RD and RF

Question 1

Gas exchange

Answer 1

Air taken in during inspiration –> O2 diffuses from alveoli –> into blood (some dissolves into plasma) –> most O2 is attached to hemoglobin

As blood passes through the lungs –> CO2 diffuses from the blood –> into alveoli –> exhaled

Question 2

Lung parenchyma

Answer 2

Portion of lungs involved in gas exchange

Question 3

02 consumption per minute for adults vs infants

Answer 3

Adults 3 to 4 ml/kg per minute

Infants 6 to 8 ml/kg per minute

Question 4

Early Signs of Tissue Hypoxia

Answer 4

1. Tachypnea
2. Inc respiratory effort - nasal flaring, retractions
3. Tachycardia
4. Pallor, mottling, cyanosis
5. Agitation, Anxiety, Irritability

Question 5

Late Signs of Tissue Hypoxia

Answer 5

1. Bradypnea
2. Inc resp - head bobbing, seesaw resp, grunting
3. Bradycardia
4. Pallor, mottling, cyanosis
5. Dec LOC

Question 6

atmospheric pressure during inspiraration

Answer 6

intrathoracic is less than atmospheric pressure

Mainly diaphragm, intervcostal muscles, accessory muscles

Question 7

atmospheric pressure during expiration

Answer 7

less than intrathoracic pressure. Relaxation of the inspiratory muscles and elastic recoil of lung and chest wall

Question 8

What happens when the diaphragm is flattened..

Answer 8

Contraction is less forceful and ventilation is less efficient. (eg acute asthma)

Question 9

3 things that control breathing

Answer 9

1. Voluntary
2. central and peripheral chemoreceptors
3. Brainstem resp centers

Question 10

Spontaneous breathing is controlled by..

Answer 10

a group of resp centers located in the brainstem

Question 11

Voluntary breathing is controlled by…

Answer 11

Cerebral Cortex

Question 12

Central chemoreceptors respond to changes in…

Answer 12

Hydrogen ion of CSF

largely determined by PaCO2

Question 13

Peripheral chemoreceptors respond to changes in…

Answer 13

Decrease in PAO2

Question 14

Upper airway obstruction location

Answer 14

Outside the thorax

Nose, Pharynx, Larynx

Question 15

Signs of upper airway

Answer 15

Stridor (insp)
Hoarseness, Cry, Barking Cough
Drooling, Snoring, Gurgling Sound

Question 16

Sings of lower airway

Answer 16

Wheezing (exp)

Question 17

Lung Tissue Disease explanation

Answer 17

Disease involving the substance of the lung
Child’s lungs become stiff
Fluid accumulation in alveoli, interstitum

Question 18

Signs of lung tissue disease

Answer 18

Grunting, Crackles

Trying to increase end-expiratory pressure

Question 19

Signs of disorder control of breathing

Answer 19

Child is “Breathing funny”

Question 20

Reasons for disorder control of breathing

Answer 20

CNS infections, seizures, brain tumor, OD, metabolic abnormalities`

Question 21

2 lower airway obstruction causes

Answer 21

1. Asthma

2. Broncholitis

Question 22

Lung tissue disease causes

Answer 22

Pneumonia, pulmonary contusion, bacterial, viral, aspiration

Question 23

What is respiratory arrest

Answer 23

The absence of respirations with detectable cardiac activity

Question 24

Specific Upper Airway Obstruction by Etiology (3)

Answer 24

1. Croup
2. Anaphylaxis
3. Foreign-body airway obstruction (FBAO)

Question 25

1. Croup Managment

Answer 25

Nebulized epinephrine | Corticosteroids

Question 26

2. Anaphylaxis Managment

Answer 26

IM Epinephrine Albuterol Antihistamine Corticosteroids

Question 27

3. Aspiration Foreign Body

Answer 27

Allow position of comfort | Specialty Consulation

Question 28

Lower Airway Obstruction by Etiology (2)

Answer 28

1. Bronchiolitis | 2. Asthma

Question 29

1. Bronchiolitis Managment

Answer 29

Nasal Suctioning | Bronchodilator Trail

Question 30

2. Asthma Management

Answer 30

``` Albuterol Corticosteroids Subcutaneous Epi Magesium Sulfate Terbutaline ```

Question 31

Lung Tissue Disease by Etiology (2)

Answer 31

1. Phenumonia/Pneumonitis (Infectious, Chemical, Aspiration) | 2. Pulmonary Edema (Cardiogenic, Noncardiogenic)

Question 32

1. Pneumonia/Pneumonitis Management

Answer 32

Albuterol Antibiotics CPAP

Question 33

2. Pulmonary Edema Management

Answer 33

Ventilation support / PEEP Vasocative support Consider Diuertic

Question 34

Disordered Control of Breathing Etiology (3)

Answer 34

1. Inc ICP 2. OD/Poisoning 3. Neuromuscular Disease

Question 35

1. Inc ICP Management

Answer 35

Avoid hypoxemia Avoid hypercarbia Avoid Hyperthermia

Question 36

2. OD/ Poisioning Managment

Answer 36

Antidote | Contact Poison Control

Question 37

3. Neuromuscular Disease

Answer 37

Consider noninvasive / invasive ventilatory support

Question 38

3 Risks of hyperventilation

Answer 38

1. Air enters the stomach (Gastric Distention) 2. Risk of pneumothorax 3. Severe air trapping

Question 39

Magensium Sulfate can be used w/ asthma as a

Answer 39

Bronchodilator

Question 40

2 uses for Terbutaline

Answer 40

1. Bronchodilator | 2. Tocolytic - anti-contraction to delay preterm labor for up to 48 hours

Question 41

What is cardiogenic pulmonary edema

Answer 41

high pressure in pulmonary capillaries causes fluid to leak into the lung interstitial and alveoli

Question 42

Most common cause of cardiogenic pulmonary edema is

Answer 42

Left ventricular myocardial dysfunction

Question 43

What type of ET is used to reduce glottic air leak

Answer 43

Cuffed ET tube

Question 44

Inc ICP fluid rate

Answer 44

20ml/kg IV isotonic crystalloid

Question 45

What drug to avoid w/ children w/ neuromuscular disease

Answer 45

Succinylcholine

Question 46

Rate of suction force needed for airway secretions

Answer 46

-80 to -120mm Hg

Question 47

OPA is used on an

Answer 47

unconscious no gag reflex pt

Question 48

Nasal Cannula oxygen rate

Answer 48

0.25 to 4 L/min

Question 49

Simple O2 mask rate

Answer 49

Minimum 6L

Question 50

Non-rebreathing mask rate

Answer 50

10 to 15 L/min

Question 51

High Flow Nasal Cannula

Answer 51

4 to 40 L/min

Question 52

DOPE

Answer 52

Displacement of the tube Obstruction of the tube Pneumo Equipment Failure

Question 53

After DOPE is checked and things are still unchanged...

Answer 53

It may be due to agitation, pain, or excessive movement Analgesia Sedation Neuromuscular block agents