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Important Information Flashcards

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1
Q

What type of medications are particularly useful in COPD patients?

A

Steroids

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2
Q

ABG PaO2 value minimum for COPD pt

A

60

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3
Q

Why BiPAP for COPD patients

A

You want to prefer BiPAP if possible because you do NOT want to put them on the vent. **They are very hard to get off the vent

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4
Q

When dx sleep apnea, which test do you want to start out with, and which test is used to definitively dx OSA?

A

Start with oximetry testing, if abnormal, polysomnogram is used to confirm the diagnosis.

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5
Q

O2 ventilation with a TBI

A

Start with 100% FiO2 via non-breather aiming for SpO2 of >95%

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6
Q

What is Mannitol typically used for?

A

For TBI
Specifically via IV if the patient is posturing

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7
Q

When should you initiate O2 therapy

A

When the adult PaO2 is <60/90% sats or <50 in infants

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8
Q

CPAP should be initiated when severe shunting is involved, how do you know when severe shunting is occuring?

A

P/F ratio <200 or cannot obtain adequate O2 on 50% FiO2
**PaO2<50 on >50% FiO2

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9
Q

epiglottitis is caused by what type of infection? What about Croup?

A

epiglottitis is caused by bacterial, croup is viral

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10
Q

Thumb sign

A

indicates epiglottitis on lateral chest x ray

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11
Q

steeple sign

A

indicates croup

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12
Q

unilateral wheezing

A

FBA

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13
Q

pulsus paradoxus is defined by what

A

BP change of 10mmHg or greater during inhalation. Should increase on exhalation and decrease during inhalation

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14
Q

is croup subglottic or supraglottic

A

subglotic

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15
Q

A kid with copious secretions probably has what?

A

bronchiolitis

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16
Q

BNP evaluates what?

A

CHF. **Rule out CHF is <100

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17
Q

Troponin levels

A

0-0.2

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18
Q

CK is elevated when?

A

When there is an MI or damage to the heart muscles

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19
Q

% of predicted values from PFTs that are used to categorize severity

A

mild-70-79
moderate- 50-69
severe- <49
Normal is 80 to 120% of predicted

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20
Q

Memiscus sign

A

Indicates pleural effusion on CXR

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21
Q

Imaging test for cancer

A

PET

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22
Q

Imaging test for P.E.

A

CT

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23
Q

Normal CO levels

A

<1.5%,

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24
Q

Normal MetHg levels

A

<1.5%

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25
Severity of sleep apnea
Measured via AHI index or RDI (respiratory disturbance index) Mild 5-14/hour moderate 15-30/hour severe >30 Normal apnea-hypopnea index is 1-4
26
Pulse, RR, and BP for infants
90-170 RR 35-45 BP 84-52 mmHg
27
Ejection fraction range
65-75%
28
Cardiac Index value
2.5-4
29
CO
Normal is 4-8Lpm
30
CVP/PAWP values
CVP 2-6mmHg PAWP 6-12 mmHg
31
How to approximate the normal level of deadspace in a person
Should assume a deadspace value equal to 1mL per pound of IBW
32
When should you pull back or rotate the catheter in the heart?
When a dampened waveform appears
33
How to calculate TLC or RV
TLC = FRC + IC RV = FRC - ERV
34
Lumbar puncture is a diagnostic test for which dz process?
GB syndrome It will show elevated protein with LOW WBC
35
Which studies can be done for Guillane Barre
electromyography (EMG) and nerve conduction studies (NCS) **Dtudies will show slowing and/or blockage of the nerve conduction
36
A positive tensilon test tells you what?
Myasthenia Gravis
37
Explain what outcome of the tensilon test suggests MG
Dramatic improvement in muscle strength within 1 minute of being administered
38
Lidocaine concentrations and where they go
39
APGAR scale assesses what 5 things
Appearance (s/s hypoxemia) Pulse, Grimace, Activity, and RR
40
What APGAR score indicates the need for resuscitation measures?
0-3 4-6 requires supportive measures 7-10 is normal
41
Why do babies start grunting?
Sign of distress, they are trying to generate their own PEEP
42
When you are treating someone with INO therapy, what are you worried about?
43
Diffuse crackles on auscultation indicates what dz process?
ARDS
44
What are the two main tests used for sleep disorders?
Over-night oximetry or a definitive polysomnography
45
Which test is used to help distinguish if a person has obstructive vs central sleep apnea?
Polysymnography **If loss of airflow of >80% while there is NO RESP EFFORT proves central apnea
46
What does a positive polysymnography test look like if the test is positive for OSA vs CSA
If the >80% drop in air flow occurs while there is still respiratory effort
47
Dornase Alfa is the drug choice for what?
Cystic Fibrosis **Works by breaking links in the DNA of the mucous
48
What does TOBI treat?
Its used to treat pseudomonas aeruginosa
49
TOBI and Pulmozyme (dornase Alfa) are being using together on a pt. What do you think is wrong with this pt?
CF the pulmozyme is used to treat the secretions while the TOBI is used to treat psuedo aeru. which is a common infection found in patients with Cystic Fibrosis
50
If CVP and PAP is high...
Lung issue
51
Increased VCP indicates
Cor Pulmonale
52
If PAWP and PAP are increased indicates
Lt sided HF
53
bilateral fluffy infiltrates on CXR
think CHF **Lt HF is used interchangeably with congestive HF**
54
When the balloon is inflated in a PAC, what is being measured
it is taking a PAWP measurement, which is the preload of your left ventricle --Your BP measures the after load of the left ventricle
55
The proximal port of the PAC measures what?
the CVP, which is your preload of the right ventricle
56
The distal port will measure PAWP when inflated, but when it is deflated, what is it measuring?
your PAP, which is your afterload of the right ventricle
57
PAP value
20-30mmHg/6-15mmHg
58
MAP value for your PAP
10-20 mmHg
59
What is the significance of an elevated PAWP over 18? (elevated is defined as being >12)
An elevated PAWP indicated that there is fluid overload, but when it is >18, its fluid overload in the lungs due to LEFT HF**
60
Three main s/s of COPD
Dyspnea, chronic cough/sputum production, and exposure to risk factors
61
ICP
10-15, but requires intervention when >20
62
what changes in pip vs plat show a compliance/airway resistance problem?
Plateau will not change, but your PiP will increase over time if it is an AIRWAY RESISTANCE PROBLEM
63
Moderate COPD FEV1
50-79%
64
Severe COPD FEV1
30-49%
65
very severe COPD FEV1
<30%
66
What drugs to treat severe COPD
Fluticasone (inhhaled steroids) and salmeterol (LABA)
67
Drugs to treat moderate COPD
LABA and LAMA (tiotropium)

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