AIRWAY FINALY - 131

AIRWAY FINALY - 131

What should we always assume about an unconscious pt's airway?

It's not open.

Agonal respirations or

respiratory failure will cause the

patient pCO2 to do...?

Increase

Your pt with pneumonia has

absent lung sounds in the L

lower lobe. Why might this be?

Alveoli plugged with Mucus

Acute airway burns require

prompt management due to

which underlying

pathophysiology?

Laryngeal edema can lead to

complete airway obstruction

What monitoring device will tell

me the most about cellular

perfusion in an asthma

exacerbation patient?

Pulse oximetry

Anemia affects perfusion in what way?

Loss of Hgb leads to less oxyhemoglobin association

For the traumatic patient who was ejected and apneic and unresponsive, when intubating, what procedure is needed?

Strict spinal stabilization during intubation.

If Capnography is malfunctioning, what has been

used to confirm carbon dioxide levels in a non-breathing patient?

Colorimetric CO2 detector.

What causes cardiac failure induced pulmonary edema ?

Increased capillary hydrostatic pressure.

For inline suctioning, how long do we suction the airway?

10 seconds

Which of the following is true regarding physiologic changes associated with emphysema?

Pulmonary capillary beds are lost

What causes an emphysema patient to have a pink appearance?

Polycythemia

What anatomical structure located in the lungs is responsible for coughing?

Airway Irritant receptors

Increased pulmonary capillary hydrostatic pressure causes?

Pulmonary edema

What is abnormality of breathing rate, pattern, or effort called?

Dyspnea

What happens when the lungs/chest wall lose elasticity

Increased work of breathing

A spinal cord injury at C4 affecting the phrenic nerve is a respiratory concern because:

Loss of diaphragmatic control will likely occur

A PaCO2 value of 60mmHg would indicate

Hypoventilation

Presents with fatigue, night

sweats, weight loss, and chronic cough; commonly seen in communal living (prison, shelter)

Tuberculosis

After getting a karate chop to the anterior neck area, what underlying area is most likely damaged?

Tracheal cartilage

The patient is unable to swallow, has stridor, and is drooling. What should you suspect?

What is Epiglottitis?

What's the fastest way to

address an occluded airway

Manual technique (i.e. jaw thrust)

In two-rescuer mechanical ventilation, what is important for the person holding the mask to do?

Keep the airway open

Which airway structure is most likely to spasm? (Other then the Glottis/Cords)

Larynx

What is the most important use

of monitoring a patient with

capnography

Advanced airway placemen

Conscious work of breathing for

those in respiratory distress can

contract what additional muscle

group?

Sternocleidomastoid

What landmark are you looking

for for a cricothyrotomy?

Cricothyroid membrane.

What relatively contraindicated

action may you perform for a

trauma pt whose airway did

NOT open with a jaw trust

Head tilt chin lift

What part of the brain controls

ventilation?

Medulla oblongata

Approximate concentration of

oxygen being delivered if

bagging a patient ONLY with a

BVM - no O2 reservoir?

20%

External respiration is the

movement of what to where?

Gases in/out of the lungs

After using a BVM w/mask on a

patient on a patient, what can

cause a patient to have less

compliance when ventilation?

Gastric distention

What is internal Respiration?

Movement of gases through the capillary wall to cells.

orm of monitoring a patient's

oxygenation/ventilation status

in the hospital?

Arterial Blood Gas

When dealing with areas of less

atmospheric pressure, such as

High Altitudes, what is

affected?

Positive-negative pressure gradient.

What's the purpose of a one-

way valve on a BVM?

Protects the rescuer from back- flow of gases/secretions

Which of the following

characteristics should all bag-

valve devices have?

Be disposable

What is a contraindication of

succinylcholine?

History suggestive of hyperkalemia

Anatomy- what is the notch at

the top of the sternum called?

Jugular Notch

transfer, how does CO2 move

from the blood into the lungs?

Diffuses out of the blood into

alveolus.

What type of biochemical is

Surfactant?

Lipoprotein

Receptor most sensitive to

changes in PCO2

Primary chemoreceptor

Why do we want to be cautious

concerning providing

ventilations "Hard and Fast?

Excessive pressure expands

chest wall abnormally

A patient with sharp chest, leg

pain and recent air travel will

have what disorder?

Ventilation to perfusion mismatch

Emphysema has good compliance but the problem is

loss of elasticity and recoil in smaller airways

If a patient has a gag reflex,

and you have to bag the patient

for an extended transport from

an MVA, how will you manage

the patient with out

pharmacological assistance?

Have a lower level provider

assist ventilations with a BVM

A patient with a swollen tongue

and drooling, with difficult

speech, what is a concern for

the patient?

Has an unstable Airway

A patient has severe arthritis,

and needs intubated. what type

of intubation is best for this

patient

Digital intubation

Positive pressure ventilations in

a cardiac causes what issues

concerning profusion?

Reduces blood return to the

heart

A side effect of suctioning patient?

Increase of intracranial Pressure

You are assessing an unresponsive 32-year-old who has a history history of asthma. The patient takes a steroid daily to help prevent asthma attacks and a bronchodilator for acute care of asthma breathing deeply at 26 times per minute, pulse is 110 and weak and the skin is warm and dry which of the following assessments would be an expected finding with this patient?

an elevated blood glucose level 

Your 24-year-old female asthmatic patient is breathing at 20 times per minute with a title volume of 200 mL. What is her minute volume?

