p.23
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are some exposures that can affect lung health?
Tobacco smoke, asthma/bronchial hyperreactivity, chronic bronchitis, respiratory infections, and TB.
p.20
Asthma Pathophysiology and Management
What defines Moderate Persistent asthma?
Symptoms daily, exacerbations affecting activity and sleep, nocturnal symptoms more than once a week, and daily use of inhaled SABA (e.g., Albuterol).
p.16
Asthma Pathophysiology and Management
What are some risk factors for developing asthma?
Genetics, obesity, sex, infections, air pollution, drugs, and food additives.
p.10
Mechanical Ventilation Modes and Management
What does the 'Volume control plus' mode in VV+ provide?
Preset tidal volume (VT) and increased patient comfort.
p.6
Extracorporeal Membrane Oxygenation (ECMO)
What is thrombosis?
The formation of a blood clot, known as a thrombus, within a blood vessel.
p.3
Burn and Inhalation Injury Management
What defines second-degree burns?
Red, wet, very painful wounds with varying depth and healing ability.
p.8
Mechanical Ventilation Modes and Management
What are the different modes of mechanical ventilation?
VC, PC, IMV, MMV, SIMV, PRVC, CMV, PAV, APRV, HFOV, VV+.
p.8
Mechanical Ventilation Modes and Management
When is Continuous Mandatory Ventilation (CMV) indicated?
In cases like tetanus, seizures, complete arrest, or crushed chest injury.
p.1
Communication Techniques
What are the 5 levels of communication?
Cliche conversation, reporting facts, personal ideas or judgments, feelings and emotions, peak communication.
p.12
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What is the primary function of BiPAP?
To provide independent positive airway pressure at both inspiration and expiration levels.
p.16
Asthma Pathophysiology and Management
What are the anatomic alterations of the lungs in asthma?
Smooth muscle constriction, excessive bronchial secretions, mucous plugging, hyperinflation, atelectasis, bronchial wall inflammation, and bronchiofibrosis.
p.28
Mechanical Ventilation Modes and Management
What is ventilator-associated pneumonia (VAP)?
An infection occurring in patients who have received mechanical ventilation for more than 48 hours.
p.19
Chronic Obstructive Pulmonary Disease (COPD) Overview
What does a decreased VC and TLC indicate in COPD?
It indicates restrictive lung disease characteristics.
p.6
Extracorporeal Membrane Oxygenation (ECMO)
What is the greatest risk associated with neurologic injury in ECMO patients?
It carries the greatest risk for morbidity and mortality.
p.10
Mechanical Ventilation Modes and Management
What determines the I-time in Volume Support mode?
The patient's respiratory demand.
p.11
Mechanical Ventilation Modes and Management
What does PEEP do to functional residual capacity (FRC)?
Increases FRC and reduces or corrects refractory hypoxia due to intrapulmonary shunting.
p.16
Asthma Pathophysiology and Management
What is exercise-induced bronchospasm (EIB)?
A condition where physical activity triggers bronchospasm.
p.18
Asthma Pathophysiology and Management
What does a decreased FEF 25-75% indicate?
It indicates potential airway obstruction.
p.18
Asthma Pathophysiology and Management
What are common signs of an asthma exacerbation?
Increased respiratory rate (RR), heart rate (HR), and blood pressure (BP).
p.19
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are the PFT findings for FVC, FEV1, and FEV1/FVC ratio in COPD?
All are decreased: FVC, FEV1, and FEV1/FVC ratio.
p.3
Communication Techniques
How do Chinese Americans typically react when unable to perform a task?
They may feel shame and embarrassment.
p.6
Pulmonary Rehabilitation Strategies
What are the adequate arterial oxygenation limits for exercise training?
PaO2 > 55 mmHg and SpO2 > 88%.
p.3
Burn and Inhalation Injury Management
What are the characteristics of third-degree burns?
Leather, dry, insensate, waxy wounds that do not heal.
p.6
Pulmonary Rehabilitation Strategies
What should be monitored during exercise if a patient is suspected of exercise hypoxemia?
Oxygen saturation (SpO2) and heart rate using a pulse oximeter.
p.8
Mechanical Ventilation Modes and Management
What does the Otis Equation relate to in mechanical ventilation?
It relates to the mechanics of ventilation, including pressure and volume relationships.
p.21
Asthma Pathophysiology and Management
What are indications for referral for expert evaluation in asthma management?
