Oxygenation/Gas Exchange

Question 1

Hypoxemia

Answer 1

Insufficient O2 transfer to blood

Question 2

Hypercapnia

Answer 2

Inadequate CO2 removal

Question 3

S/S of Acute Respiratory Failure (ARF)

Answer 3

• Dyspnea/SOB
• Tachypnea
• Orthopnea
• Tachycardia
• Confusion/altered mental status
• Irritability/agitation
• Restlessness

Question 4

ARF PaO2

Answer 4

<60 mmHg

Question 5

ARF PaCO2

Answer 5

> 45 mmHg

Question 6

Examples of non-cardiogenic pulmonary edema

Answer 6

• Pneumonia
• Acute respiratory distress syndrome
• Sepsis
• DIC
• Inhaling harmful fumes
• High altitude pulmonary edema

Question 7

Examples of cardiogenic pulmonary edema

Answer 7

• CHF
• Dysrhythmias
• Shock

Question 8

Increased ventilation perfusion mismatch (V/Q mismatch)

Answer 8

Areas of the lung receive O2, but decreased or no blood flow

Question 9

Example of increased V/Q mismatch

Answer 9

Pulmonary emboli

Question 10

S/S of increased V/Q mismatch

Answer 10

• Severe dyspnea
• Tachypnea
• Pain
• Cough
• Hemoptysis

Question 11

Decreased V/Q mismatch

Answer 11

Receive blood flow, but no or compromised oxygen exchange

Question 12

Example of decreased V/Q mismatch

Answer 12

• Mucous plug
• Secretion in airway
• Pneumonia
• Asthma
• Atelectasis

Question 13

Shunt extreme V/Q mismatch

Answer 13

Blood flows through the pulmonary capillaries without gas exchange - good blood flow shunting away from poorly ventilated alveoli

Question 14

Examples of shunt extreme V/Q mismatch

Answer 14

• Alveoli filled with fluid
• Collapsed alveoli

Question 15

Hypercapnic Respiratory Failure Etiology

Answer 15

• Too slow respirations
• Too shallow respirations
• Diminished lung function

Question 16

Hypercapnia s/s

Answer 16

• Dyspnea
• Headache
• Peripheral and conjunctival vasodilation
• Tachycardia
• Hypertension
• Dysrhythmia
• Disorientation
• Confusion
• Decreased LOC
• Respiratory acidosis

Question 17

Hypercapnia Progression

Answer 17

• Respiratory center depression
• Decreased rr
• Progressive somnolence/coma
• Tremors
• Seizures
• Bradycardia
• Hypotension
• Cardiac dysrhythmia

Question 18

Pulmonary edema

Answer 18

Fluid accumulation in the alveoli and interstitial spaces of lungs

Question 19

Most common cause of pulmonary edema

Answer 19

Left sided heart failure

Question 20

S/S of pulmonary edema

Answer 20

• SOB
• Tachypnea
• Hypoxemia
• Frothy secretions
• Rales/crackles during auscultation

Question 21

Pleural effusion

Answer 21

Collection of fluid around the lungs/pleural space, limits expansion of lungs

Question 22

S/S of pleural effusion

Answer 22

• Dyspnea
• Worsening cough
• Chest pain/pain on inspiration
• Diminished/absent breath sounds on affected area depending on size

Question 23

Atelectasis

Answer 23

Complete or partial collapse of the lung, alveoli within the lung become deflated

Question 24

Common cause of atelectasis

Answer 24

• Airway obstruction from retained exudates/secretions

Question 25

Rapid s/s of atelectasis

Answer 25

- Pain on affected side - Sudden dyspnea - Cyanosis

Question 26

Gradual s/s of atelectasis

Answer 26

- Asymptomatic - Mild SOB - Coughing

Question 27

CPAP

Answer 27

1 pressure setting that delivers a steady continuous pressurized air into the airway throughout spontaneous inspiration and exhalation

Question 28

What is needed for CPAP to work?

Answer 28

Intact respiratory drive and adequate tidal volume

Question 29

What does CPAP help with?

Answer 29

- Increases O2 - Decreases work of breathing - Increases intrathoracic pressure - Decreases preload/work of heart

Question 30

BiPAP

Answer 30

2 pressure settings that delivers a different pressure for inspiratory and expiratory phases of breathing

Question 31

What does BiPAP correct?

Answer 31

- Hypercapnia - Hypercarbia

Question 32

ARDS Pathology

Answer 32

Acute lung injury from unregulated systemic inflammatory response to acute injury or inflammation

Question 33

ARDS s/s

Answer 33

- Tachypnea with use of accessory muscles at rest - Nasal flaring - Tachycardia at rest - Hypotension - Fever possibly - Bilateral crackles, coarse rhonchi - Cold, mottled dusky extremities - Prolonged CRT

Question 34

Worsening s/s of ARDs

Answer 34

- Dyspnea/tachypnea - Cough - Chest discomfort - Anxiety/restlessness

Question 35

ARDS progression

Answer 35

- A: assault to the pulmonary system - R: respiratory distress - D: decreased lung compliance - S: severe respiratory failure