Chapter 13: Respiratory Emergencies

Question 1

Define

Dyspnea

Answer 1

Shortness of breath (SOB) or difficulty breathing

Question 2

Define

Respiration

Answer 2

Exchange of oxygen and CO2

Question 3

Define

CO2 retention

Answer 3

Chronically high blood CO2 –> respiratory center no longer responds to high blood levels of CO2. From impaired exhalation or producing too much.

Question 4

Define

Acidosis

Answer 4

Buildup of excess acid in the blood or tissues resulting from primary illness

Question 5

Define

Adventitious breath sounds

Answer 5

Abnormal breath sounds: wheezing, rhonchi, rales

Question 6

Define

Alkalosis

Answer 6

Build of of base in body fluids

Question 7

Define

Anaphylaxis

Answer 7

Systemic allergic reaction, possibly including shock and respiratory failure. Usually within 30 minutes of exposure to allergen.

Question 8

Define

Asthma

Answer 8

Acute spasm of bronchioles, associated with excess mucus production and swelling of mucous lining.

Ask: have you been hospitalized for this before?

Question 9

Define

Atelectasis

Answer 9

Collapse of alveolar spaces

Question 10

Define

Bronchial breath sounds

Answer 10

Normal sounds of air moving through bronchi

Question 11

Define

Bronchiolitis

Answer 11

Inflammation of bronchioles usually in children <2 yo, often caused by respiratory syncytial virus

Question 12

Define

Bronchitis

Answer 12

• Acute or chronic inflammation of the lung that may damage tissue
• associated with cough and production of sputum
• sometimes fever depending on cause

Question 13

Define

Chronic bronchitis

Answer 13

Irritation of major lung passageways from infectious disease or smoke

Question 14

Define

COPD

Answer 14

Chronic obstructive pulmonary disease. Slow process of dilation and disruption of airways and alveoli cuased by chronic bronchial obstruction

Question 15

Define

Common cold

Answer 15

Viral infection. Swollen nasal mucous membranes and production of fluid in sinuses and nose

Question 16

Define

Croup

Answer 16

• Inflammatory disease of upper respiratory system
• may cause partial airway obstruction
• characterized by barking cough and stridor.
• Usually in children.

Question 17

Define

Diphtheria

Answer 17

Infectious disease in which a membrane forms, lining the pharynx. It can severely obstruct the passage of air into the larynx.

Question 18

Define

Embolus

Answer 18

Blood clot or other substance in circulatory system that can cause blockage

Question 19

Define

Emphysema

Answer 19

Disease of lungs with extreme dilation and eventual destruction of pulmonary alveoli. Loss of elastic material around alveoli because inflamed airways prevent easy exhalation. Poor gas exchange. One form of COPD. Beware of suppressing hypoxic drive with O2.

Question 20

Define

Hay fever

Answer 20

Allergic response usually to outdoor airborne allergens. Also called allergic rhinitis.

Question 21

Define

Hyperventilation

Answer 21

Rapid/deep breathing that causes blood alkalosis. Verbally instruct pt to slow their breathing, give supplemental O2. Moral support.

Question 22

Define

Hyperventilation syndrome

Answer 22

Occurs in absence of physical problems. RR as high as 40 shallow breaths/min or low as 20 deep breaths/min

Question 23

Define

Hypoxia

Answer 23

Not enough oxygen in body’s cells

Question 24

Describe

Hypoxic drive

Answer 24

Backup system to control respirations when oxygen levels fall. In pt’s with no CO2 reflex, giving too much O2 can depress breathing. Unless the pt is unconcious, use low flow and slowly adjust higher until symptoms improve. Shaun says: ALWAYS GIVE O2

Question 25

# Define Influenza type A

Answer 25

Crossed animal/human barrier. H1N1 is a strain.

Question 26

# Define MDI

Answer 26

Metered dose inhaler. Spray can used to direct meds though mouth into lungs

Question 27

# Define Oxygenation

Answer 27

Process of delivering O2 to blood

Question 28

# Define Pandemic

Answer 28

Outbreak that occurs on global scale

Question 29

# Define Pleural effusion

Answer 29

Collection of fluid between the lung and chest wall that may compress lung. Response to irritation, infection, CHF, or cancer. Dyspnea typically comes on suddenly.

Question 30

# Define Pleuritic chest pain

Answer 30

Sharp stabbing pain in the chest worsened by deep breath or other chest wal movement, often caused by inflammation of irritation of the pleura

Question 31

# Define Pneumonia

Answer 31

Infectious disease of the lung that damages lung tissue. Often associated with immune system compromise.

Question 32

# Define Pneumonitis

Answer 32

Inflammation of the lung

Question 33

# Define Pneumothorax

Answer 33

Partial or complete accumulation of air in pleural space

Question 34

# Define Pulmonary edema

Answer 34

Buildup of fluid in the lungs, usually a result of CHF

Question 35

# Define Pulmonary embolism

Answer 35

Blood clot that breaks off from large vein and lodges in lung, cutting of blood flow. S/S: dyspnea, chest pain, hemoptysis, cyanosis, tacypnea, hypoxia. May cause cardiac arrest

Question 36

# Define Rales

Answer 36

Crackling, rattling breath sounds signaling fluid in the alveoli

Question 37

# Define RSV

Answer 37

Respiratory syncytial virus. ## Footnote * Virus that causes lung/passages infection. * Can lead to other illnesses, like bronchiolitis and pneumonia. * Highly contagious * spread through droplets. * Infants with RSV often refuse fluids and get dehydrated.

