T FISDAP ( Airway)

Which patient would be classified as "immediate" during and MCI?

8 year old female with no respirations after 5 positive pressure ventilations.

A 13 year old female watching a horror movie states she can't catch her breath and her fingers are numb. Respirations are 30 and deep with Sp02 of %100. She is speaking in clear sentences, has clear and equal breath sounds. You should?

Calmly reassure her, encouraging her to calmly slow her rate of breathing.

You have inserted an OPA for a 21 year old apneic male. How many times per minute should you ventilate him with a BVM?

10 to 12

Proper technique to suction patient's airway includes?

Oxygenating and ventilating before and after suctioning.

When ventilating patient with BVM, what is the appropriate oxygen flow rate?

15 liters/min

An obese man complains of sever difficulty breathing. His skin is cool and moist and breathing 22 times per minute. He indicates he never goes to the doctor and often feels dizzy after walking. You should?

Apply a nonrebreather mask at 10 liters/min

A 42 year old asthmatic patient complains of chest pain, shortness of breath and a violent cough that produces brownish sputum. What is the most likely cause?

42 YO with Pneumonia

An 89 year old patient complains of difficulty breathing and a productive cough that has gotten worse over the past 12 hours. You should suspect?

Pneumonia

As the diaphragm and intercostal muscles relax, the chest cavity?

Decreases in size, causing exhalation

During initial assessment of an adult's respiratory status, you should?

Evaluate both the respiratory rate and the rise and fall of the chest

In which group of patients are you likely to encounter "see-saw" breathing?

Pediatrics

Which sequence correctly traces the path oxygen takes from the atmosphere to the lungs?

Mouth, Pharynx, trachea, bronchi, alveoli.

A 16 year old asthmatic female in a tripod position complains of increased shortness of breath. SpO2 is 79%. You should administer oxygen at?

16 YO 10 lpm via nonrebreather mask

A 34 year old man is saying he is choking, You note stridor and hoarseness in his voice. What should you do?

Encourage him to cough

An unresponsive trauma patient is gurgling. When you suction the oropharynx with a rigid catheter, the patient gags. You should?

Assess insertion depth of the catheter

Thin 54 year old male with a nonproductive cough complains of difficulty breathing. Sitting upright with hands on his knees and you see retractions. Notice oxygen tubing around the house. You should suspect medical history of?

Chronic Bronchitis

Semiconscious patient's dentures completely loosened. You should?

Remove dentures

Carbon dioxide and oxygen exchange at the alveolar level by which process?

Diffusion

20 year old female unable to catch breath after minor car crash, numbness and tingling to hands and face. Vitals are P 118, R 24. What should you do?

High flow oxygen with a nonrebreather mask

Which term best describes respiratory difficulty?

Dyspnea

What is the amount of air that normally reaches the alveoli in an adult?

350 mL

The average adult ventilation is 500 mL, but there is an area of dead space that traps 150 mL of air. 350 mL effectively reaches the alveoli for oxygen and carbon dioxide exchange.

A 77 year old female has dyspnea, speaks in short word burst, and breathes with pursed lips. Lung sounds are diminished, distant, and clear. Vital signs are BP 152/90, P 86 and irregular, R 23. What should you suspect?

Empysema

Emphysema is a chronic destructive process of the alveoli. The alveoli regenerate but they are misshaped and consist of scar tissue. The scar tissue inhibits gas exchange. She has pursed lips because she is attempting to keep the alveoli open. Without the extra effort her alveoli will collapse due to increased surface tension.

An 18 year old male is cyanotic and complains of sharp chest pain and difficulty breathing after lifting weights. Vital signs are BP 110/66, P 88, R 22. What is the most likely cause?

Spontaneous pneumothorax

Performing strenuous activites can, on occasion, cause a collapsed (spontaneous pnemothorax) He has stable vital signs so you should suspect a S.P. If he had been hypotensive (88/40), you should suspect that the S.P had developed into a tension pneumothorax.

An unresponsive 43 year old male is cool, pale, diaphoretic, and breathing 6 times a minute. Which device should you use to administer oxygen?

Bag-valve mask

He is unresponsive and breathing too slow. This is a "Sick" patient and assisting his ventilations should be the first intervention. You can increase his respiratory rate with a bag valve mask, which is why it is the most correct choice.

A 42 year old male complains of shortness of breath after being sprayed with super-heated steam. He has burns to his face, neck and upper chest. Vital signs are BP 112/66, P 124, R 28 shallow and labored. What should you do?

Assist his ventilations

He is in respiratory failure. His breathing is ineffective because his respirations are fast and shallow. Shallow respirations do not allow for adequate oxygen exchange because the air is not drawn down far enough into the lungs. Assisting his breathing with positive pressure ventilations will help reduce any pulmonary edemy from the lower airway burns.

