Quiz 11 - Lung Disease and Anesthetic Concerns Flashcards Preview

GNURS627/Respiration/Physiology for Anesthesa > Quiz 11 - Lung Disease and Anesthetic Concerns > Flashcards

Flashcards in Quiz 11 - Lung Disease and Anesthetic Concerns Deck (21):
1

What are the classical triad of symptoms for asthma?

-Wheeze
-Cough
-Dyspnea

2

Preop history - what should you always ask about COPD history?

Smoking history (how long, when did you quit and have you ever smoked)
* Dyspnea - exercise tolerance, home O2 requirement, baseline SPO2 on RA

3

What other preop history would you like to know for COPD?

Productive cough
Wheezing
Admissions to hospital/ER
Prior Surg Hx

4

Preop studies for COPD

SpO2 on RA
ABG
CXR
CBC (may have elevated Hct)
PFT (FEV1 < 2 liters is not good)
Electrolytes (may have elevated bicarb)

5

What FEV1 and FEV1/FVC values would indicate high risk?

FEV1 < 2 Liters
FEV1/FVC < 0.5

6

What are some signs/symptoms of Chronic Bronchitis?

Cough
Sputum production
Recurrent infections
Blue Bloaters

7

What are some causes of Chronic Bronchitis?

Smoking and occupational exposure

8

What are some common characteristics of a "Blue Bloater"?

Short, fat neck
Frequent wheeze
Relatively young
Obese, OSA, Pickwickian syndrome
Cyanotic

9

What are some signs and symptoms of Emphysema?

Progressive dyspnea (SOB)
variable cough
Loss of pulmonary elastic recoil
Pink puffer

10

What are some common characteristics of a "Pink Puffer"?

thin
older
minimal cough
pink color
dyspnea, hyperinflation, distant breath sounds
Pursed lip breathing = auto PEEP

11

What are some causes of emphysema?

smoking
coal miners
alpha-1 antitrypsin deficiency (auto digestion of lung tissue by proteases)

12

What is asthma?

-Airway HYPERREACTIVITY
-Bronchial wall INFLAMMATION
-Degrees of REVERSIBLE airflow dyspnea

13

What is the normal inspiration and expiratory ratio?

1:2

14

What is the inspiration and expiratory ratio for COPD?

1:3

15

What type of drugs should be avoided during broncho spasms?

-HISTAMINE releasing drugs:
Pentothal
Morpine
Atracurium
Mivacurium
Neostigmine

16

Cessation of greater than _____ weeks will reduce post-op pulmonary complications.

8

17

Cessation of smoking 12 hours prior to surgery does what?

-Reduce Carbon Monoxide (COHb)
-Reduce nicotine levels

18

What does nicotine stimulate?

-Sympathetic ganglia - catecholamines released form adrenal medulla - increasing HR BP, and SVR.

19

How long will nicotine stimulation persist for?

-30 minutes after last cigarette

20

What should be done prior to intubation of a smoker?

-Preoxygenate well
-Avoid instrumentation of airwayuntil deep level of anesthesia

21

T/F: Asthmatic bonchitis can only partially reversible.

True (Some degree of obstruction will always remain.