Question 38

# Define Rhonchi

Answer 38

Coarse breath sounds heard in pt's with chronic mucus in airways.

Question 39

# Define Small volume nebulizer

Answer 39

Device that turns liquid medicine into mist for inhalation. Treats stuff like asthma.

Question 40

# Define Stridor

Answer 40

A harsh, high pitched, barking inspiratory sound often heard in acute laryngeal obstruction.

Question 41

# Define Vesicular breath sounds

Answer 41

Normal breath sounds from alveoli

Question 42

# Define Wheezing

Answer 42

High pitched, whistling breath sound, usually on expiration, in pt's with asthma or COPD

Question 43

# Discuss List possible problems with lungs (actual physical problems that can arise from diseases)

Answer 43

* Gas exchange in alveoli hindered by fluid, infection, or collapsed alveoli (atelectasis) * Alveolar wall itself damaged, interrupting gas exchange * Air passages obstructed (muscle spasm, mucus, floppy wall) * Blood flow obstructed by clots * Filled pleural space inhibits expansion

Question 44

# Discuss Define Epliglottitis

Answer 44

Disease in which epiglottis becomes inflamed and enlarged. May cause upper airway obstruction. DO NOT SUCTION AIRWAYS WITH EPIGLOTTITIS (could cause more swelling and result in complete airway obstruction).

Question 45

# Discuss Acute pulmonary edema

Answer 45

* Fluid buildup in lung. * laying pt down will kill him (orthopnea) * Often from CHF (look for telltale hypertension) * Ask: how many pillows do you sleep with?

Question 46

# Discuss Wet lung sounds vs. dry lung sounds

Answer 46

Wet lung sounds: often pulmonary edema. Dry lung sounds: often COPD. Not always.

Question 47

# Discuss Spontaneous pneumothorax

Answer 47

Pt's with emphysema or asthma are at higher risk, often during severe coughing. Sometimes in tall skinny people.

Question 48

# Discuss Status epilepticus

Answer 48

Prolonged seizure. Seizures every few minutes without regaining consciousness or seizure lasting longer than 30 minutes could be life threatening. Pt needs meds to stop seizure and manage airway. NEEDS ALS OR HOSPITAL

Question 49

# Discuss Carbon monoxide poisoning

Answer 49

Pt may think they have the flu: headache, dizziness, fatigue, nausea, vomiting

Question 50

# Discuss How to perform focused breathing assessment

Answer 50

PASTE ## Footnote * P: Progression * A: Associated chest pain * S: Sputum * T: Talking tiredness * E: Exercise tolerance

Question 51

# Discuss Cystic fibrosis

Answer 51

Body's salt/water balance messed up, so mucus becomes thicker and more difficult to move, causing frequent infection in lungs.

Question 52

# Discuss CPAP

Answer 52

Continuous positive airway pressure device. Indications: moderate to severe resp distress from pulmonary edema or COPD, able to follow commands, RR \>26 or pulse ox \<90%. Contraindication: low BP, resp arrest, s/s of pneumothorax or chest injury, tracheostomy, decreased LOC, gastrointestinal bleeding.

Question 53

# S/S Asthma

Answer 53

Wheezing, bronchospasm

Question 54

# S/S Anaphylaxis

Answer 54

Flushed skin, urticaria (hives), generalized edema, low BP, laryngeal edema

Question 55

# S/S Bronchitis

Answer 55

Chronic cough, wheezing, cyanosis, productive cough

Question 56

# S/S CHF

Answer 56

* Dependent edema, * rales * paroxysmal nocturnal dyspnea (waking up because of dyspnea, often relieved by sitting upright)

Question 57

# S/S Croup

Answer 57

* Fever, * barking cough, * pediatric pt

Question 58

# S/S Emphysema

Answer 58

Barrel chest, pursed lip breathing, dyspnea on exertion

Question 59

# S/S Pneumonia

Answer 59

* Dyspnea * chills and fever * cough * dark sputum

Question 60

# S/S Pneumothorax

Answer 60

Sudden chest pain w dyspnea, unilateral decreased lung sounds

Question 61

# S/S Pulmonary embolism

Answer 61

Sharp pinpoint pain, dyspnea, sudden onset, after surgery or childbirth

Question 62

# S/S Tension pneumothorax

Answer 62

Progressive SOB, decreasing LOC, JVD, tracheal deviation

Question 63

# S/S Pertussis

Answer 63

* Coughing spells, * whooping sounds, * fever, * pediatric pt's

Question 64

# Discuss What's a key question to ask an asthma pt?

Answer 64

Have you ever been hospitalized for this before?