What are the structures that brach off the trachea into the lower airway?

Bronchi

The trachea splits at the carina into the left and right bronchus. The bronchi get smaller and smaller until it reaches the terminal bronchioles where the alveoli are located.

What is the term for high-pitched whistling sounds heard during expiration?

Wheezing

Wheezing is a high pitched whistling sound heard on EXHALATION. Wheezing suggest there is a LOWER airway OBSTRUCTION or CONSTRICTION. Exhalation is a passive process, and the wheezing noise is air passively leaving constricted bronchioles.

The use of accessory muscles and nasal flaring are signs of what type of breathing?

Labored

The use of accessory muscles is a sign of respiratory distress or failure. Nasal flaring is the body's response in effort to increase the size of the airway and attempt to draw in more air with each breath.

Expect to initially see an increased respiratory rate and heart rate with labored breathing. As the patient begins to tire, the respiratory rate and quality will begin to decrease, which worsens the problem.

What is the term for abnormal breath sounds that result from an obstructed airway?

Stridor

Stridor is an UPPER airway obstruction caused by the tissue swelling around the trachea, larynx, or epiglottis during INSPIRATION.

A 53 year old male is sleepy, diaphoretic, difficult to arouse, and breathing 8 times a minute. What should you suspect?

Respiratory Failure

This rate is too slow and the fact that he is sleepy and difficult to arouse shows that he is in respiratory failure. An adult with a respiratory of 8 is too slow for adequate gas exchange.

An alert 32 year old female complains of difficulty breathing. She speaks in 2-3 word sentences and has oxygen saturation of 92%. What should you do?

Apply high flow oxygen.

-She is alert and her respirations are still effective without the need for assisting ventilations. She only complains of shortness of breath, so applying high flow oxygen should be the first treatment.

A 56 year old female has a complete airway obstruction from a piece of food. She becomes unconscious while you asses her. What should you do?

When a patient has a completely obstructed airway and become unconscious the first thing you should do is start chest compressions.

A male complains of mild respiratory distress. He smokes 4 packs of cigarettes a day and reports a consistent cough and frequent respiratory infections. Chest sounds reveal bilateral rhonci. What should you suspect?

THE MALE HAS Chronic bronchitis (sounds like snoring, excess mucus)

A febrile 44 year old male complains of shortness of breath and has dull chest pain. He has been coughing up "rusty" sputum for the last three days. What is the most likely cause?

Pneumonia

Pneumonia is an infection of the lung tissue and the "rusty" sputum (spit) is a sign of lower airway infection. He is febrile (fever) from an immune response to the infection, and the "dull" chest pain is a common symptom at the location of the infection.

a 75 year old female complains of a sudden onset of right sided chest pain and dyspnea. She is recovering from a recent hip surgery. What should you expect?

Pulmonary embolism

A pulmonary embolism is typically the result of a clot that has formed in the lower extremity with poor circulation.

Hip surgery requires a patient to be immobilized for an extended period of time which can permit a clot to form in the distal portion of an extremity.

The sudden unilateral chest pain is the lung with the clot. Any lung tissue distal of the clot will not allow for adequate oxygen exchange.

How should you insert a nasopharyngeal airway?

First step is to face the bevel towards the septum. Apply a water soluble lubricant, do not use an oil based lubricant.

What is the Name of the hollow, semi flexible tube that carries in held air from the larynx to the lungs?

Trachea

The trachea is a tube like structure that allows air passage from the upper airway into the lungs

What is the most common location for an airway obstruction

Pharynx

This passage way is shared by air and food so it is a common site for a partial or complete obstruction, which could be food or a flaccid tongue

What part of the respiratory system contains the vocal chords?

larynx

This structure is directly above the trachea the vocal cords are located here it is also known as the voice box

What is directly posterior to the nose?

nasopharynx

The nasopharynx connects the opening of the nostrils to the soft palate? Which is located at the back of the mouth. This passage is designed to warm up and held air in filter out fine particulate matter.

What ring shaped structure forms the lower portion of the larynx?

Cricoid Cartilage (RING SHAPE)

Where is Sellick's Maneuver applied?

cricoid cartilage

Sellicks maneuver is also called cricoid pressure. It inhibits gas entering the stomach during assisted ventilations.

What happens to your diaphragm during inhalation?

Contracts

The diaphragm contracts in a downward motion drawing air into the lungs.

What is the name of the cartilaginous Ridge in the trachea at which the right and left lungs split?

Carina

Located beneath the sternum.

What is directly posterior to the mouth?

Oropharynx

How many lobes are in the lungs?

5

3 on the right and two on the left.

What is the name of the passageway shared by the digestive tract and the respiratory systems for air and food?

