Unit One, Chapters 45/49
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| show | To fix the underlying reason the patient was ventilated for in the first place, thus leading to getting the patient off the vent.
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| show | respiratory failure
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| show | respiratory failure
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| show | 60
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| show | 50 (with an acid pH)
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| True or False. Respiratory failure can be a cute or chronic. | show 🗑
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| show | by interpreting the ABG
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| What are the 2 types of respiratory failure? | show 🗑
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| show | V/Q mismatch
shunt
hypoventilation
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| show | V/Q mismatch
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| What is the overall V/Q ratio? | show 🗑
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| _____ occurs when disease disrupts the normal ventilation/perfusion balance. | show 🗑
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| show | CBABE - causing bronchospasm, mucus plugging, inflammation, premature airway closure
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| True or False. Hypoxemia that results from V/Q mismatch will respond to supplemental oxygen therapy. | show 🗑
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| True of False. Hypoxemia that results from a shunt will respond to supplemental oxygen therapy. | show 🗑
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| show | increased use of accessory muscles.
nasal flaring
cyanosis
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| Bluish tint around the lips. | show 🗑
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| show | heart failure
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| show | peripheral cyanosis or acrocyanosis
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| Cyanosis is more common in patients with polycythemia. In prolonged hypoxemic respiratory failure, polycythemia may result when oxygen delivery to the tissue is compromised and _____ is released from the kidneys to stimulate _____ production. | show 🗑
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| show | CNS
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| show | radiolucent
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| V/Q mismatch x-ray can present as _____ when alveoli are consolidated or atelectatic. | show 🗑
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| show | 2-3%
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| show | shunt
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| What are 2 types of shunts? | show 🗑
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| show | pathological
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| show | physiological
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| show | does not
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| show | A shunt does not respond to supplemental oxygen because the gas exchange unit is not open?
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| How should a shunt be treated to increase the FRC? | show 🗑
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| How do shunts present clinically? | show 🗑
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| show | Hypoxemic Respiratory Failure
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| What is Type II Respiratory Failure? | show 🗑
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| What is a rare cause of significant hypoxemia at rest called? | show 🗑
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| show | pulmonary fibrosis
asbestosis
sarcoidosis
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| Thickening and scarring of the interstitium is called______. | show 🗑
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| Which cause of hypoxemia usually happens on exertion? | show 🗑
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| Signs and symptoms: dyspnea, dry cough, fine basilar crackles on auscultation, digital clubbing. | show 🗑
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| show | pulmonary hypertension
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| X-ray: normal film, reduced lung volumes with interstitial markings. | show 🗑
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| X-ray: enlarged right ventricle and pulmonary arteries | show 🗑
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| X-ray: hyperinflated, dark | show 🗑
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| show | perfusion/diffusion impairment
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| show | exudates
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| show | hepatopulmonary syndrome
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| Signs and symptoms: ascites, jaundice, spider nevi. | show 🗑
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| show | platypnea
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| show | orthodeoxia
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| show | diffusion impairment
perfusion/diffusion impairment
decreased inspired oxygen
venous admixture
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| show | decreased (partial pressure) of inspired oxygen - barometric pressure decreases
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| Which cause of hypoxemia is a decrease in mixed venous PO2 returning to the heart? | show 🗑
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| If there is a decrease in mixed venous PO2 returning to the heart, what will need to happen? | show 🗑
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| What is the most common cause of low mixed venous oxygen level? | show 🗑
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| show | hypoventilation
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| _______ and _______ both present with an increased AaDO2. | show 🗑
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| show | 10-25 torr on room air
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| How is age-specific AaDO2 calculated? | show 🗑
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| show | V/Q mismatch
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| Even with 100% oxygen delivery a true ______ will show little to no improvement in oxygenation. | show 🗑
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| show | by adding PEEP
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| What is normal PaO2? | show 🗑
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| show | inadequate oxygenation or lung failure
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| show | > 450 torr on supplemental oxygen
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| The A-a gradient is used to estimate the degree of ________ and the degree of _______ _______. | show 🗑
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| show | atelectasis
pulmonary edema
pneumonia
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| show | 10% or less
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| What is a mild physiological shunt percentage? | show 🗑
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| show | 20% - 30%
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| show | > 30%
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| What is the cause of a high A-a gradient? | show 🗑
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| show | PaO2/PAO2 ratio
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| show | 0.75 - 0.95 ( 75% - 95% of oxygen in alveolus gets into the arteries)
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| What arterial and alveolar ratio value is considered critical? | show 🗑
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| show | PAO2 = (Pb - Ph20)FiO2 - PaCO2 x 1.25
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| What is a normal oxygenation ratio or P/F ratio? | show 🗑
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| If a patient has hypoxemia accompanied by increased work of breathing and rising/falling PaCo2 and falling pH. What is the next step? | show 🗑
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| show | ventilatory failure
pump failure
bellows failure
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| What rises if dead space (Vd/Vt) rises? | show 🗑
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| show | insidious exposure
impairment in respiratory control
impairment of respiratory effectors
increased work of breathing
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| Cause of hypercapnic respiratory failure due to inhaling increased amount of CO2 . | show 🗑
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| When CO2 scrubbers in the settings of anesthesia machines or life-support systems in closed systems are defective, what could occur? | show 🗑
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| show | insidious exposure
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| show | impairment in respiratory control
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| show | obesity hypoventilation syndrome
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| What is the Hallmark of impairment in respiratory control? | show 🗑
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| What system is responsible for the operation of the lungs? | show 🗑
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| List the diseases associated with an impairment in respiratory effectors (muscles). (elevated CO2 and muscle fatigue) | show 🗑
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| show | drooling
weak cough
dysarthria - impairment in uttering words
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| show | increased dead space that accompanies COPD
elevated Raw that accompanies asthma
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| show | intrinsic PEEP (auto-PEEP)/air trapping
aka occult and inadvertent PEEP
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| List some causes of increased WOB. | show 🗑
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| show | PaCO2
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| show | 35 to 45 mmHg
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| show | acute hypoventilation or hypercapnic respiratory failure
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| What leads to an increased cerebral blood flow and is often accompanied by headaches? | show 🗑
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| show | CO2 narcosis
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| show | 0.3 - 0.4
0.2 - 0.4
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| A Vd/Vt of > 0.6 indicates a critical increase in _____. | show 🗑
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| The best indicator of impending ventilatory failure is to watch for a rising _____ _____ with no change or only a slight increase in PaCO2. | show 🗑
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| show | bicarb
blood pH
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| In a cute hypercapnic failure, the pH will drop _____ for every 10 torr rise in PaCO2. | show 🗑
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| show | 0.03
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| What is another name for acute-on-chronic respiratory failure? | show 🗑
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| What are the most common precipitating factors of exacerbations? | show 🗑
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