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dx imaging
dx imaging and PT with respiratory failure
| Question | Answer |
|---|---|
| What is the optimal position for radiograph or plain film? | Standing, PA and lateral with full inspiration, can do AP |
| What type of contrast is used for chest radiographs? | low contrast to see soft tissues |
| What are the 5 primary pieces of information that can be gathered from an echocardiogram? | valve function, EF, wall motion, pericardial effusion, wall thickness |
| What does cardiac catheterization assess for? | cardiac hemodynamics, pressures of pulmonary artery, left ventricle and coronary artery |
| What does an X-ray for Coronary Calcium Score assess for? | Amount of atherosclerosis is present |
| What does a high resolution CT scan assess for? | contractile function and velocity of blood flow |
| What are the signs and symptoms of respiratory symptoms? | high respiratory rate, nasal flaring, cyanotic lips, labored breathing with increased use of accessory mm or abdominals |
| What are the ABG values of type I respiratory failure? | PaO2 <60; PaCO2 WNL |
| What are the ABG values of type II respiratory failure? | PaO2 < normal; PaCO2 > normal |
| What are the most common causes of acute respiratory failure? | sepsis, aspiration, thoracic or multisystem trauma and pneumonia |
| what are the less common reasons of acute respiratory failure? | neuromuscular disease, atelectasis, COPD, asthma, drug overdose, pneumothorax |
| what is respiratory failure? | inadequate gas exchange leading to hypercapnia (high CO2) or hypoxemia (low O2) |
| What are the causes of respiratory failure? | pathology of lung parenchyma, airway obstruction, musculoskeletal or neurologic conditions affecting ventilatory pump |
| What is type I respiratory failure? | Hypoxic respiratory failure |
| what are the indications of hypoxic respiratory failure (type I)? | deficient O2 delivery to the tissues, PaO2 < 60 mmHg; low inspired O2, hyperventilation, impaired diffusion, ventilation-perfusion mismatch, R to L shunting. increased metabolic demands |
| what measures can be used to determine if someone is hypoxic or hypoxemic? | ABGs, SpO2; slow declining cognitive function |
| What is Type II respiratory failure? | hypercapnic respiratory failure |
| What are the indications of hypercapnic respiratory failure? | PaCO2 > 50 mmHg (pH < 7.35); increased CO2 production (fever, sepsis, burns); decreased alveolar ventilation (dec RR, tidal volume, inc work of breathing and dead space) |
| What are the causes of type III and IV respiratory failure? | Type III (peri-operative): atelectasis due to anesthesia, supine positioning, obesity, ascites, airway secretions, incision Type IV (Shock): not enough blood to the tissue; cardiogenic, hypovolemic, septic |
| What is cardiogenic shock? | not enough blood being pumped out of the heart |
| what is hypovolemic shock? | loss off blood, decreases perfusion to tissues |
| what is septic shock? | vasodilation throughout the body, heart is unable to pump enough blood to perfuse tissues |
| What are the clinical signs and symptoms of acute respiratory failure? | dec O2 saturation or cyanosis, altered mental status, increased work of breathing, diaphragmatic fatigue, abnormal ABG, stress response |
| Why might you put someone on ventilation? | inability to maintain airway patency, or protect against aspiration/clear secretions; failure of ventilation pump; failure to oxygenate (gas exchange issue), anticipation of deterioration |
| What are the primary physiologic objectives of mechanical ventilation? | support pulmonary gas exchange reduce metabolic cost of breathing minimize ventilator-induces lung injury |
| What are the primary clinical objectives of mechanical ventilation? | reverse hypoxemia, acute respiratory acidosis; relieve respiratory distress; prevent or reverse atelectasis, reverse ventilatory mm fatigue; dec systemic or myocardial O2 consumption, stabilize chest wall, permit sedation or neuromuscular blockage |
| What are the two types of mechanical ventilation? | pressure and volume |
| What is true about pressure and volume with mechanical ventilation? | pressure and volume tend to have an inverse relationship |
| what type of mechanical ventilation is the most dangerous? | volume dependent regulation tends to be a bigger problem ; especially if the lungs are unable too inflate and the pressure increases within the thorax |
| What are the goals for PT management for patients with respiratory failure? | maximize ventilation perfusion rate, airway clearance; improve strength/endurance of ventilatory mm, prevent deconditioning, maintain functional mobility |
| What are the common signs of distress when a pt is on a vent? | consciousness, increased RR or HR, irregular breathing pattern, agitation or panic, chanes to ABG ((pH or PaCO2)) |
Created by:
mcush1
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