Ch 15 Respiratory Emergencies Flashcards
(100 cards)
1
Q
Acidosis
A
Buildup of excess acid in the blood or body tissue that results from a primary illness
2
Q
Adventitious breath sounds
A
Abnormal breathing sounds such as wheezing, stridor, rhonchi and crackles
3
Q
Alkalosis
A
Buildup of excess base (lack of acids) in the body fluids
4
Q
Anaphylaxis (anaphylactic shock)
A
An extreme, life threatening, systemic allergic reaction that may induce shock and respiratory failure
5
Q
Asthma
A
An acute spasm of the smaller air passages (bronchioles) associated with excessive mucus production and swelling of the mucous lining of the respiratory passages
6
Q
Atelectasis
A
Collapse of the alveolar spaces of the lungs
7
Q
Bronchial breath sounds
A
Normal breath sounds made by air moving through the bronchi
8
Q
Bronchiolitis
A
Inflammation of the bronchioles that usually occurs in children younger than 2 and is often caused by the respiratory syncytial virus
9
Q
Bronchitis
A
Acute or chronic inflammation of the lung that may damage lung tissue; usually associated with cough, production of sputum, and fever (depending on cause)
10
Q
Carbon dioxide retention
A
Condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center no longer responds to high levels of CO2 in the blood
11
Q
Carbon monoxide
A
An odorless, colorless, tasteless and highly poisonous gas that results from incomplete oxidation of carbon in combustion
12
Q
Chronic bronchitis
A
Irritation of the major lung passageways from infections disease or irritants such as smoke
13
Q
COPD
A
Chronic obstructive pulmonary disease
A slow process of dilation and disruption of the airways and alveoli caused by chronic bronchial obstruction
14
Q
CPAP
A
Continuous positive airway pressure
A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent endotracheal intubation
15
Q
Crackles
A
Crackling, rattling breath sounds signaling fluid in the air spaces of the lungs, formerly called rales
16
Q
Croup
A
An inflammatory disease of the upper respiratory system that may cause partial airway obstruction and is characterized by a barking cough; usually seen in children
17
Q
Diphtheria
A
An infectious disease in which a membrane forms, lining the pharynx; this lining can severely obstruct the passage of air into the larynx
18
Q
Dyspnea
A
Shortness of breath or difficulty breathing
19
Q
Embolus
A
A blood clot or other substance in the circulatory system that travels to a blood vessel where it causes a blockage
20
Q
Emphysema
A
A disease of the lungs in which there is extreme dilation and eventual destruction of the pulmonary alveoli with poor exchange of oxygen and carbon dioxide; loss of elasticity that leaves “holes” that resemble air pockets or cavities; one form COPD
21
Q
Epiglottitis
A
A disease in which the epiglottis becomes inflamed and enlarged and causes partial or complete upper airway obstruction; symptoms are sudden onset
22
Q
Hay Fever
A
Allergic response to outdoor airborne allergens such as pollen or sometimes indoor allergens such as dust mites or pet dander; Allergic Rhinitis
23
Q
Hyperventilation
A
Rapid or deep breathing that lowers the blood carbon dioxide level below normal
24
Q
Hyperventilation syndrome
A
Panic attack
Occurs in the absence of other physical problems; respirations may be as high as 40 shallow breaths per min or as low as only 20 very deep breaths per min
25
Hypoxia
When the body's cells and tissues do not have enough oxygen
26
Hypoxic drive
When chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases
27
Influenza type A
A virus that has crossed the animal/human barrier and infected humans, recently reaching the pandemic level with H1N1
28
Metered-dose inhaler
MDI
| Miniature spray canister used to direct medications through the mouth and into the lungs
29
Orthopnea
Severe dyspnea experienced when lying down and relieved by sitting up
30
Pandemic
An outbreak that occurs on a global scale
31
Paroxysmal Nocturnal Dyspnea
Severe shortness of breath, especially at night after several hours of reclining; the person is forced to sit up and breathe
32
Pertussis
Whooping cough
Airborne bacterial infection that affects mostly children under 6; patients will be feverish and exhibit a "Whoop" sound on inspiration after a coughing attack; highly contagious through droplet infection
Can lead to pneumonia in infants, cracked ribs in geriatric patients; Patients may find it hard to eat, sleep or breathe