 

4000ml

You are called to a local soccer complex for a player experiencing sudden chest, pain and shortness of breath. The tall, thin male patient tells you that he was lunging to block a shot on goal. When the symptoms started your assessment reveals that the anterior chest is symmetrical and non-tender lung sounds are slightly diminished in the right upper lobe. The neck veins are flat and the trachea is midline which of the following is the most likely cause of the patient symptoms ?

spontaneous pneumothorax 

Which of the following would be the most expected medication provided for a patient and respiratory distress as a result of our acute respiratory distress syndrome

 corticosteroid

Which of the following would negatively affect carbon dioxide alveolar diffusion?

 

pulmonary edema

Which of the following would be the most likely position you would transport a patient experiencing breathing distress ?

Fowlers 

When a patient has severe pneumonia, what is the principle problem for the body? 

oxygen cannot upload to the pulmonary circulation. 

Which of the following describes the action of an inhaler such as albuterol?

 

Dilates the bronchioles 

What is the primary reason we administer an inhaler?

 

to provide immediate bronchodilation to decrease upper and lower airway secretions

Which of the following measures carbon dioxide throughout the ventilatory cycle as a waveform?

Capnography 

Which of the following would cause disruptions in perfusion while diffusion would be normal?

pulmonary embolism

Which of the types of sputum listed below would you most likely expect to see in a patient with active lung cancer?

Hemoptysis

Which of the following is most likely the cause of Stridor?

a narrowing of the upper airway 

What is the main problem when pulmonary edema is present?

 

oxygen cannot diffuse through fluid in the alveoli

Which of the following appropriately describes the glottic opening?

 

It is the largest on inspiration.

What is the name of the three bony prominences in the upper airway that slow the flow of air to allow for warming and humidifying?

 

Turbinates 

You are providing care to an adult patient with congestive heart failure who is complaining of respiratory distress. You misdiagnose the patient as having pneumonia and begin standard treatment. Which of the following would be the MOST detrimental result of your incorrect field impression?

 

Nitroglycerin induced hypotension.

Which of the following is the most dangerous result of an undetected esophageal placement of an endotracheal tube?

Hypoxia

Rescuers have decided a medical patient must be intubated.  Which of the following recommendations would be harmful in a non-traumatic respiratory arrest victim?

ventilating the esophagus 5 to 10 times after insertion

  Which of the following complications associated with rapid sequence and intubation would be the paramedics, greatest concern ?

aspiration

Which of the following is the principle reason for securing an endotracheal tube ?

to reduce the likelihood of an inadvertent extubation

Which of the following sedatives would work best for a patient in need of intubation who is conscious and hypotensive?

Etomidate

Which of the following is the best reason to perform an advanced airway procedure?

It protects the airway from aspiration.

How would a rescuer improve a patient’s Fio2 level on a non-breathing, ventilated patient?

increase oxygen flow rate

During assessment of a patient with an altered mental status, which treatment or assessment must be your HIGHEST priority?

maintaining an open, patent airway

Which of the following would be a common complication of sedating a patient prior to intubation?

hypotension

You are treating a patient with a cervical spine fracture allowing ventilations to occur through the use of 2/3 of the diaphragm.  The patient is spontaneously breathing at a rate of 12.  This patient would have which of the following:

respiratory acidosis with a capnometry reading of 50

An obese female requires emergency intubation which of the following tubes would be set up for this patient?

7.5mm  

Which of the following landmarks are used to size an oral airway properly?

   corner of the mouth to the tip of the ear lobe

Identify the anatomical location that occur blade is inserted into during oral intubation?

Vallecula

Which of the following techniques would be the best way to secure and protect an endotracheal tube?

   apply a manufactured securing device

Which of the following devices would best be used to correct snoring respirations for an adult patient with an intact, gag reflex?

   nasal airway

 Which of the following methods would be the most effective to ventilate an unresponsive patient who is suffering from adult respiratory distress syndrome, where you were unable to secure the airway with an endotracheal tube ?

 insertion of supraglottic airway and positive pressure ventilation

how would you improve a patient’s FiO2 level on a non-breathing ventilated patient?

 increase oxygen flow rate 

Identify, which of the following statements is most TRUE regarding pulmonary circulation.

oxygen rich blood returns to the left side of the heart via the pulmonary vein. 

The percentage of arterial, hemoglobin saturated with oxygen molecules is known as

SaO2

Atelectasis is BEST described as:

collapse of the alveolar sacs

When is the glottis  opening the largest ? 

upon inspiration  

A patient with a spinal cord injury at C7 will hypoventilate because:

 

no innovation of the intercostal muscles    

Which statement is TRUE regarding normal atmosphere air?

at sea level, atmospheric air pressure is approximately 760MMHG .

Identify the structure located at the division of the trachea into the right and left bronchus

Carina

When there is a physiological reason for a decrease in title volume, the body will compensate by:

increasing the respiratory rate

Identify the anatomical location that curved blade is inserted into during or intubation?

Vallecula

  You have a patient who has suffered a brain injury with increasing intracranial pressure. Which of the following types of respirations would you LEAST likely expect to see?

Kussmaul 

Rescuers are inserting double-lumen style airway into a traumatic arrest victim.  Select the statement that is MOST accurate regarding the double-lumen style airway and trauma patients

he majority of the time this tube is inserted blindly into the esophagus

During resuscitation, rescuers perform a cricoid pressure maneuver during ventilations.  Which of the following statements is most TRUE regarding this procedure?

Complications of this procedure include esophageal rupture and possibly laryngeal trauma

Which of the following PT’s would benefit the MOST from an advanced airway?

An unresponsive infant with epiglottitis

Which of the following is correct regarding the technique for performing an open cricothryotomy?

Make a 1-2cm vertical incision over the membrane

Which of the following is a CONTRAINDICATION for an open cricothyrotomy but is allowable for needle cricothyrotomy?      

Patients under the age of 8

BIPAP might be

considered more akin to normal respiration because it allows for variable pressure, making it more comfortable and effective for some patients.