool, and clammy. Her pupils are equal and reactive but sluggish to respond to light. The pulse oximeter reading is 86%. The monitor shows a sinus tachycardia at 128 bpm. Your priority treatment for this patient should be:
administration of oxygen via a nonrebreather mask
18
Your 5-year-old patient appears acutely ill. He is sitting in a tripod position, is leaning forward, and is drooling. He has dyspnea and a loud inspiratory stridor. His mother reports that he was relatively fine this morning, but he now has a temperature of 104 degrees. You suspect that this child is suffering from:
epiglottitis
18
You arrive on the scene and find a patient experiencing hyperventilation syndrome due to an emotionally charged situation. You would expect this patient to initially be in:
respiratory alkalosis
19
\_\_\_\_\_\_\_\_\_\_ is contraindicated in patients with facial and head injuries
nasotracheal intubation
19
Your 5-year-old patient appears acutely ill. He is sitting in a tripod position, is leaning forward, and is drooling. He has dyspnea and a loud inspiratory stridor. His mother reports that he was relatively fine this morning, but he now has a temperature of 104 degrees. You suspect that this child is suffering from:
epiglottitis
20
You are in danger of injuring what gland if you do not correctly identify the landmarks when performing a needle cricothyrotomy?
thyroid
20
\_\_\_\_\_\_\_\_\_\_ is contraindicated in patients with facial and head injuries
nasotracheal intubation
20
Upon completion of the initial assessment, you also find the radial pulse is present and strong with a rate of 122 bpm. The skin is normal color, warm and dry. The pulse oximeter reads 92%. You should immediately:
apply a nonrebreather mask at 15 lpm
21
Cerebrospinal fluid that leaks from the nose is called:
cerebrospinal rhinorrhea
21
You are in danger of injuring what gland if you do not correctly identify the landmarks when performing a needle cricothyrotomy?
thyroid
22
A patient who suffers a spinal cord injury at the level of C5 would likely present with which of the following signs or symptoms?
difficulty in breathing
23
You are treating a patient who has been removed from a burning residential structure by the fire department. You suspect the patient has smoke inhalation. You note carbonaceous sputum and singed nasal hair. He has a respiratory rate of 45 per minute. He does not respond to painful stimuli. You note cyanosis and diaphoresis to the skin. You should immediately:
begin positive pressure ventilation with a bag-valve-mask connected to supplemental oxygen
23
A patient who suffers a spinal cord injury at the level of C5 would likely present with which of the following signs or symptoms?
difficulty in breathing
24
The purpose of the distal cuff on the tracheal tube when inflated with 5 to 10 cc of air is to:
seal the trachea to prevent air from escaping and aspiration
24
As you attempt to place the tracheal tube using the straight blade, the patient begins to gag and retch. You should immediately:
discontinue intubation efforts and ventilate, using the bag-valve-mask
24
Which of the following respiratory diseases causes a distortion in the alveolar surface area and decreases the alveolar-capillary interface?
emphysema
24
As you attempt to place the tracheal tube using the straight blade, the patient begins to gag and retch. You should immediately:
discontinue intubation efforts and ventilate, using the bag-valve-mask
25
Alveoli resist collapse due to the presence of a chemical that reduces surface tension called:
surfactant
25
The purpose of the distal cuff on the tracheal tube when inflated with 5 to 10 cc of air is to:
seal the trachea to prevent air from escaping and aspiration
26
Your patient experiences difficulty breathing only when lying supine. The difficulty subsides when the patient is sitting erect. This condition is known as:
orthopnea
26
Alveoli resist collapse due to the presence of a chemical that reduces surface tension called:
surfactant
27
Dysphonia can be best defined as:
Difficulty speaking
27
Your patient experiences difficulty breathing only when lying supine. The difficulty subsides when the patient is sitting erect. This condition is known as:
orthopnea
28
The lateral borders of the glottis are the:
vocal cords
28
Dysphonia can be best defined as:
Difficulty speaking
29
The spasmodic closure of the vocal cords is known as:
Laryngospasm
30
Which muscles, which are used during times of respiratory distress, include the sternocleidomastoid muscles of the neck.
