-
how soon will a pt succumb brain injury or death without adequate airway maintenance and ventilation
6 to 10 mins
-
presence of gas or air in the pleural cavity
pneumothorax
-
high pitched noise while inhaling
stridor
-
bluish appearance
cyanosis
-
difficulty speaking
dysphonia
-
-
what muscle
directly supports the tongue &
indirectly supports the epiglottis
submandibular
-
epiglottis may block the airway at the ?
larynx
-
causes of airway obstruction
- tongue (tftlea)
- foreign bodies
- trauma
- laryngeal spasm
- edema
- aspiration
-
large poorly chewed pieces of food can obstruct the upper airway by becoming lodged in the ?
are commonly called ?
- hypopharynx
- cafe coronaries
-
narrowest part of the adults airway
glottis
-
-
-
inability to move air in and out of the respiratory system
asphyxia
-
causes of laryngeal spasm and edema include
- trauma
- anaphylaxis
- epiglottis
- inhalation of superheated air, smoke, or toxic substanc
- aggressive intubation
- (taeia)
-
most commonly aspirated material
vomitus
-
-
vomitus consists of
- food particles
- protein dissolving enzymes
- hydrochloric acid
- gastrointestinal bacteria
- (fphg)
-
what happens when vomitus enter the lungs
it increases interstitial fluid and pulmonary edema
-
gastrointestinal bacteria complications occur in________ percent of pt who aspirate foreign matter
50 to 80
-
one condition that the body s metabolic demand for oxygen can exceed the pt ability to supply iti
sepsis
-
_____ is the key to airway management in every patient
vigilance
-
absence of breath sounds on one side may indicate a
pneumothorax or hemothroax
-
asymmetrical chest wall movement that lessens respiratory efficiency
paradoxical breathing
-
defect in the chest wall that allows a segment to move freely, causing paradoxical chest wall movement
flail chest
-
making the pt condition better
ameliorates
-
making the pt conditions worse
exacerbates, aggravates
-
early in respiratory compromise the __________system will be stimulated to help offset the lack of oxygen
- sympathetic nervous system
- pt will appear pale and diaphoretic
-
cyanosis is considered a ______sign of resp compromise
- late
- usually affects the lips,fingernails,skin
-
cherry red skin discoloration may be associated with
carbon monoxide poisoning
-
increased difficulty breathing while laying down
orthopnea
-
abnormal of breathing rate, pattern, effort
dyspnea
-
-
absence or near absence of 02
anoxia
-
the brain can survive how long in a premorbid state
4-6 mins
-
usually causes by nasal irritation
sneezing
-
spasmodic contraction of the diaphragm with spastic closure of the glottis
hiccups
-
hyper-inflates the lungs and re-expands atelectative alveoli. occurs about once a min
sighing
-
occurs against a partially closed epiglottis
grunting
-
severe chronic obstructive pulmonary disease may sustain a ___________ during inspiration
drop in BP
-
deep slow or rapid gasping breathing commonly found in diabetic ketoacidosis
kussmauls reparations
-
progressively faster breathing alternating gradually with shallow slower breathing indicating brainstem injury
cheyne-stokes respirations
-
irregular pattern with rate and depth with sudden, periodic episodes of apnea, indicating increased intracranial pressure
biots reparations
-
deep rapid respirations indicating increased intracarnial pressure
central neurogenic hyperventilation
-
where is the apex
just beneath the clavicle
-
where is the bass
8th or 9th intercostal space midclavicular line
-
partial obstruction of the upper airway by the tongue
snoring
-
accumulation of blood vomitus and other secretion in the upper airway
gurgling
-
musical squeaking or whistling sound heard in inspiration and expiration associated with bronchial constriction
wheezing
-
heard on inspiration associated with fluid in the smaller bronchioles