When asthma is not controlled or requires specialized care.
p.23
Chronic Obstructive Pulmonary Disease (COPD) Overview
What tests are used for diagnosing COPD?
Pulmonary function tests.
p.1
Communication Techniques
What is essential for developing and maintaining relationships in communication?
Honesty, trust, and respect.
p.26
Mechanical Ventilation Modes and Management
What are Mallampati Scores used for?
To assess the airway and predict the difficulty of intubation.
p.28
Mechanical Ventilation Modes and Management
What is the leading cause of death among patients with hospital-acquired infections?
Ventilator-associated pneumonia (VAP).
p.10
Mechanical Ventilation Modes and Management
What is the purpose of the active exhalation valve in VV+?
Allows spontaneous breathing and vents excessive pressure.
p.10
Mechanical Ventilation Modes and Management
How is pressure support adjusted in Volume Support mode?
Higher pressure support for less comfort and lower for more comfort.
p.21
Asthma Pathophysiology and Management
What are the long-term goals of asthma management?
Symptom control and risk reduction of future exacerbations.
p.21
Asthma Pathophysiology and Management
What is the focus of Step 4 in asthma management?
One or two controllers, plus as-needed reliever medication (systemic steroid).
p.11
Mechanical Ventilation Modes and Management
What can trigger a high PEEP alarm?
Auto-PEEP, air-trapping, insufficient inspiratory flow, insufficient expiratory time, and extreme high compliance.
p.17
Asthma Pathophysiology and Management
What are the key symptoms of asthma?
Recurrent wheezing, coughing, shortness of breath (SOB), and chest tightness.
p.7
Renal Failure and Neurotransmitter Functions
What can cause increased intracranial pressure (ICP)?
Bleeding in the brain, tumors, strokes, aneurysms, high blood pressure, or brain infections.
p.7
Renal Failure and Neurotransmitter Functions
What is the function of neurons?
They receive sensory input, send motor commands, and relay electrical signals.
p.4
Burn and Inhalation Injury Management
How does smoke inhalation affect morbidity in burn patients?
It increases morbidity due to stimulation of the inflammatory response and loss of small airway patency.
p.30
Communication Techniques
When is nasal intubation indicated?
When access to the mouth is unavailable, such as in oral trauma or deformities.
p.1
Communication Techniques
What is the significance of level 2 communication?
Involves feelings and emotions, used in an atmosphere of trust and mutual respect.
p.26
Mechanical Ventilation Modes and Management
What can happen if cuff pressure is overinflated?
It can obstruct blood flow, causing ischemia, tissue ulceration, and necrosis.
p.3
Communication Techniques
What is an important aspect of communication with Asian Americans?
Nonverbal communication is important.
p.6
Pulmonary Rehabilitation Strategies
What is the recommended minimum duration for exercise training in pulmonary rehabilitation?
No less than 20 minutes, 3 times per week.
p.6
Pulmonary Rehabilitation Strategies
What is the difference between diaphragmatic breathing and thoracic breathing?
Diaphragmatic breathing involves the stomach moving, while thoracic breathing involves minimal breath drawn into the lungs using intercostal muscles.
p.8
Mechanical Ventilation Modes and Management
What is the primary function of Pressure Control mode?
To limit pressure to a set peak pressure while allowing tidal volume to fluctuate.
p.21
Asthma Pathophysiology and Management
What does Step 5 of asthma management entail?
Higher level care and/or add-on treatment: Leukotriene inhibitors, allergy shots.
p.24
Pulmonary Rehabilitation Strategies
What does a decreased FVC indicate?
Possible restrictive lung disease.
p.15
Asthma Pathophysiology and Management
What are common respiratory symptoms of asthma?
Bilateral wheezing, shortness of breath, chest tightness, cough, increased respiratory rate and heart rate.
p.15
Asthma Pathophysiology and Management
What indicates the need for mechanical ventilation in asthma patients?
Severe respiratory distress or failure.
p.7
Renal Failure and Neurotransmitter Functions
What happens to carbon dioxide levels during hypoventilation?
The body's carbon dioxide level rises.
p.7
Renal Failure and Neurotransmitter Functions
What does the Peripheral Nervous System (PNS) do?
