Chapter 4 - Respiratory Distress

Question 1

What is pneumonia?

Answer 1

Inflammation of the lung parenchyma resulting from either infectious or non-infectious causes.

Question 2

What are infectious organisms?

Answer 2

Bacteria
Viruses
Fungi
Protozoa

Question 3

Common extrinsic factors for asthma:

Answer 3

Smoking
Exercise
Dust mites
Pet hair
Pollen

Question 4

Intrinsic factors for asthma:

Answer 4

Aspirin
Beta-blockers
Viral infections
Emotional distress

Question 5

Diaphoretic-

Answer 5

Sweaty

Question 6

Febrile

Answer 6

High temperature

Question 7

Tachycardia

Answer 7

Increased heart rate

Question 8

Tachypnoeic

Answer 8

Increased reap rate

Question 9

ABG’s

Answer 9

A test of gases and pH in arterial blood

Question 10

Coarse rales -

Answer 10

A series of short low popping sounds, also called crackles

Question 11

Haemoptysis

Answer 11

Coughing bloody sputum

Question 12

Working out Fi02%

Answer 12

4 x 02 rate (6L/min) + 20

Question 13

Pneumonia affects gas exchange in which structures of the lungs?

Answer 13

Alveoli

Question 14

Assessment of patient with pneumonia includes-

Answer 14

White cell count
Mental status 
FBC/Serum electrolytes 
Breath sounds 
?Purse lip breathing
Use or accessory muscles

Question 15

A person with pneumonia is likely to display which lung sound on auscultation?

Answer 15

Rales (Crackles)

Question 16

The body’s respiratory centre is primarily stimulated by:

Answer 16

A rise in blood carbon dioxide

Question 17

Common causes for low arterial oxygen levels (hypoxaemia).

Answer 17

Hypoxia
Hypoventilation
Ventilation
Perfusion mismatch 
Diffusion abnormalities

Question 18

Inflammation of pneumonia is most likely to cause an alteration in:

Answer 18

Diffusion of gases

Question 19

When dealing with a very breathless patient ask what kind of questions?

Answer 19

Yes / No

Closed ended

Question 20

Groups of people most likely affected by pneumonia:

Answer 20

Elderly
Alcoholics
Immunocompromised
Chronic illness

Question 21

Pleural effusion

Answer 21

Build up of fluid in the space between the lung and chest wall

Question 22

Empyema

Answer 22

Pockets of pus that form in the space between lung and chest wall

Question 23

Productive cough

Answer 23

Sputum material coughed up from the lungs

Question 24

Lung abscess

Answer 24

Pockets of pus that form in the lung itself

Question 25

Secondary infection due to medication

Answer 25

Secondary bacterial lung infection after a viral infection

Question 26

Bacteraemia or septicaemia

Answer 26

Bacteria in the bloodstream or throughout the body

Question 27

Dyspnoea

Answer 27

Clinical sign of hypoxia, manifested by a feeling of breathlessness

Question 28

Fatigue

Answer 28

Subjective sensation of a patient reporting loss of endurance

Question 29

Malaise

Answer 29

Generalised feeling of being unwell

Question 30

Normal Pa02 for a healthy 30yom would be between:

Answer 30

80-100

Question 31

Normal PaC02 for a 30yom would be between:

Answer 31

35-45

Question 32

A normal pH for a 30yom would be between:

Answer 32

7.35 - 7.45

Question 33

When someone has a fever due to pneumonia, what would you expect in this instance?

Answer 33

Haemoglobin would release oxygen more readily and bind it less readily

Question 34

Most important cue cluster for a patient with pneumonia:

Answer 34

``` Tachypnea Fever Purulent sputum A cough Coarse rales Oxygen saturation lower than normal ```

Question 35

Early signs of hypoxia include:

Answer 35

``` Tachypnoea or bradypnoea Tachycardia or bradycardia Pa02 50-60mmHg PaC02 59-60mmHg Confusion ```

Question 36

Late signs of hypoxia include:

Answer 36

``` Tachypnoea or bradypnoea Cyanosis Unresponsiveness to verbal command Tachycardia or bradycardia Pa02 <50mmHg PaC02 > 60mmHg Sp02 <90% ```

Question 37

Nasal prongs flow rate:

Answer 37

2-4 litres | Fi02 - 0.24 - 0.36

Question 38

Hudson mask flow rate:

Answer 38

6-15 litres per minute | Fi02 - 0.4-0.6

Question 39

Non-rebreather mask flow rate:

Answer 39

10-15 litres per minute | Fi02 0.6-0.9

Question 40

High flowers position will:

Answer 40

Assist in lung expansion

Question 41

Wheezes are caused by:

Answer 41

Narrowed airways

Question 42

An asthma attack is caused by substances released from mast cells which cause:

Answer 42

Broncho-constriction and inflammation

Question 43

Peak exploratory flow rate can be defined as:

Answer 43

The maximum amount of air that a person is capable of expiring during forced expiration.

Question 44

Expiration occurs when:

Answer 44

The intercostal muscles and diaphragm relax.

Question 45

The most characteristic alteration in lung volume that is caused by air trapping in asthma is:

Answer 45

Functional residual capacity

Question 46

Reversibility of airflow obstruction is necessary to -

Answer 46

Diagnose asthma

Question 47

What breath sound is not suggestive of asthma?

Answer 47

Stridor

Question 48

Characteristics of asthma include:

Answer 48

SOB Cough Chest tightness Wheeze

Question 49

Side effects of bronchodilators include:

Answer 49

Palpitations and tremors

Question 50

Interventions for long term management of asthma include:

Answer 50

1- provide written/verbal instructions for future reference 2- teach the correct use of PEFR meter(peak flow) 3- Implement strategies to decrease anxiety 4 - Discuss lifestyle changes such as warming up slowly before exercising in cold weather