Respiratory Emergencies - Causes of Dyspnea part 2 & Assessment

Question 1

A lung disease that is characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible

Answer 1

Chronic obstructive pulmonary disease

Question 2

COPD

Answer 2

Chronic obstructive pulmonary disease

Question 3

An umbrella term that is used to describe several lung diseases, including emphysema and chronic bronchitis

Answer 3

COPD

Question 4

An ongoing irritation of the trachea and bronchi

Answer 4

Chronic bronchitis

Question 5

Cause of COPD

Answer 5

Direct lung and airway damage from repeated infections or inhalation of toxic gases and particles. But most commonly from cigarette smoking

Question 6

With ___, excess musus is constantly produced, obstructing small airways and alveoli

Answer 6

Bronchitis

Question 7

Chronic oxygenation problems can lead to ___

Answer 7

High-side heart failure and fluid retention, such as edema in the legs

Question 8

Most common form of COPD

Answer 8

Emphysema

Question 9

Loss of elastic material in the lungs that occurs when the alveolar air spaces are chronically stretched due to inflamed airways and obstruction of airflow out of the lungs

Answer 9

Emphysema

Question 10

Most patients with COPD will ___

Answer 10

Chronically produce sputum, have a chronic cough, and have difficulty expelling air from their lungs, with long expiration phases and wheezing

Question 11

Patients with pulmonary edema caused by congestive heart failure will often have ___ lung sounds. Those who it is caused by COPD will often have ___ lung sounds

Answer 11

1. Wet
2. Dry

Question 12

Asthma, hay fever, and anaphylaxis are the result of ___

Answer 12

An allergic reaction

Question 13

An acute spasm of the bronchioles associated with excessive mucus production and with swelling of the mucous lining of the respiratory passages

Answer 13

Asthma

Question 14

Asthma produces ___

Answer 14

A characteristic wheezing on exhalation, the same air passages open easily on inhalation

Question 15

In severe cases of asthma, ___ may develop

Answer 15

Cyanosis and/or respiratory arrest

Question 16

Allergic rhinitis

Answer 16

Hay fever

Question 17

Hay fever causes ___

Answer 17

Coldlike symptoms, including runny nose, sneezing, congestion, and sinus pressure

Question 18

Severe allergic reaction characterized by airway swelling and dilation of blood vessels all over the body, which may lower BP

Answer 18

Anaphylaxis

Question 19

Most anaphylactic reactions occur within ___ of exposure to the allergen

Answer 19

30 minutes

Question 20

Partial or complete accumulation of air in the pleural space

Answer 20

Pneumothorax

Question 21

Pneumothorax caused by trauma or medical conditions is called ___

Answer 21

Spontaneous pneumothorax

Question 22

The natural elasticity of the lung tissue causes the lung to ___ during pneumothorax

Answer 22

Collapse

Question 23

Who is most susceptible to spontaneous pneumothorax

Answer 23

1. Patients with emphysema and asthma when a weakened portion of the lung ruptures, often during severe coughing
2. Tall, thin young men, particularly while performing strenuous activites

Question 24

A patient with spontaneous pneumothorax has ___ and might report ___

Answer 24

1. Dyspnea
2. Pleuritic chest pain

Question 25

A sharp, stabbing pain on one side that is worse during inspiration and expiration or with certain movement of the chest wall

Answer 25

Pleuritic chest pain

Question 26

Collection of fluid outside the lung on one or both sides of the chest

Answer 26

Pleural effusion

Question 27

What does pleural effusion do?

Answer 27

Compresses the lung or lungs and causes dyspnea

Question 28

The fluid in pleural effusion may collect in large volumes in response to ___

Answer 28

Any form of irritation such as infection, congestive heart failure, or cancer

Question 29

When you listen with a stethoscope to a patient with dyspnea resulting from pleural effusion, you will hear ___

Answer 29

Decreased breath sounds over the region of the chest where the fluid has moved the lung away from the chest wall

Question 30

Patients with pleural effusion will frequently feel better if they are ___

Answer 30

Sitting upright

Question 31

Always consider ___ first in patients who were eating just before becoming short of breath