Accessory muscles
31
Which signs and symptoms would you not commonly see with a patient suffering from carboxyhemoglobin?
Kussmaul’s respirations
31
\_\_\_\_\_\_\_ are which are used during times of respiratory distress, include the sternocleidomastoid muscles of the neck.
Accessory Muscles
32
During transillumination intubation, the following pieces of equipment are necessary:
Lighted stylet
32
Which signs and symptoms would you not commonly see with a patient suffering from carboxyhemoglobin?
Kussmaul’s respirations
33
\_\_\_\_\_\_\_\_\_is the act of moving air into and out of the lungs. For \_\_\_\_\_\_\_\_\_to occur, the diaphragm and intercostal muscles must function properly.
Ventilation
Ventilation
33
During transillumination intubation, the following pieces of equipment are necessary:
Lighted stylet
34
The _______ is the major muscle of breathing; it is innervated by the ________ \_\_\_\_\_\_\_\_\_.
Diaphragm
phrenic nerves
34
Ventilation is the act of moving air into and out of the lungs. For ventilation to occur, the diaphragm and intercostal muscles must function properly.
35
The size of the ET tube used in pediatric patients is ____ to \_\_\_\_\_.
2.5-4.5
35
The _______ is the major muscle of breathing; it is innervated by the ________ \_\_\_\_\_\_\_\_\_.
Diaphragm
phrenic nerves
36
The narrowest portion of the laryngeal airway in children is the:
cricoid cartilage
36
The size of the ET tube used in pediatric patients is ____ to \_\_\_\_\_.
2.5-4.5
37
What are the muscles between the ribs, that are innervated by the intercostal nerves.
Intercostal muscles
37
The narrowest portion of the laryngeal airway in children is the:
cricoid cartilage
38
What anatomic feature marks the beginning of the hypopharynx?
hyoid bone
38
The intercostal muscles, the muscles between the ribs, are innervated by the intercostal nerves.
39
You have just administered a medication containing beta-adrenergic properties. You would expect which of the following physiologic effects?
bronchodilation
39
What anatomic feature marks the beginning of the hypopharynx?
hyoid bone
40
You are called to the scene of a local factory for a patient who had a syncopal episode. Upon your arrival, you find the patient sitting at the desk in the foreman’s office. He is very diaphoretic and ashen gray. The patient responds to verbal stimuli with incomprehensible sounds.
Your first priority in the assessment and management of the patient is to:
You should immediately perform which of the following?
ensure the patient has a patent airway
administer oxygen via a nonrebreather at 15 lpm
40
You have just administered a medication containing beta-adrenergic properties. You would expect which of the following physiologic effects?
bronchodilation
41
You are at the scene and treating a 47-year-old patient who reports a history of asthma for the last 40 years. His BP is 142/98 mmHg, radial pulse is 136 beats per minute, and respirations are 36 per minute. He is cyanotic and is using his accessory muscles when breathing. When you auscultate his lungs, no wheezing is heard in any lung fields. The SpO2 reading is 78%.
You should suspect that there is no wheezing because:
As you continue your assessment, you note that the blood pressure falls by approximately 18 mmHg as the patient inhales. You would note this as:
The above sign is an indication that the patient:
As part of the patient treatment, you should immediately:
the bronchioles are maximally constricted and there is minimal air movement
pulsus paradoxus
has a severe increase in his intrathoracic pressure from air trapping
place the patient on a nonrebreather mask at 15 lpm and administer albuterol via a nebulizer as quickly as possible
41
You are called to the scene of a local factory for a patient who had a syncopal episode. Upon your arrival, you find the patient sitting at the desk in the foreman’s office. He is very diaphoretic and ashen gray. The patient responds to verbal stimuli with incomprehensible sounds.
Your first priority in the assessment and management of the patient is to:
You should immediately perform which of the following?
ensure the patient has a patent airway
administer oxygen via a nonrebreather at 15 lpm
42
Which of the following is not a pathophysiologic response to the chemical mediators being released in an anaphylactic reaction?
reduction in bronchiole mucosal inflammation
42
You are at the scene and treating a 47-year-old patient who reports a history of asthma for the last 40 years. His BP is 142/98 mmHg, radial pulse is 136 beats per minute, and respirations are 36 per minute. He is cyanotic and is using his accessory muscles when breathing. When you auscultate his lungs, no wheezing is heard in any lung fields. The SpO2 reading is 78%.
