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Define airway
Movement of air in or out with a single inspiration or exhalation.
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The name of the bifurcation in the trachea is called the ______ and it divides into the right and left ______.
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How far do you insert suction and what is the amount of time to suction?
- As far as you can see, to the base of the tongue.
- 15 seconds.
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What is the average alveolar ventilation in liters that a person will breathe in one minute?
4 to 4.5 L/minute
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What is one cause of wheezing?
- Lower airway obstruction
- Asthma
- Bronchitis
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List five structures of the upper airway
- Nasopharynx (nose)
- Orapharynx (mouth)
- Tongue
- Larynx
- Epiglottis
- Vocal Chords
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Name three complications of hyperventilating your patient.
- Increases intrathoracic pressure
- Barotrauma
- Decreased preload
- Decreased CO
- Gastric distension
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What are the two primary muscles used in respiration?
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Name two adjuncts used to maintain an open airway.
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List seven functions of the respiratory system.
- Transfer of oxygen to the body
- Removal of CO2 and waste
- Temperature
- Homeostasis
- Phonation
- Warm air
- Moisten air
- Filter
- Acid-base balance
- Oxygenation
- Ventilation
- Gas exchange
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List six structures in the lower airway.
- Trachea
- Mainstem Bronchus (L and R)
- Bronchi
- Bronchioles
- Alveolar ducts
- Alveoli
- Lungs
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What is the difference between the right and left lungs?
- Right has 3 lobes
- Left has 2 lobes
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Define oxygenation and ventilation.
- Oxygenation: Saturation of the body with oxygen.
- Ventilation: Movement of air in or out of the body in a single inspiration or expiration
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Name to maneuvers to open an airway.
- Head tilt chin lift
- Jaw thrust
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What is the best indicator that a BVM is working properly?
Equal chest rise and fall.
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What stimulates respiration?
Hypoxic / CO2 drive
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Define dead air space.
- Air between the mouth and alveoli.
- Air that never reaches the alveoli.
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Describe how to measure an OPA. What are two advantages and disadvantages?
- Measure: From the corner of the mouth to the ear.
- Advantages: Blocks tongue from back of the throat, bite block, better than an NPA, can suction through them.
- Disadvantages: Can trigger a gag reflex, cannot use on semi-conscious or conscious, can cause soft tissue trauma, may occlude airway
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Which structure prevents food from entering the trachea?
Epiglottis.
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List the flow rate for a nasal cannula, non-rebreather, and bag valve mask.
- NC: 2-6 L/min
- NRB: 8-15 L/min
- NVM: 15+
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Define respiratory distress.
Inadequate ventilation and oxygenation
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What is the maximum suctioning time and why is there a limit?
- Max: 15 seconds
- Limit: Removal of potential oxygen from patient
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How do you measure an NPA? What are two advantages and disadvantages?
- Measurement: Tip of the nose to tip of the ear.
- Advantages: Can be used on conscious and semi-conscious patients, can be used in patients with a gag reflex, doesn't block the airway, suction through it.
- Disadvantages: Soft tissue injury, epistaxis, easily occluded, may have troubling inserting with a piercing or abnormality, painful
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Define respiratory failure.
Inability to ventilate and oxygenate.
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What is the mechanism that allows for gas exchange at the alveolar level?
Diffusion
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What two techniques make for excellent BVM usage? What two ways can you hold the mask individually? What about with a partner?
- Two techniques: good seal, good technique
- Solo: EC and OK clamps
- Two person: Double EC and thumb method
- Always use two person ventilation if possible.
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What is the primary purpose of performing cricoid pressure when using a BVM?
Prevent gastric distension.
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How often do you ventilate a patient in respiratory arrest with a pulse? What is the rate per minute?
- Rate: 5-6 seconds
- Minute rate: 10-12 times per minute
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What are possible causes of stridor?
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What is the cause of rales/crackles
- Pulmonary edema
- Pneumonia
- Congestive Heart Failure (CHF)
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How do you check fremitus?
- Ask the patient to say "ninety-nine" several times in a normal voice
- Palpate using the ball of your hand
- You should feel the vibrations transmitted through the airways to the lung
- Increased tactile fremitus suggests consolidation of the underlying lung tissues
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How do you change a regulator?
- Check the bottle, make sure it's oxygen.
- Check the expiration date.
- Look for cracks, deformities etc.
- Check the seal of the bottle.
- Check the o-ring on the regulator.
- Crack the bottle.
- Attach the regulator to the tank.
- Turn the tank on, two full turns to the left.
- Apply apparatus to the tank.
- Apply apparatus to the patient.
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