It feeds information into the brain from senses and carries signals for muscle movement.
p.7
Renal Failure and Neurotransmitter Functions
What is the spinal cord?
A cylindrical structure that carries messages between the brain and the rest of the body.
p.29
Mechanical Ventilation Modes and Management
How is the proper size for an Oropharyngeal Airway (OPA) determined?
By measuring from the corner of the mouth to the angle of the jaw.
p.31
Arterial Blood Gas (ABG) Analysis
What is a major effect of carbon monoxide (CO) poisoning?
It prevents hemoglobin from carrying oxygen effectively.
p.1
Communication Techniques
What are open-ended questions?
Questions that are thought-provoking and encourage detailed responses.
p.28
Mechanical Ventilation Modes and Management
What is one strategy to reduce VAP?
Elevating the head of the bed by 30-45 degrees.
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
How does age affect the risk of developing COPD?
COPD risk increases with age.
p.2
Communication Techniques
What are the two dimensions of communication?
Cognitive dimension (thoughts) and affective dimension (emotions).
p.3
Burn and Inhalation Injury Management
What is the characteristic of first-degree burns?
Red, dry, painful wounds that may slough the next day.
p.6
Pulmonary Rehabilitation Strategies
What does the 6-Minute Walk Test (6MWT) allow patients to do?
Set their own pace and rest while measuring their exercise capacity.
p.8
Mechanical Ventilation Modes and Management
What happens to tidal volume in Volume Control mode?
Tidal volume remains constant despite changes in respiratory mechanics or effort.
p.24
Pulmonary Rehabilitation Strategies
What does FEV1 measure?
Forced Expiratory Volume in one second.
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What does Venovenous (VV) ECMO provide support for?
Only respiratory failure.
p.15
Asthma Pathophysiology and Management
What are the types of asthma?
Allergic, Nonallergic, Late-onset, and Asthma with fixed airflow limitation.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What is the risk level of Group D in COPD?
High-risk with >2 exacerbations per year, at least 1 hospitalization, and constant symptoms.
p.25
Mechanical Ventilation Modes and Management
What are the differences between Etomidate and Ketamine?
Etomidate is used for induction with minimal cardiovascular effects, while Ketamine provides analgesia and sedation.
p.7
Renal Failure and Neurotransmitter Functions
What is the function of the Central Nervous System (CNS)?
It processes information and controls most body functions, including awareness and movement.
p.9
Mechanical Ventilation Modes and Management
What is the function of the auto-mode feature in the Siemens 300A ventilator?
Incorporates PRVC and volume support, providing time-cycled ventilation if no patient-triggering effort is detected.
p.4
Burn and Inhalation Injury Management
What can excessive resuscitative fluids lead to in smoke inhalation cases?
Non-cardiogenic pulmonary edema.
p.29
Mechanical Ventilation Modes and Management
What is Propofol (Diprivan) primarily used for?
To provide sedation in ventilated patients and for induction and maintenance of anesthesia.
p.31
Arterial Blood Gas (ABG) Analysis
What does the Oxygen Dissociation Curve represent?
It illustrates the relationship between oxygen saturation and partial pressure of oxygen in the blood.
p.28
Mechanical Ventilation Modes and Management
What are some common induction agents used in anesthesia?
Propofol, Etomidate, Ketamine.
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
Why is COPD often underdiagnosed?
Due to its symptoms being mistaken for normal aging or other conditions.
p.19
Chronic Obstructive Pulmonary Disease (COPD) Overview
What is the expected change in lung volumes such as VT and RV in COPD?
VT is increased, while IRV and ERV may be normal or decreased, and RV is increased.
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are some non-pulmonary consequences of COPD?
Heart problems, kidney failure, etc.
p.3
Communication Techniques
What communication strategy is preferred by Japanese Americans?
Asking open-ended questions to avoid saying 'no'.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What is an advantage of using an oronasal mask?
Good seal, more effective ventilation.
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What does ECMO stand for?
Extracorporeal Membrane Oxygenation.
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What are some indications for ECMO?
ARDS, status asthmaticus, pulmonary hemorrhage, pulmonary embolism, and more.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What defines Group C in COPD?
>2 exacerbations per year and at least 1 hospitalization in the last year.
p.14
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What are common side effects of CPAP therapy?
Nasal congestion, nosebleed, dry or sore mouth.
p.17
Asthma Pathophysiology and Management
What does a PEFR increase indicate in asthma monitoring?
