Exam 2: Airway

Question 1

Describe the pathway of O2 as it enters the body and gets to the alveoli.

Answer 1

Nasopharynx/oropharynx > larynx > epiglottis, vocal cords > glottis > trachea > carina > bronchi > bronchus > bronchioles > alveoli

Question 2

Define the process of diffusion and where it occurs in the lungs?

Answer 2

in alveoli and capillary beds. Diffusion of gas exchange is when CO2 or O2 goes from high concentration to low concentration.

Question 3

List the steps in caring for a patient who is choking, including responsive and unresponsive patients.

Answer 3

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Question 4

Describe the indications for suctioning and describe the technique for doing so.

Answer 4

suction when airway is visibly full of secretions/fluid. Measure catheter from corner of mouth to jaw corner. Insert catheter that lenght, not suctioning yet. Suction on way out circular motions no more than 10-15 seconds.

Question 5

What is a rigid suction and when would it be used?

Answer 5

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Question 6

What is a soft-tip suction and when would it be used?

Answer 6

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Question 7

List the indications for the head-tilt chin-lift and jaw-thrust maneuvers.

Answer 7

open the airway of an unconscious and unresponsive patient

Question 8

How would you insert an oropharyngeal airway (OPA)?

Answer 8

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Question 9

How would you insert an nasopharyngeal airway (NPA)?

Answer 9

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Question 10

List the steps in the primary assessment including the pertinent findings.

Answer 10

ABCs | airway is open and patent = look for obstructions | Breathing = rate, rhythm, quality and lung sounds = look for respiratory distress/failure | circulation = cap refill = good perfusion; pulses, skin signs = look for shock

Question 11

What muscles are working in inhalation and exhalation?

Answer 11

intercostal muscles and diaphragm

Question 12

What is the role of the phrenic nerve?

Answer 12

carries the signal to and from the medulla oblongata

Question 13

What is the proper O2 flow rate in L/min for the nasal cannula?

Answer 13

2-6 L/min

Question 14

What is the proper O2 flow rate in L/min for the NRB?

Answer 14

10-15 L/min

Question 15

What is the proper O2 flow rate in L/min for the BVM?

Answer 15

15 L/min

Question 16

What are the 7 signs and symptoms and breathing rates of a patient suffering from respiratory distress?

Answer 16

RR = < 8/min or > 30/min | dyspnea | HR/RR increase | retractions | tripoding/upright position | 2-3 word-dyspnea | noisy breathing/lung sounds | restlessness | normal mental status

Question 17

What are the 4 signs and symptoms and breathing rates of a patient suffering from respiratory failure?

Answer 17

shallow respirations | cyanotic | HR/RR decreases | altered mental status

Question 18

What is the key difference between respiratory distress and respiratory failure?

Answer 18

mental status | normal = distress | altered = failure

Question 19

List the steps for ventilating a patient with a stoma?

Answer 19

tracheostomy mask to BVM (if no mask present = use child/infant mask) | no head-tilt, chin-lift or jaw thrust. | suction = French/soft tip catheter

Question 20

What is a stoma?

Answer 20

opening in neck connecting the skin to trachea

Question 21

Define tidal volume.

Answer 21

amount of air inhaled in 1 breath

Question 22

Define minute volume.

Answer 22

amount of air inhaled in 1 minute

Question 23

Define compliance.

Answer 23

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Question 24

Define seesaw respirations.

Answer 24

chest and abdomen move opposite directions (up and down)

Question 25

Define dyspneic.

Answer 25

abnormal breathing pattern, short of breath

Question 26

Define apneic.

Answer 26

Patient is not breathing.

Question 27

Describe the signs and symptoms of a patient suffering from anaphylaxis.

Answer 27

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Question 28

Why do the signs and symptoms of anaphylaxis happen?

Answer 28

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Question 29

Describe the signs and symptoms of a patient suffering epiglottitis.

Answer 29

swelling of epiglottis | high grade fever | raspy voice | stridor | copious drooling | tripoding

Question 30

Why do the signs and symptoms of epiglottitis happen?

Answer 30

fever = due to Hib flu strand | raspy voice = swelling puts pressure on other structures | stridor = narrowing of upper airway passages | drooling = hard to swallow

Question 31

Describe the signs and symptoms of a patient suffering asthma.

Answer 31

expiratory wheezing | prolonged expiratory phase | dyspnea/labored breathing

Question 32

Why do the signs and symptoms of asthma happen?

Answer 32

immune system response = intermittent swelling of bronchioles/bronchi (bronchospasm)

Question 33

What is a beta-2 agonist medication?

Answer 33

beta-2 receptor controls bronchi constriction/dilation | beta-2agonist medication = dilates bronchi

Question 34

Why must beta-2 agonist medication be administered to a respiratory patient?

Answer 34

allow broncho-dilation = open up lower airways = more air in airways

Question 35

Describe the signs and symptoms of a patient suffering chronic bronchitis and why these symptoms occur.

Answer 35

irritation of airways = airway constriction and buildup of excess mucus | excess mucus = due to irritants | productive cough = trying to cough out mucus

Question 36

Describe the signs and symptoms of a patient suffering emphysema and why these symptoms occur.

Answer 36

long expiratory phase = wheezing = broncho-constriction = dried out alveoli | crackles

Question 37

What are the 2 types of COPD-diseases?

Answer 37

emphysema and chronic bronchitis

Question 38

What is a pneumothorax?

Answer 38

air enters the pleural space = putting pressure onto lung = decrease in volume of air inhaled

Question 39

What is a tension pneumothorax?

Answer 39

air cannot escape pleural space = mediastinal shift

Question 40

Signs and symptoms of tension pneumothroax

Answer 40

JVD | tracheal deviation to unaffected side | diminished/absent breath sounds

Question 41

Signs and symptoms of pneumothorax

Answer 41

diminished or absent breath sounds but no JVD/tracheal deviation

Question 42

Describe the 5 signs and symptoms of a patient suffering pneumonia and why these symptoms occur.

Answer 42

fever/chills = immune system reaction to URI infection | worsened productive cough = dried up mucus due to body temp | excess mucus production = immune system response to infection | rhonchi breath sounds | brown sputum | pleuritic CP = irritation of pleural membrane from the coughing

Question 43

Describe the signs and symptoms of a patient suffering cystic fibrosis and why these symptoms occur.

Answer 43

sinus congestion = excess mucus | wheezing = excess mucus in airways | chronic productive cough | dyspnea | pneumonia = due to germs stuck in mucus

Question 44

Describe the signs and symptoms of a patient suffering from pulmonary embolism and why these symptoms occur.

Answer 44

acute SOB = sudden clot of pulmonary vessel | pinpoint CP = at the site of thrombus/blockage | clear lung sounds | respiratory distress/failure = not enough O2 circulating | failure to improve with O2 = blood can't oxygenate well through lungs bc of blockage

Question 45

Describe the signs and symptoms of a patient suffering from CHF and why these symptoms occur.

Answer 45

crackles = pulmonary edema = from damage of one of the heart chambers = backup of fluid in pulmonary circulation | severe dyspnea | lower extremity edema = backup of fluid in venous system | pink frothy sputum = due to blood in lungs