week2

Question 1

1What is the process of respiration?

Answer 1

Respiration is the process in which the body’s cells are supplied with O2 and CO2 is eliminated from the body.

Question 2

What is internal respiration?

Answer 2

It is the movement of gasses across the cell membrane in the systemic capillary

Question 3

What is external respiration?

Answer 3

It is the movement of gasses across the cell membrane in the alveolar capillary circulation

Question 4

What is the VQ Ratio?

Answer 4

The VQ Ratio is the relationship between ventilation (V) and perfusion (Q)
It is the balance between alveoli ventilation and vascular perfusion

Question 5

What is the normal alveolar Ventilation rate?

Answer 5

4L/min

Question 6

What is the normal pulmonary perfusion rate?

Answer 6

5L/min

Question 7

What is the normal VQ Ratio?

Answer 7

0.8

Question 8

Ventilation

Answer 8

mechanical movement of air to and from the atmosphere and the alveolar (in and out of the lungs)

Question 9

Perfusion

Answer 9

the pumping or flow of blood into the tissues and organs

Question 10

What happens when ventilation is reduced in the VQ ratio?

Answer 10

The VQ ratio reduces and the patient becomes hypoxic

Question 11

What happens when the perfusion is reduced in the VQ ratio?

Answer 11

VQ ratio increases and the patient becomes hypoxaemic

Question 12

What is non-invasive ventilation (NIV)?

Answer 12

A non-invasive system which delivers positive pressure breaths to a patient who is breathing spontaneously (Devices include CPAP, BiPAP)

Question 13

What is mechanical ventilation?

Answer 13

Invasive positive pressure ventilation, usually used when a patient has inadequate breathing pattern or rate.

Question 14

Discuss nursing care of the patient with altered gas exchange

Answer 14

Monitor resp rate & pattern
monitor tidal volume
Check for cyanosis
Check GCS

Question 15

What is the normal acid-base balance Ph of the blood?

Answer 15

7.35-7.45

Question 16

What is the normal PaO2?

Answer 16

80-100mmHg

Question 17

What is the normal PaCO2?

Answer 17

35-45mmHg

Question 18

What is the normal HCO3 (bicarb)?

Answer 18

22-26mmol/l

Question 19

What is the normal BE (base excess)?

Answer 19

+/- 3mmol/l

Question 20

What is the normal Oxygen saturation?

Answer 20

> 94.5 – 98.2%

Question 21

What are the ABG signs of Respiratory Alkalosis?

Answer 21

PACO2 of Below 35mmHg

Question 22

What are the ABG signs of Respiratory Acidosis?

Answer 22

PaCO2 of above 45mmHg

Question 23

What are the ABG signs of Hypoxaemia?

Answer 23

PaO2 levels below 80mmHg

Question 24

What are the ABG signs of Metabolic (blood) Acidosis?

Answer 24

HCO3 below 22mmol/l

Question 25

What are the ABG signs of Metabolic Alkalosis?

Answer 25

HCO3 above 26mmol/l

Question 26

How do we tell if a patient is (Ph) compensating or not?

Answer 26

``` uncompensated = Ph, PaCO2 & HCO3 abnormal compensated = Ph normal, PaCO2 & HCO3 are abnormal ```

Question 27

What are the clinical symptoms of type 1 respiratory failure?

Answer 27

Hypoxaemic low PaO2 normal/low PaCO2 mismatch between ventilation and perfusion

Question 28

What are the clinical symptoms of type 2 respiratory failure?

Answer 28

Hypercapnoeic/hypoxaemic High PaCO2 & Low PaO2 Alveolar hypoventilation

Question 29

What is the Oxygen Cascade?

Answer 29

The oxygen cascade describes the process of decreasing oxygen pressure from atmosphere to mitochondria

Question 30

What are high flow delivery systems?

Answer 30

High flow delivery systems are oxygen delivery systems which guarantee FIO2 irrespective of breathing pattern, high and low concentrations are both possible (e.g. Venturi mask)

Question 31

What are low flow delivery systems?

Answer 31

Low flow delivery systems are oxygen delivery systems which mix with room air and are influenced by breathing patterns. (e.g. nasal prongs, Hudson mask, non-rebreather)

Question 32

What is Amoxicillin?

Answer 32

A moderate spectrum beta lactamase sensitive aminopenicillin used for gram negative bacteria (e.g. influence ``` Dosage Adults – 250mg 8 hourly Children – 20mg/kg/day divided into 8 hourly doses Repeat 4-6 hrs PRN – Emergency ```

Question 33

What are some possible reactions to Amoxicillin?

Answer 33

``` Anaphylaxis Rash Urticaria Nausea Vomiting Diarrhoea ``` Contraindications Sensitivity to penicillins or cephalosporins

Question 34

What is paracetamol?

Answer 34

It is an analgesic and antipyretic which inhibits prostaglandin synthesis in the CNS Peaks 20-120 mins average 51mins Half life 6 hrs Dosage Adults – 1G every 4 hours (Maximum daily dose of 4G) Children – 15mg/KG (max 60 - 90mg/kg/day)

Question 35

What are possible reactions to paracetamol?

Answer 35

Allergic reactions Dyspepsia Nausea Haematological reactions (Blood) Contraindications Other paracetamol containing drugs

Question 36

What is the treatment for an overdose of paracetamol?

Answer 36

- Gastric Lavage (pump stomach) if within 1 hour of ingestion - Administration of Acetylcysteine if within 4hrs post ingestion with a maintenance dose for 21 hrs - Multiple bloods for hepatic function testing