An increase of >10% in adults or >13% in children after 4 weeks of anti-inflammatory therapy.
p.4
Burn and Inhalation Injury Management
What are some effects of thermal inhalation injury on the upper airways?
Upper airway blistering, mucosal congestion, vascular congestion, epithelial sloughing, and accumulation of thick secretions.
p.4
Burn and Inhalation Injury Management
What occurs during the early stage of inhalation injury?
Increased secretion production, bronchospasm, altered mucosal ciliary transport, and mucous retention.
p.30
Communication Techniques
What is the difference between ventilation and oxygenation?
Ventilation refers to the movement of air in and out of the lungs, while oxygenation refers to the process of delivering oxygen to the body's tissues.
p.1
Communication Techniques
What characterizes level 5 communication?
Cliche conversation; no genuine sharing, shallow and superficial.
p.20
Asthma Pathophysiology and Management
What laboratory test findings are associated with asthma?
Eosinophilia, Charcot-Leyden crystals, casts of mucus (Kirschman spirals), and increased IgE levels.
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are the common conditions present in patients with COPD?
Chronic bronchitis and emphysema.
p.18
Asthma Pathophysiology and Management
What physical sign may indicate a barrel chest?
Increased anteroposterior chest diameter.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What are some hazards or complications associated with the treatment?
Respiratory or cardiac arrest, pH < 7.20, uncooperative patient, excessive airway secretions.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What does IPAP improve?
Ventilation and hypoxemia due to hypoventilation.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
How should IPAP and EPAP be adjusted?
In 2 cm H2O increments to regulate ventilation and oxygenation.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What is a disadvantage of using nasal pillows?
Not as effective due to lower ventilation efficiency.
p.21
Asthma Pathophysiology and Management
What is the first step in the stepwise management approach for asthma?
As needed Reliever Inhaler; Albuterol.
p.11
Mechanical Ventilation Modes and Management
What is the optimal PEEP level?
The lowest pressure level (10 cm H2O) that offers the most benefits with the least side effects.
p.21
Asthma Pathophysiology and Management
What are the key components of managing asthma exacerbations?
Aerosolized medication and O2 therapy.
p.15
Asthma Pathophysiology and Management
What do peak flow meters measure in asthma patients?
Peak expiratory flow rate.
p.14
Arterial Blood Gas (ABG) Analysis
What is the role of the Severinghaus electrode?
It is a modern PCO2 electrode used for measuring carbon dioxide levels.
p.7
Renal Failure and Neurotransmitter Functions
What is hyperventilation?
Rapid or deep breathing usually caused by anxiety or panic.
p.9
Mechanical Ventilation Modes and Management
What is a key feature of SIMV?
Mandatory frequency with slightly variable time intervals between mechanical breaths, allowing spontaneous breathing.
p.4
Burn and Inhalation Injury Management
What happens in the intermediate stage (2 to 5 days post exposure) of inhalation injury?
Thermal injuries begin to improve while deep pulmonary pathology progresses.
p.29
Mechanical Ventilation Modes and Management
What are some adverse effects of Propofol?
Apnea, bradycardia, laryngospasm, bronchospasm, coughing, dyspnea, hypotension, and infusion site pain.
p.1
Communication Techniques
What does level 3 communication involve?
Personal ideas or judgments; beginning of self-disclosure with some risk.
p.20
Asthma Pathophysiology and Management
What characterizes Mild Persistent asthma?
Symptoms more than once a week but less than once a day, exacerbations affecting activity and sleep, and nocturnal symptoms more than twice a month.
p.16
Asthma Pathophysiology and Management
What causes hyperinflation of alveoli in asthma?
Air trapping due to bronchospasm and mucous plugging.
p.10
Mechanical Ventilation Modes and Management
What is HFOV in mechanical ventilation?
High-frequency oscillatory ventilation, a form of pressure-controlled IMV.
p.28
Mechanical Ventilation Modes and Management
What is a 'sedation vacation'?
A daily practice to assess the patient's readiness to be weaned off sedation.
p.2
Communication Techniques
What is transactional communication?
A form of communication where each party is both a sender and a receiver.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What is a disadvantage of using a nasal mask?
Gas leaks, nasal dryness or drainage.
p.11
Mechanical Ventilation Modes and Management
What are the mechanisms to end inspiration in mechanical ventilation?
