Advanced Respiratory and Critical Care Flashcards (Fill-in-the-Blank)

Fill-in-the-blank flashcards covering airway management, ventilator care, chest drainage, ARDS, burns, and shock topics from the lecture notes.

During Rapid Observation, if obstruction is identified, the next step is to __.

intubate

Cuff pressures should be maintained between 20 and 25 mm Hg (24 to 30 cm H2O) because high cuff pressure can cause tracheal bleeding, ischemia, and pressure necrosis, whereas low cuff pressure can increase the risk of __.

aspiration pneumonia

Endotracheal intubation may be used for no longer than __ days, by which time a tracheostomy must be considered.

14 to 21 days

Endotracheal suctioning removes __ through the tube.

tracheobronchial secretions

A tracheostomy is used to bypass an upper airway obstruction, allow removal of secretions, and to long-term mechanical ventilation.

permit

The tracheostomy long-term complication list includes airway obstruction, infection, rupture of the innominate artery, dysphagia, fistula formation, tracheal dilatation, and __.

tracheal ischemia and necrosis

The four types of positive-pressure ventilation are Volume-cycled, Pressure-cycled, High frequency oscillatory support, and __.

NIPPV (noninvasive positive-pressure ventilation)

Noninvasive ventilation indications include Continuous Positive Airway Pressure (CPAP) and __.

BiPAP (Bi-level Positive Airway Pressure)

A C-mode on a ventilator stands for __ ventilation.

Assist-control (A/C) ventilation

SIMV stands for __.

Synchronized Intermittent Mandatory Ventilation

To address an increase in peak airway pressure due to coughing or secretions, you should __ the airway for secretions.

suction

The ABCDE Bundle components include Awakening and Breathing trials, Delirium monitoring, and Early __.

Mobility

Weaning is the process of withdrawal of dependence upon the __.

ventilator

In a chest drainage system, the water-seal chamber acts as a calibrated __.

manometer

If suction is required, a __ bottle is added to the chest drainage system.

third

The depth of water in the suction control chamber determines the amount of negative pressure; bubbling indicates that air is entering the __ chamber.

suction control

Parkland Formula Volume for fluid resuscitation uses LR and is calculated as 4 mL × %BSA × weight (kg) for the first 24 hours; half of this is given in the first __ hours.

8 hours

Emergent or resuscitative phase is from the onset of injury to the completion of __ resuscitation.

fluid

Major Burns are defined as involving more than __% TBSA.

30%

Major burn infections commonly involve __ and MRSA.

Pseudomonas

The three phases of burn injury are Emergent (resuscitative), Acute (intermediate), and __.

Rehabilitation

ARDS management includes PEEP to keep alveoli open, prone positioning, and supportive care; if PEEP cannot be maintained despite sedation, neuromuscular blocking agents may be used to achieve __.

paralysis

BNP levels help distinguish ARDS from __ pulmonary edema.

cardiogenic

Virchow’s triad risk factors for pulmonary embolism include venous stasis, hypercoagulability, and __ endothelial disease.

venous (endothelial) injury/disease

Prevention of PE includes early ambulation and the use of __ devices.

Sequential Compression Devices (SCDs)

Neurogenic shock presents with low BP and bradycardia and warm, dry skin due to loss of __ tone.

sympathetic

Distributive (circulatory) shock includes septic, neurogenic, and __ shock.

anaphylactic

In shock management, fluid replacement and vasoactive medications are used to restore intravascular volume and vasomotor tone; nutritional support is also essential. This combination is part of __ management.

shock

Crystalloids used in fluid replacement include 0.9% saline and lactated Ringer’s; hypertonic solutions are also used; a potential complication is __ edema.

pulmonary/overload edema (fluid overload)

Vasoactive medications are titrated to the patient’s response and are usually given through a central line to avoid __ injury.

extravasation

The parametric burn resuscitation protocol recommends starting fluid resuscitation immediately and continuing for the first __ hours post-injury (Parkland protocol).

24 hours

Wound debridement in burn care can be natural (spontaneous), mechanical, or __ (surgical).

surgical

Biobrane is a type of __ dressing used in burn wound management.

skin substitute (biosynthetic dressing)

Enteral nutrition is preferred in burn care; jejunal feeds are used to maintain nutrition with lower risk of __.

aspiration

American Burn Association criteria for referral to a burn center includes partial-thickness burns covering at least __% TBSA, among other criteria.

10%

A major burn injury often requires early excision and wound closure, sometimes followed by a skin graft; this is called __ debridement.

surgical

In burn care, circumferential dressings should be applied in a distal-to-proximal direction to promote return of excess fluid to the central circulation; this helps prevent __ from distal to proximal areas.

edema/edema buildup

The Zones of Burn Injury include the zone of coagulation, zone of stasis, and zone of __ hyperemia.

hyperemia

The major organisms associated with burn wound infection include Pseudomonas and __.

MRSA

The Parkland Formula includes giving half of the calculated LR volume in the first 8 hours and the remainder over the next __ hours.

16 hours

In the emergent phase of burn care, pain management is addressed with IV medications; oxygen and large-bore IVs are started early, and the patient is stabilized; this is part of the plan for __ care.

emergent/resuscitative

A chest tube drainage system must be kept below the level of the chest to promote __ drainage.

gravity

The air-fluid drainage in chest tubes is monitored by the water-seal chamber, which can show an air leak as __ in the chamber.

bubbling

In burn wound care, occlusive dressings may be used over graft sites to protect the graft and promote proper adherence; these dressings are typically left in place for __ days.

3 to 5

The term for the collapse of alveoli and exudate flow leading to impaired gas exchange in burns and ARDS is __.

hypoxemia/hypoxia