33
Pleural effusion
Collection of fluid between the lungs and the chest wall that may compress the lung
34
Pleuritic chest pain
Sharp, stabbing pain in the chest that is worsened by a deep breath or other chest wall movement; often caused by inflammation or irritation of the pleura
35
Pneumonia
Infection of the lungs that damages the lunch tissue
Risk factors include:
Institutional residence (Nursing home, etc)
Recent hospitalization
Chronic diseases (renal failure, etc)
Immune system compromise (chemotherapy, HIV, etc)
History of COPD
36
Pneumothorax
Partial or complete accumulation of air in the pleural space; "collapsed lung"
37
Pulmonary edema
Buildup of fluid in the lungs, usually as the result of CHF
38
Pulmonary embolism
A blood clot that breaks off from a large vein and travels to the blood vessels of the lungs, causing obstruction of blood flow
39
Respiration
The exchange of oxygen and carbon dioxide
40
Respiratory Syncytial Virus
RSV
Virus that causes a infection of the lungs and breathing passages; can lead to other illnesses such as bronchiolitis and pneumonia; Highly contagious through droplets
41
Rhonchi
Coarse breath sounds heard in patients with chronic mucus in the airways
42
Small-volume nebulizer
Device that holds liquid medicine that is turned into a fine mist; patients inhale the medication into the airways and lungs as treatment for conditions such as asthma
43
stridor
A harsh, high pitched, barking inspiratory sound often heard in acute laryngeal (upper airway) obstruction
44
TB
Tuberculosis
A disease that can lay dormant in a person's lungs for decades, then reactivate; Many strains are resistant to antibiotics; Spread through cough
45
Ventilation
the exchange of air between the lungs and the environment, spontaneously by the patient or with assistance; "breathing"
46
Vesicular breath sounds
Normal breath sounds made by air moving in and out of the alveoli
47
Wheezing
A high-pitched, whistling breath sound, characteristically hear on expiration in patients with asthma or chronic obstructive pulmonary disease
48
Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the _____
hypoxic drive
49
What must be assessed in every respiratory patient?
Lung sounds
50
Crackles (rales) are caused by _____
Air passing through fluid
51
“PASTE” is an alternate assessment tool for _____
respiratory patients
52
What is the genetic disorder that predisposes the patient to repeated lung infections?
Cystic fibrosis
53
In what area of the lungs does respiration occur?
Alveoli
54
In order for efficient pulmonary gas exchange to occur:
oxygen and carbon dioxide must be able to freely diffuse across the alveolar–capillary membrane
55
Which of the following is MOST characteristic of adequate breathing?
A) 22 breaths/min with an irregular pattern of breathing and cyanosis
B) 30 breaths/min with supraclavicular retractions and clammy skin
C) 20 breaths/min with shallow movement of the chest wall and pallor
Correct!
D) 24 breaths/min with bilaterally equal breath sounds and pink skin
D) 24 breaths/min with bilaterally equal breath sounds and pink skin
56
```
Which of the following conditions would be LEAST likely to result in hypoxia?
A) Pleural effusion
B) Severe anxiety
C) Pulmonary edema
D) Narcotic overdose
```
B) Severe anxiety
57
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the most likely cause of this patient's condition?
Spontaneous pneumothorax
58
Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?
A) Pulmonary edema, history of hypertension, and anxiety
B) Difficulty breathing, two-word dyspnea, and tachycardia
C) Conscious and alert patient with an oxygen saturation of 85%
D) Shortness of breath and a blood pressure of 76/56 mm Hg
D) Shortness of breath and a blood pressure of 76/56 mm Hg
59
Asthma is caused by a response of the:
Immune System
60
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the most important treatment for this patient is:
epinephrine
61
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:
Abnormal breath sounds
62
While auscultating an elderly woman's breath sounds, you hear low-pitched “rattling” sounds at the bases of both of her lungs. This finding is most consistent with what condition?
Aspiration pneumonia
63
You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:
instruct him to hold his breath for as long as he comfortably can.