Volume-cycled, pressure-cycled, flow-cycled, and time-cycled.
p.8
Mechanical Ventilation Modes and Management
What is a key characteristic of Pressure Control mode regarding alveolar pressure?
It prevents localized alveolar overdistention by not exceeding the set peak pressure.
p.21
Asthma Pathophysiology and Management
What protocols are followed when asthma is controlled?
Regular monitoring and maintenance therapy.
p.7
Renal Failure and Neurotransmitter Functions
What role does acetylcholine play in the body?
It controls skeletal muscles and influences neurotransmitters like dopamine and serotonin.
p.7
Renal Failure and Neurotransmitter Functions
What are neurotransmitters?
Chemical messengers that carry signals from one neuron to another target cell.
p.4
Burn and Inhalation Injury Management
What are the consequences of thermal injuries to the lower airways?
Mucosal edema, vascular congestion, epithelial sloughing, obliterative bronchiolitis, atelectasis, and pulmonary edema.
p.30
Communication Techniques
What are some complications associated with nasal intubation?
Laryngospasm, coughing, and nosebleeds.
p.29
Mechanical Ventilation Modes and Management
What is the purpose of a Nasopharyngeal Airway (NPA)?
To prevent airway obstruction and aid in bronchoscope passage.
p.1
Communication Techniques
What defines peak communication?
The highest level of communication, intimate and reserved for select individuals.
p.20
Asthma Pathophysiology and Management
What is the significance of increased IgE levels in asthma?
It indicates extrinsic asthma.
p.26
Mechanical Ventilation Modes and Management
What are the risks of underinflated cuff pressure?
Leaks can cause aspiration and Ventilator-Associated Pneumonia (VAP).
p.18
Arterial Blood Gas (ABG) Analysis
What does ABG indicate during an asthma exacerbation?
Acute alveolar hyperventilation.
p.18
Asthma Pathophysiology and Management
What chest assessment finding indicates prolonged expiration?
I:E ratio greater than 1:3.
p.19
Chronic Obstructive Pulmonary Disease (COPD) Overview
What does a decrease in FEF 25-75% indicate?
It indicates obstructive lung disease.
p.13
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What does EPAP improve?
Oxygenation by increasing FRC and reducing intrapulmonary shunting.
p.2
Communication Techniques
What is the range of intimate space?
1 inch to 18 inches (1.5 feet).
p.6
Pulmonary Rehabilitation Strategies
What is pursed-lip breathing?
A technique that allows people to control their oxygenation and ventilation by inspiring through the nose and exhaling through the mouth at a slow controlled flow.
p.21
Asthma Pathophysiology and Management
What does Step 3 of asthma management involve?
One or two controllers, plus as-needed reliever medication (long-acting).
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What are the two types of ECMO?
Venovenous (VV) and Venoarterial (VA).
p.8
Mechanical Ventilation Modes and Management
What is the significance of tidal volume in maintaining desired PaCO2?
A constant tidal volume is important for maintaining a desired PaCO2.
p.17
Asthma Pathophysiology and Management
What is intrinsic asthma?
Nonallergic or nonatopic asthma triggered by factors like stress and cold air.
p.9
Mechanical Ventilation Modes and Management
What determines the tidal volume (VT) in pressure support ventilation?
The PS level, amount of patient effort, flow cycle criteria, resistance, and compliance of the respiratory system.
p.9
Mechanical Ventilation Modes and Management
What does Pressure-Regulated Volume Control (PRVC) aim to achieve?
Provides volume-controlled breaths with the lowest pressure possible by altering inspiratory flow and I-time.
p.4
Burn and Inhalation Injury Management
What are the effects of irritants or chemicals like chlorine on the airways?
They can cause inhalation injury.
p.29
Mechanical Ventilation Modes and Management
What are the adverse effects of Dexmedetomidine?
Hypotension, bradycardia, and sinus arrest.
p.23
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are indicators for diagnosing COPD in patients over 40?
Dyspnea, chronic cough, chronic sputum production, history of exposure to risk factors, and family history of COPD.
p.10
Mechanical Ventilation Modes and Management
What is the role of the piston pump in HFOV?
It oscillates to create cycles of pressure above and below MAP.
p.28
Mechanical Ventilation Modes and Management
What is the function of Hi-Lo vacs in ventilated patients?