You should suspect that there is no wheezing because:
As you continue your assessment, you note that the blood pressure falls by approximately 18 mmHg as the patient inhales. You would note this as:
The above sign is an indication that the patient:
As part of the patient treatment, you should immediately:
the bronchioles are maximally constricted and there is minimal air movement
pulsus paradoxus
has a severe increase in his intrathoracic pressure from air trapping
place the patient on a nonrebreather mask at 15 lpm and administer albuterol via a nebulizer as quickly as possible
43
In fatal anaphylactic reactions, the most prominent clinical features identified that are related to the fatal episode are:
bronchoconstriction, vasodilation, and an increase in capillary permeability
43
Which of the following is not a pathophysiologic response to the chemical mediators being released in an anaphylactic reaction?
reduction in bronchiole mucosal inflammation
44
The spasmodic closure of the vocal is known as:
Laryngospasm
44
In fatal anaphylactic reactions, the most prominent clinical features identified that are related to the fatal episode are:
bronchoconstriction, vasodilation, and an increase in capillary permeability
45
During the expiration phase of the respiratory cycle, which physiologic process takes place?
intrathoracic pressure increases
45
During inhalation, the diaphragm _________ and the intercostal muscles \_\_\_\_\_\_\_.
Contracts, Contract
46
Lung overinflation due to a rapid ascent in a diving incident may result in:
air embolism
46
During the expiration phase of the respiratory cycle, which physiologic process takes place?
intrathoracic pressure increases
47
You have just placed a tracheal tube in an unresponsive apneic patient. You should determine correct tube placement by:
viewing the tube pass the glottic opening during direct observation
47
Lung overinflation due to a rapid ascent in a diving incident may result in:
air embolism
48
You are called to the scene of a fire at a trailer park. When you arrive, you find the fire department on the scene battling a fully engulfed trailer. The fire officer directs you over to an open area where you find what appears to be a male patient in his fifties lying supine on the ground. The fire officer reports that the patient was burned when he suddenly was awakened by the fire and he stood straight up and tried to get out. The firefighters arrived and removed him from the trailer that he lived in. Upon approaching the patient, you note the skin is reddened and blistered circumferentially to the entire face, neck, upper body, and upper extremities. The hands are brown and charred, with skin sloughing off. The patient is not responding to verbal stimuli. You note stridor on inspiration and soot around his nose and mouth. His respirations are 42/minute with very little chest rise. His radial pulse is present at 132 bpm.
Your first immediate action is to:
begin positive pressure ventilation and prepare for
tracheal intubation
48
You have just placed a tracheal tube in an unresponsive apneic patient. You should determine correct tube placement by:
viewing the tube pass the glottic opening during direct observation
49
You arrive on the scene and find an adult patient lying supine in bed, breathing with agonal respirations. You should:
immediately begin bag-valve-mask ventilation
49
You are called to the scene of a fire at a trailer park. When you arrive, you find the fire department on the scene battling a fully engulfed trailer. The fire officer directs you over to an open area where you find what appears to be a male patient in his fifties lying supine on the ground. The fire officer reports that the patient was burned when he suddenly was awakened by the fire and he stood straight up and tried to get out. The firefighters arrived and removed him from the trailer that he lived in. Upon approaching the patient, you note the skin is reddened and blistered circumferentially to the entire face, neck, upper body, and upper extremities. The hands are brown and charred, with skin sloughing off. The patient is not responding to verbal stimuli. You note stridor on inspiration and soot around his nose and mouth. His respirations are 42/minute with very little chest rise. His radial pulse is present at 132 bpm.
Your first immediate action is to:
begin positive pressure ventilation and prepare for tracheal intubation
50
What three items are crucial for the tissues to receive the needed nutrients.