Answer 31

Upper airway obstruction

Question 32

Anything in the circulatory system that moves from its point of origin to a distant site and lodges there, obstructing subsequent blood flow in that area

Answer 32

Embolus

Question 33

Emboli can be ___

Answer 33

Fragments of blood clots that break off and travel through the bloodstream, or foreign bodies that enter the circulation such as a bubble of air

Question 34

A blood clot fired in a vein, usually in the legs or pelvis, that breaks off and circulates through the venous system

Answer 34

Pulmonary embolism

Question 35

The embolus can also come from the ___ in a patient with atrial fibrillation

Answer 35

Right atrium

Question 36

Pulmonary emboli may occur as as result of ___

Answer 36

Damage to the lining of vessels, a tendency for blood to clot unusually fast, or most often, slow blood flow in a lower extremity

Question 37

Slow blood flow in the legs is usually caused by ___

Answer 37

Long-term bed rest

Question 38

Risk factors for pulmonary emboli

Answer 38

Pregnancy, active cancer, and bed rest, as well as recent surgery in the legs or pelvis

Question 39

Signs and symptoms of pulmonary emboli

Answer 39

1. Dyspnea (often sudden onset) 2. Tachycardia 3. Tachypnea 4. Varying degrees of hypoxia 5. Cyanosis 6. Acute chest pain 7. Hemoptysis

Question 40

Hemoptysis

Answer 40

Coughing up blood

Question 41

Buildup of excess base in the body fluids

Answer 41

Alkalosis

Question 42

Possible causes of hyperventilation

Answer 42

Patient with diabetes with high blood glucose level, overdose of aspirin, or a severe infection

Question 43

Hyperventilation is the body trying to compensate for ___

Answer 43

Acidosis

Question 44

Alkalosis is the cause of many of the symptoms associated with ___

Answer 44

Hyperventilation syndrome

Question 45

Hyperventilation syndrome symptoms

Answer 45

1. Anxiety 2. Dizziness 3. Numbness 4. Tingling of the hands and feet 5. Carpopedal spasms

Question 46

Painful spasms of the hands and/or feet

Answer 46

Carpopedal spasms

Question 47

Hyperventilation syndrome breath range

Answer 47

1. As high as 40 shallow breaths/min 2. As low as 20 deep breaths/min

Question 48

How to treat hyperventilation

Answer 48

Initially verbally instruct to slow breathing, if that doesn't work, give oxygen and transport to the hospital

Question 49

In cases of patient exposure to industrial chemicals at an industrial site, the patient needs to be ___

Answer 49

Decontaminated by trained responders before you take responsibility

Question 50

After a patient has been decontaminated from exposure to industrial chemicals, you should ___

Answer 50

Gather info from the first responders about the substance and the cause of dyspnea

Question 51

Inhalation injuries can cause ___

Answer 51

Aspiration pneumonia that can result in pulmonary edema. Can also cause lung damage

Question 52

People exposed to CO may think they have the ___

Answer 52

Flu

Question 53

Patients exposed to CO initially report ___

Answer 53

Headache, dizziness, fatigue, nausea, and vomiting. May report dyspnea on exertion and chest pain and display nervous system symptoms such as impaired judgement, confusion, or even hallucinations

Question 54

The worst CO exposures may result in

Answer 54

Syncope or seizure

Question 55

Treatment for conscious CO poisoning patients

Answer 55

Removal from space and high-flow oxygen by nonrebreathing mask

Question 56

Treatment of unconscious or those with an altered LOC CO poisoning patient

Answer 56

May need all airway control with an airway adjunct and ventilation using a bask-mask device

Question 57

The worst case patients of CO poisoning may be treated with ___

Answer 57

Hyperbaric or pressurized oxygen therapy

Question 58

If there are multiple people with dyspnea, consider the possibility of ___

Answer 58

An airborne hazardous material release

Question 59

A patient in significant respiratory distress will want to ___

Answer 59

Sit up

Question 60

If the patient is in respiratory distress ___

Answer 60

Place them in the Fowler or semi-Fowler position and administer oxygen at 15 L/min via non-rebreathing mask