To remove subglottic secretions above the endotracheal tube cuff.
p.6
Pulmonary Rehabilitation Strategies
What is the goal of pulmonary rehabilitation?
To improve the patient's quality of life and increase their functional capacity.
p.3
Burn and Inhalation Injury Management
What tool can be used to calculate burn surface area?
Wallace Rule of Nines or computer applications.
p.21
Asthma Pathophysiology and Management
What are some nonpharmacologic interventions for asthma?
Bronchopulmonary rehabilitation, smoking cessation, breathing exercises.
p.15
Asthma Pathophysiology and Management
What are the classifications of asthma severity?
Mild, Moderate, Severe, and Steps 1 to 6.
p.11
Mechanical Ventilation Modes and Management
What does the Otis Equation help determine?
The optimal frequency that corresponds with the lowest work of breathing on a patient on adaptive support.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What pharmacologic treatment is recommended for Group A COPD?
Short-acting beta-agonists (SABA) like Albuterol.
p.14
Arterial Blood Gas (ABG) Analysis
What does the Henderson-Hasselbalch equation express?
The hydrogen ion equilibrium in relation to pH and the carbonic acid buffer system.
p.9
Mechanical Ventilation Modes and Management
What is the primary indication for using synchronized intermittent mandatory ventilation (SIMV)?
To provide partial ventilatory support and maintain respiratory muscle strength.
p.4
Burn and Inhalation Injury Management
What is a key diagnostic tool for inhalation injury?
<p>Bronchoscopy and pathologic markers</p>
p.30
Communication Techniques
What are the indications for oral intubation?
Relief of airway obstruction, protection of airway, facilitation of suctioning, and support of ventilation.
p.1
Communication Techniques
What is the focus of level 4 communication?
Reporting facts; involves some sharing on neutral topics without personal content.
p.12
Bilevel Positive Airway Pressure (BiPAP) Guidelines
What are some indications for using BiPAP?
Prevent intubation, chronic ventilatory failure, restrictive chest wall disease, neuromuscular disease, and nocturnal hypoventilation.
p.18
Asthma Pathophysiology and Management
What is a sign of severe asthma episodes related to blood pressure?
Pulsus paradoxus: decrease in BP on inspiration and increase on expiration.
p.28
Mechanical Ventilation Modes and Management
Why is daily oral care with chlorhexidine important for ventilated patients?
To reduce the risk of ventilator-associated pneumonia (VAP).
p.2
Communication Techniques
What does proxemics study?
The amount of space people feel is necessary to set between themselves and others.
p.3
Burn and Inhalation Injury Management
What do fourth-degree burns involve?
Involvement of underlying subcutaneous tissue, tendon, or bone.
p.21
Asthma Pathophysiology and Management
What is included in Step 2 of asthma management?
Low dose controller medication plus needed reliever medication (Cimbalport; corticosteroid).
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What is the primary purpose of ECMO?
To allow the heart and lungs to rest and heal by bypassing them.
p.15
Arterial Blood Gas (ABG) Analysis
What are the components of the Clark electrode?
Platinum cathode and silver anode in a buffered potassium chloride solution.
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What is a critical management aspect of ECMO?
Circuit monitoring, including visual checks and frequent ABGs.
p.15
Asthma Pathophysiology and Management
What are the differences between SABA’s, LABA’s, and Controller Medications?
SABA’s are short-acting bronchodilators, LABA’s are long-acting bronchodilators, and Controller Medications are used for long-term control.
p.17
Asthma Pathophysiology and Management
What are common allergens that can trigger asthma?
House dust, mites, animal dander, cockroach allergen, fungi, molds, and yeast.
p.7
Renal Failure and Neurotransmitter Functions
What is hypoventilation?
Breathing that is too shallow or too slow to meet the body's needs.
p.17
Asthma Pathophysiology and Management
What is the FEV1/FVC ratio in adults with asthma?
Decreased; typically between 0.75 - 0.80.
p.29
Mechanical Ventilation Modes and Management
What is Dexmedetomidine (Precedex) used for?
To provide sedation, anxiolysis, and analgesia without respiratory depression.
p.31
Mechanical Ventilation Modes and Management
What is deadspace in respiratory physiology?
It refers to areas of the lungs where gas exchange does not occur.
p.1
Communication Techniques
What are closed questions?