Pharynx

The name of the passageway is pharynx is also known as the throat. The nasal cavity and a mouth share this passage way. Air moves down the larynx and food travels into the esophagus.

56 year old female struggling to breathe with wheezing. She is unable to hold her head up or follow commands. What should you do?

Check airway for foreign body obstructions

What nerve primarily controls respiration?

Phrenic

Unresponsive 16 year old male has snoring respirations after diving in a pond and nearly

drowning. You should?

Compressions

Which is an indication of an upper airway obstruction?

Indicator is Stridor

What is the sound of a lower airway obstruction?

Wheezing

An adult is breathing at a rate of 6 beats per minute. You should?

Ventilate the ADULT via bag-valve mask

Prescribed inhalers are helpful for patients with an obstructive pulmonary disease because they?

Activate Beta 2 receptors

A 50 year old is not breathing and has a faint pulse. You should?

BVM

A patient has a history of COPD. Before assisting him in self-administering his inhaler you

should?

Shake vigorously

How often should you ventilate a patient who is apneic and has a pulse?

5-6

A 14 year old female Is short of breath. She has a history of cystic fibrosis. Lung sounds

reveal coarse rhonchi. What is the most likely cause of her condition?

mucous secretions

A 64-year-old woman with a complete laryngectomy is in respiratory arrest you should?

suction the stoma completely

When ventilating a patient with a bag valve mask device you should?

use two rescuers whenever possible

A 28-year-old patient is experiencing Dyspnea and wheezing which medication should you request from medical control?

albuterol inhaler

20 year old male complains of sudden onset shortness of breath. He is breathing at 24 times per minute and his pulse oximetry is 85% you should?

Administer oxygen via non-rebreather mask 15 lpm

A 34-year-old male says he's choking. You note Stridor and hoarseness in his voice what should you do?

encourage him to cough

Which condition could be considered an upper airway obstruction?

Epiglottitis

An 18-year-old male complains of shortness of breath. He has a history of asthma and self administered two doses of his prescribed metered dose inhaler with no relief. Vital signs are P104 R 22 SP02 91% what should you do?

Administer oxygen by non-rebreather mask

Which of the following conditions is most likely to cause decreased compliance while ventilating via bag valve mask?

tension pneumothorax

A febrile 2 year old male in respiratory distress with crackles in the lower left lung field. You

should suspect?

Pneumonia

Which of the following shows a sign of lower respiratory tract problem?

Expiratory wheezes and long expiration

A 64 year old male complains of dyspnea and is coughing up blood tinged sputum. Upon auscultation you note cracks bilaterally. What should you suspect?

Tuberculosis

Which statement indicates that the patient is suffering from a CHF rather than Pneumonia?

feels like I'm drowning when I sleep

When suctioning blood, fluid, and mucous from the oropharynx, the most appropriate device

is?

A rigid tip suction catheter

The reason for assessing the radial and the carotid pulse simultaneously is to?

Confirm Cardiac Rhythm Problem

A patient presents with a sudden onset of shortness of breath crackles, hypertension, and jugular distension. You Should suspect?

Acute Pulmonary Edema

A 73 year old male is dyspneic. You note jugular vein distension and dependent edema. Vital

signs are BP 158/93, P 130 R 36. What should you suspect?

Congestive Heart Failure

A 19-year-old female began choking after eating a hot dog. When you first arrived on scene, she was coughing and drooling.Now, she is drowsy, slow to respond, and unable to cough. You should?

Perform abdominal thrusts

A 65 year old male is having trouble breathing. He is moderately overweight and has been coughing up yellowish phlegm. He smokes two packs of cigarettes a day and reports having episodes like this for many years

Chronic bronchitis

Which of the following can be present with a sudden onset of difficult breathing and

diminished breath sounds

pneumothorax

A semi-conscious 34 year old male begins to gag after insertion of an OPA

Insert an NPA

An 18 year old febrile patient complains of malaise for several days. He is taking an oral antibiotic for an upper respiratory infection. Vital signs are bp 128/72, P118 and weak, R22 with rhonchi

Bronchitis

Which of the following assessment findings should cause you to suspect a history of COPD?

Barrel shaped chest

A thin 75 year old male complains of difficulty breathing. He states he has smoked "3 packs of

cigarettes a day for 30 years." He has bilateral wheezes

Emphysema

16 asthmatic female is in tripod position complains of increased shortness of breath. SPO2 is 79% you should administer oxygen at

10 lpm via nonrebreather

During a long transport you are administering oxygen

Consider using a humidified oxygen

A 45 year old female is complaining of breathing difficult. Her lung sounds are clear but she is becoming cyanotic on the lips

Deliver oxygen via nonrebreather at 15 lmp to 45 YO Female