Question 61

If the patient's breathing has inadequate depth or the rate is too slow, ___

Answer 61

Ventilations may need to be assisted with a bag-mask device

Question 62

Questions to ask yourself when evaluating a patient's ventilations

Answer 62

1. Is air going in and out 2. Does the chest rise and fall with each breath 3. Is the rate appropriate for the age of the patient

Question 63

Life threats to the patient found in the primary assessment

Answer 63

1. Problems with the ABCs 2. Poor initial general impression 3. Unresponsiveness 4. Potential hypoperfusion or shock 5. Chest pain associated with a low BP 6. Severe pain anywhere 7. Excessive bleeding

Question 64

Placement of the stethoscope when listening to breath sounds from the back

Answer 64

Place the head between and below the scapulae

Question 65

Normal breath sounds made by air moving in and out of the alveoli

Answer 65

Vesicular breath sounds

Question 66

Abnormal breath sounds, such as wheezing, stridor, rhonchi, and crackles

Answer 66

Adventitious breath sounds

Question 67

Normal breath sounds made by air moving through the bronchi

Answer 67

Bronchial breath sounds

Question 68

Make sure to listen for a ___ at each location on the chest

Answer 68

Full respiratory cycle

Question 69

When assessing for fluid collection in the lungs, ____

Answer 69

Pay special attention to the lower lung fields. Start from the bottom up and determine at which level you start to hear clear breath sounds

Question 70

Snoring sounds are indicative of a ___

Answer 70

Partial upper airway obstruction, usually in the oropharynx

Question 71

Wheezing indicates ___

Answer 71

Constriction and/or inflammation in the bronchus

Question 72

Wheezing is generally heard ___

Answer 72

On exhalation as a high-pitched, almost musical or whistling sound

Question 73

Crackles used to be called ___

Answer 73

Rales

Question 74

The sounds of air trying to pass though fluid in the alveoli

Answer 74

Crackles

Question 75

A crackling or bubbling sound typically heard on inspiration

Answer 75

Crackles

Question 76

High-pitched crackles are called ___

Answer 76

Fine crackles

Question 77

Low-pitched crackles are called ___

Answer 77

Coarse crackles

Question 78

Low-pitched rattling sounds caused by secretions or mucus in the larger airway

Answer 78

Rhonchi

Question 79

Rhonchi are sometimes referred to as ___

Answer 79

Junky lung sounds

Question 80

The high-pitched sound heard on inspiration as air tries to pass through an obstruction in the upper airway

Answer 80

Stridor

Question 81

This sound indicates a partial obstruction of the trachea

Answer 81

Stridor

Question 82

Any sign or symptom that commonly accompanies a particular condition, but is absent

Answer 82

Pertinent negative

Question 83

Diseases associated with wheezes

Answer 83

1. Asthma 2. COPD 3. Congestive heart failure 4. Pneumonia 5. Bronchitis 6. Anaphylaxis

Question 84

Diseases associated with rhonchi

Answer 84

1. COPD 2. Pneumonia 3. Bronchitis

Question 85

Diseases associated with crackles

Answer 85

1. Congestive heart failure 2. Pneumonia

Question 86

Diseases associated with stridor

Answer 86

1. Croup 2. Epiglottitis

Question 87

Diseases associated with decreased or absent breath sounds

Answer 87

1. Asthma 2. COPD 3. Pneumonia 4. Hemothorax 5. Pneumothorax 6. Atelectasis

Question 88

Questions to ask about a patient in respiratory distress

Answer 88

1. What is the patient's general state of health 2. Has the patient had any childhood or adult diseases 3. Have there been any recent surgical procedures or hospitalizations 4. Have there been any traumatic injuries

Question 89

An additional assessment for a compliant of shortness of breath or difficulty breathing uses the mnemonic ___

Answer 89

PASTE

Question 90

PASTE

Answer 90

P: Progression A: Associated chest pain S: Sputum T: Talking tiredness E: Exercise tolerance

Question 91

A secondary assessment of the cardiovascular system, especially when there is associated chest pain, should include ___

Answer 91

Checking and comparing distal pulses, reassessing the skin condition, and being alert for bradycardia and tachycardia