Ventilation
Oxygenation
Respiration
50
You arrive on the scene and find an adult patient lying supine in bed, breathing with agonal respirations. You should:
immediately begin bag-valve-mask ventilation
51
You are called to the scene of a residence and have just delivered a baby. You cut the umbilical cord. As you are assessing the newborn, you note that the heart rate is 82 beats per minute and the core of the body and extremities are cyanotic.
You should immediately:
As you continue with the above treatment, you note that the heart rate is now 58 beats per minute. You should immediately:
begin positive pressure ventilation
begin chest compressions and positive pressure ventilation
51
Ventilation, oxygenation, and respiration are crucial for the tissues to receive the needed nutrients.
52
What is the primary effect of an exposure to cyanide?
cellular asphyxia due to inhibition of cell enzymes
52
You are called to the scene of a residence and have just delivered a baby. You cut the umbilical cord. As you are assessing the newborn, you note that the heart rate is 82 beats per minute and the core of the body and extremities are cyanotic.
You should immediately:
As you continue with the above treatment, you note that the heart rate is now 58 beats per minute. You should immediately:
begin positive pressure ventilation
begin chest compressions and positive pressure ventilation
53
Alternative to endotracheal intubation:
nasogastric tube
53
What is the primary effect of an exposure to cyanide?
cellular asphyxia due to inhibition of cell enzymes
54
You are now controlling the airway with a tracheal tube that has been successfully placed. Based on the mechanism of injury and patient presentation, the second most immediate critical concern with the patient’s condition while he is in your care is:
effects from toxic inhalation
54
Alternative to endotracheal intubation:
nasogastric tube
55
Digital intubation is accomplished by using which of the following?
A. Laryngospasm
B. Your hand
C. Stylet
D. BronchoscopeB. Your
B. Your hand
55
You are now controlling the airway with a tracheal tube that has been successfully placed. Based on the mechanism of injury and patient presentation, the second most immediate critical concern with the patient’s condition while he is in your care is:
effects from toxic inhalation
56
You are ventilating an infant with the bag-valve-mask device. At what ventilation rate should the patient be ventilated?
minimum of once every 3 seconds, delivered over 1 to 1.5 seconds
56
You arrive on the scene to find a 26-year-old male patient who was involved in an auto accident. The patient is cyanotic, responds to deep verbal stimuli, is dyspneic, has cool clammy skin, BP 86/74, HR 138, RR 46. Subcutaneous emphysema is present, along with absent breath sounds to the left thorax. JVD is present.
You should suspect the patient is suffering from which of the following conditions?
tension pneumothorax to the left hemithorax
Your treatment for the patient in sequence of priority would include:
1. assist ventilation with supplemental oxygen attached to the ventilation device
2. needle decompression of the left thorax
3. initiate an intravenous line of normal saline
4. rapid transport
1, 2, 4, 3
57
You arrive on the scene and find a 45-year-old female patient with poor hygiene in the local homeless shelter. Upon your assessment you find the following: unresponsiveness; tachycardia; pale, cool skin; rapid, deep respirations at 34/minute. You note a fruity odor on the breath of the patient. The supervisor at the shelter indicates that she is a regular there. He states that he believes she is an alcoholic; however, he believes that she quit drinking a few days ago. Her medical history reveals no significant chronic diseases or conditions. Her BP is 122/66 mmHg; ECG shows a sinus tachycardia; and SpO2 is 98% on room air.
Your initial differential diagnosis of this condition is:
Your initial treatment would consist of:
If you were able to measure the blood gases in this patient, you would suspect the pH to be:
The type of respirations the patient is displaying is referred to as:
diabetic ketoacidosis
1. nonrebreather at 15 lpm
2. IV line of normal saline
less than 7.35 mmHg
Kussmaul’s Sign
57
You are ventilating an infant with the bag-valve-mask device. At what ventilation rate should the patient be ventilated?
minimum of once every 3 seconds, delivered over 1 to 1.5 seconds
58
The amount of air that actually reaches the alveoli (alveolar tidal volume) and is involved in gas exchange in the average-sized adult person is approximately (based on a normal tidal volume):
350 ml
58
You arrive on the scene and find a 45-year-old female patient with poor hygiene in the local homeless shelter. Upon your assessment you find the following: unresponsiveness; tachycardia; pale, cool skin; rapid, deep respirations at 34/minute. You note a fruity odor on the breath of the patient. The supervisor at the shelter indicates that she is a regular there. He states that he believes she is an alcoholic; however, he believes that she quit drinking a few days ago. Her medical history reveals no significant chronic diseases or conditions. Her BP is 122/66 mmHg; ECG shows a sinus tachycardia; and SpO2 is 98% on room air.