64
You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:
viral infection of the upper respiratory tract
65
His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from:
bronchiolitis
66
You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from:
Tuberculosis
67
Deoxygenated blood is carried from the heart to the lungs through the
Pulmonary arteries and arterioles
68
Oxygenated blood is carried from the lungs to the heart through the
Pulmonary veins and venules
69
S/S of Asthma
Wheezing on inspiration/expiration
| Bronchospasm
70
S/S of Anaphylaxix
```
Flushed skin or hives
Generalized edema
Decreased BP
Laryngeal edema with dyspnea
Wheezing or stridor
```
71
S/S of Bronchiolitis
```
Shortness of breath
Wheezing
coughing
fever
dehydration
tachypnea
tacycardia
```
72
S/S of Bronchitis
Chronic cough (with sputum production)
Wheezing
Cyanosis
tachypnea
73
S/S of CHF
Dependent edema
crackles (pulmonary edema)
Orthopnea
Paroxysmal nocturnal dysnpnea
74
S/S of the Common Cold
cough
runny nose
sore throat
75
S/S of Croup
Fever
barking cough
stridor
mostly seen in pediatric patients
76
S/S of Diphtheria
Difficulty breathing and swallowing
Sore throat
thick, gray buildup in throat or nose
fever
77
S/S of Emphysema
```
Barrel chest
pursed lip breathing
dyspnea on exertion
Cyanosis
Wheezing/decreased breath sounds
```
78
S/S of Epiglottitis
```
Dyspnea
high fever
stridor
drooling
difficulty swallowing
severe sore throat
tripod or sniffing position
```
79
S/S of Influenza type A
Cough
Fever
Sore throat
fatigue
80
S/S of Pertussis
Coughing spells
"Whooping" sounds
fever
81
S/S of Pneumonia
```
Dyspnea
chills, fever
cough
green, red or rust colored sputum
localized wheezing or crackles
Presentation in children is often: Rapid, labored breathing, lips/fingernails present bluish gray, may be fever, abdominal pain, vomiting
```
82
S/S of Pneumothorax
sudden chest pain with dyspnea
decreased breath sounds unilaterally
subcutaneous emphysema
83
S/S of Pulmonary embolus
```
Sharp chest pain
Sudden onset
dyspnea
tachycardia
clear breath sounds initially
```
84
S/S of Tension pneumothorax
```
Severe shortness of breath
decreased/altered LOC
neck vein distension
tracheal deviation (late sign)
hypotension; signs of shock (late sign)
```
85
S/S of Respiratory syncytial virus
Cough
wheezing
fever
dehydration
86
S/S of Tuberculosis
cough
fever
fatigue
productive/bloody sputum
87
Cardiac asthma
Wheezing experienced due to left-sided heart failure because the alveoli are so full of fluid that bubbles (the condition that gives the sound of crackles) cannot form
88
PASTE
Progression - O of OPQRST, when it began, how has it worsened over time
Associated chest pain - Can be a symptom of cardiac problems
Sputum - Have they been coughing up sputum?
Talking tiredness - Indicator of distress, full sentences or only a few words?
Exercise tolerance - decreases with dyspnea and hypoxia, what were they doing before?
89
Administer _____ (if available) for patients with upper airway infections and dyspnea
humidified oxygen
90
Do not attempt suctioning or an oropharyngeal airway for patients with suspected ____
Epiglottitis
91
Low blood pressure contradicts the use of ____
CPAP
| Because of increased pressure inside the chest, blood flow returning to the heart is diminished
92
CPAP is not used in patients with the following conditions
```
Respiratory arrest
S/S of pneumothorax
tracheotomy
decreased LOC
inability to follow commands
active gastrointestinal bleeding
```
93
Treatment for spontaneous pneumothorax
Administer O2
Prompt transport
Closely monitor
Be ready to assist with ventilations, support the airway and provide CPR if needed
94
Treatment for COPD
Assist with patient's prescribed inhaler, but be alert for side effects as COPD pts often overuse
Prompt transport
Place in most comfortable position (likely upright)
95
Treatment for anaphylaxis
```
Remove the offending agent
Administer epinephrine
Maintain the airway
Administer oxygen and be ready to assist breathing as needed
Prompt transport
```
96
Treatment for asthma
```
Administer oxygen
Assist with inhaler as needed
Prompt transport
Effort breathing = exhausting, a patient who stops struggling to breath is NOT recovering and is likely at a critical stage
Aggresive airway management
Oxygen
Transport and consider ALS
```
97
Treatment for PE
Administer Oxygen
Place in position of comfort
Prompt transport
98
Treatment for airway obstruction
Clear the airway if possible
Airway management - chin-tilt, jaw-thrust
Administer oxygen
Prompt transport
99
Tracheostomy disfunction
At home ventilation connected by a tracheostomy tube typically in children or geriatric patients; may become obstructed -- clear the obstruction of possible, place in a position of comfort, provide suctioning
If unable to airway the obstruction, consider ALS
100
Cystic Fibrosis
Genetic disorder affecting lungs and digestive systems. Disrupts the normal function of cells that make up the sweat glands in the skin and that line the lungs and digestive systems. Disrupts the natural balance of salt and water, and results in thick, sticky mucus in the lungs or other organs