crackles
-
rattling noise heard on inspiration associated with inflammation mucus or fluid in the bronchioles
rhonchi
-
stiffness or flexibility of the lung tissue indicated by how easy air flow into the lungs
compliance
-
tachycardia usually accompanies
hypoxemia in adults
-
bradycardia hints at
anoxia with imminent cardiac arrest
-
measure hemoglobin 02 sat in peripheral tissues
pulse oximetry
-
saturation of arterial blood with oxygen as measured by pulse oximetry expressed as a percentage
oxygen saturation percentage(Sp02)
-
Sp02 does correlate with
Pa02
the greater p02 the greater 02 sat
-
what is often called the 5th vital sign
pulse ox
-
pulse ox readings between 91 and 94 percent indicate
mild hypoxia
-
95 to 99 precent on pulse ox is
normal
-
pulse ox reading between 86 and 91 percent indicates
moderate hypoxia
-
pulse ox reading below 85 percent is considered
severe hypoxia
-
causes of false pulse ox readings include
- carbon monoxide poisoning
- high intensity light
- certain hemoglobin abnormalities
(chc)
-
measurment of of hemoglobin 02 sat in the peripheral tissue
pulse oximetry
-
recording or display of the measurements of exhaled carbon dioxide concentration
capnography
-
measurement of expired c02
display of partial pressure of c02
capnometry
-
graphic recording or display of the capnometry reading over a time
capnography
-
device that measures expired c02 level
capnograph
-
visual representation of the expired c02 waveform
capnogram
-
measurement of the c02 concentration at the end of expiration
end tidal co2 (etc02)
-
partial pressure of end tidal c02 in a mixed gas solution
PETC02
-
partial pressure of c02 in arterial blood
PaC02
-
co2 is transported by the ________ to the ________side of the heart
- venous system
- right side of the heart
-
normal ETCO2 is ____mm less than the partial pressure of carbon dioxide (Pac02)
1 to 2
-
ETC02 is normally expressed as a ______
PETC02 a partial pressure is expressed as______
-
ETCO2 levels reflect
- pulmonary blood flow and cardiac output
- not ventilation
-
decreased ETC02 levels can be found in
- shock
- cardiac arrest
- pulmonary embolism
- bronchospasm
- incomplete airway obstruction
- (scpbi)
-
increased ETC02 levels can be found in
- hypoventilation
- respiratory depression
- hyperthermia
(hrh)
-
CO2 is either detected by using a
colorimetric or an infrared device
-
disposable ETC02 detector
colorimetric
-
colorimetric devices cannot detect
hyper or hypocarbia
c02 level
-
sudden drop of ETC02 to zero could be from
- esophageal intubation
- ventilator disconnection of defect in ventilator
- defect in co2 analyzer
(evd)
-
sudden decrease of ETC02
- leak in ventilator system
- partial disconnect in ventilator
- partial airway obstruction (secretion)
(lpp)
-
exponential decrease of ETC02
- pulmonary embolism
- cardiac arrest
- hypotension
- severe hyperventilation
(pchs)
-
change in c02 baseline
- calibration error
- water droplet in analyzer
- mechanical failure
(cwm)
-
sudden increase in ETC02
- accessing an area of the lung previously obstructed
- release of tourniquet
- sudden increase blood pressure
(ars)
-
gradual lowering of ETC02
- hypovolemia
- decreasing cardiac output
- decreasing body temp
(hdd)
-
gradual increase in ETC02
- rising body temp
- hyperventilation
- c02 absorption
- partial airway obstruction
(rhcp)
-
electronic ETC02 detector are either
- qualitative (simply detect the C02)
- quantitave ( determine how much c02)
-
phase 1 in capnogram
resp baseline
-
phase 2 of capnogram
resp upstroke
-
phase3 of capnogram
resp plateau
-
phase 4 of capnogram
inspiratory phase
-
during cpr ETC02 levels have been found to correlate well with
- cardiac output
- coronary perfusion
-
EDD( esophageal detector device) is contraindicated in
peds
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