Your initial differential diagnosis of this condition is:
Your initial treatment would consist of:
If you were able to measure the blood gases in this patient, you would suspect the pH to be:
The type of respirations the patient is displaying is referred to as:
diabetic ketoacidosis
1. nonrebreather at 15 lpm
2. IV line of normal saline
less than 7.35 mmHg
Kussmaul’s Sign
59
You are treating a firefighter who has inhaled noxious toxins in a fire. The patient presents with confusion and a severe headache and breathing is labored at 38 times a minute. You should first:
assist ventilations with a bag-valve-mask and intubate
59
The amount of air that actually reaches the alveoli (alveolar tidal volume) and is involved in gas exchange in the average-sized adult person is approximately (based on a normal tidal volume):
350 ml
60
What is the purpose of the second hold in the barrel of an endotracheal tube, known as the Murphy’s Eye?
it enables airflow even if the end of the tube is occluded
60
You are treating a firefighter who has inhaled noxious toxins in a fire. The patient presents with confusion and a severe headache and breathing is labored at 38 times a minute. You should first:
assist ventilations with a bag-valve-mask and intubate
61
In children, the most common cause of conscious airway obstruction is:
Food
61
What is the purpose of the second hold in the barrel of an endotracheal tube, known as the Murphy’s Eye?
it enables airflow even if the end of the tube is occluded
62
You are preparing to intubate an apneic 12-day-old infant. What size laryngoscope blade and tracheal tube would be appropriate in this situation?
size 1 straight blade with a 3.5 ET tube
62
In children, the most common cause of conscious airway obstruction is:
Food
63
Choose the correct statement that pertains to the epiglottis.
the epiglottis lies above (superior) to the larynx
63
You are preparing to intubate an apneic 12-day-old infant. What size laryngoscope blade and tracheal tube would be appropriate in this situation?
size 1 straight blade with a 3.5 ET tube
64
Tracheal intubation would be initially contraindicated for which of the following patients?
76-year-old male who has ingested a large amount of Darvon pills
64
Choose the correct statement that pertains to the epiglottis.
the epiglottis lies above (superior) to the larynx
65
Total lung capacity in the average adult male is approximately:
4L
5L
6L
7L
6L
65
Tracheal intubation would be initially contraindicated for which of the following patients?
76-year-old male who has ingested a large amount of Darvon pills
66
Choose the statement that is associated with the use of the straight blade during tracheal intubation.
it provides greater displacement of the tongue, thus it is preferred in treating infants
66
Upon completing your initial assessment, you would immediately:
Apply humidified oxygen via a nonrebreather mask
67
In infants and children, normal tidal volume is approximately:
4 to 6 mL/kg
5 to 7 mL/kg
6 to 8 mL/kg
7 to 9 mL/kg
6 to 8 mL/kg
67
Choose the statement that is associated with the use of the straight blade during tracheal intubation.
it provides greater displacement of the tongue, thus it is preferred in treating infants
68
Ventilation is the process of moving air:
a. into the body tissues
b. into and out of the lungs
c. into the cellular level
d. into the alveoli
b. into and out of the lungs
69
The phrenic nerves stimulate the:
a. diaphragm
b. sternocleidomastoid
c. intercostal muscles
d. all of the above
a. diaphragm
70
Hyperventilation occurs when ________ elimination exceeds ________ production.
a. oxygen, CO2
b. CO2, Oxygen
c. oxygen, oxygen
d. CO2, CO2
CO2, oxygen
71
During a failed intubation, which of the following is an acceptable alternative?
a. King LT airway
b. Combitube
c. Laryngeal mask airway
d. All of the Above
D. All of the above
72