Questions that give limited insight and typically result in yes or no answers.
p.12
Mechanical Ventilation Modes and Management
How does Adaptive Support Ventilation (ASV) adjust to patients?
It changes the number of mandatory breaths and pressure support level according to the patient's breathing pattern.
p.26
Mechanical Ventilation Modes and Management
What is the main difference between OPA and NPA?
OPA (Oropharyngeal Airway) is used in unconscious patients, while NPA (Nasopharyngeal Airway) can be used in conscious patients.
p.16
Asthma Pathophysiology and Management
What type of asthma is triggered by specific allergens?
Extrinsic or allergic asthma.
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are the primary causes of COPD?
Primarily caused by cigarette smoking.
p.10
Mechanical Ventilation Modes and Management
How does HFOV achieve oxygenation?
By lung recruitment of high mean airway pressure (MAP).
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
What genetic predisposition is associated with COPD?
Alpha1-Antitrypsin deficiency, which prevents the lungs from protecting themselves.
p.3
Communication Techniques
What is a common behavior regarding eye contact among Asian Americans?
They typically avoid eye contact.
p.2
Communication Techniques
What are the 3 V's of communication?
Verbal (7%), Vocal (38%), Visual (55%).
p.10
Mechanical Ventilation Modes and Management
What are the control and trigger variables in mechanical ventilation?
Control variable delivers a breath (PC or VC); trigger variable starts inspiration (pressure, flow, or time).
p.8
Mechanical Ventilation Modes and Management
What does PEEP stand for in mechanical ventilation?
Positive End-Expiratory Pressure.
p.8
Mechanical Ventilation Modes and Management
What is the purpose of Pressure Support Ventilation (PSV)?
To augment the patient's spontaneous effort with a set level of pressure support.
p.24
Pulmonary Rehabilitation Strategies
What does a decreased FEV1 indicate?
Possible obstructive lung disease.
p.15
Asthma Pathophysiology and Management
What is a key feature of asthma symptoms?
Symptoms vary over time and in intensity.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What treatment is suggested for mild exacerbations in COPD?
SABA, with or without a short-acting antimuscarinic bronchodilator.
p.17
Asthma Pathophysiology and Management
What are some other factors that can exacerbate asthma?
GERD, nocturnal asthma, perimenstrual asthma, and allergic bronchopulmonary aspergillosis.
p.17
Asthma Pathophysiology and Management
What is the significance of FEV1 in asthma diagnosis?
An increase of >12% (>200mL) after inhaling a bronchodilator or 4 weeks of anti-inflammatory therapy indicates asthma.
p.9
Mechanical Ventilation Modes and Management
How does decreased flow affect pressure and I-time in PRVC?
Decreased flow leads to decreased resistance and pressure, while increasing I-time.
p.29
Mechanical Ventilation Modes and Management
How is the proper size for a Nasopharyngeal Airway (NPA) determined?
By measuring from the tip of the nose to the ear lobe.
p.24
Pulmonary Rehabilitation Strategies
What is the significance of the FEV1/FVC ratio?
It helps in diagnosing obstructive and restrictive lung diseases.
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What does Venoarterial (VA) ECMO provide support for?
Both cardiac and respiratory support.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What are the symptoms of Group B in COPD?
Symptoms include shortness of breath (SOB) going up a flight of stairs, with 1 or fewer exacerbations per year and no hospitalizations.
p.14
Arterial Blood Gas (ABG) Analysis
What is the significance of hydrogen ions (H+) in acid-base balance?
They are crucial for determining pH levels in the body.
p.7
Renal Failure and Neurotransmitter Functions
What is the role of the Autonomic Nervous System (ANS)?
It regulates involuntary processes like heart rate, blood pressure, and respiration.
p.29
Mechanical Ventilation Modes and Management
In which patients should an OPA be used?
In unconscious or comatose patients only.
p.11
Mechanical Ventilation Modes and Management
What hazards can occur with PEEP levels greater than 10 cm H2O?
Barotrauma, decreased venous return, increased ICP, alterations of renal functions, and water metabolism.
p.11
Mechanical Ventilation Modes and Management
What conditions can trigger a high inspiratory pressure alarm?
Increase in resistance or decrease in compliance, such as water in the circuit, secretions, kinking of ET tube, tension pneumothorax, or coughing.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What is pulmonary cachexia in COPD?
A prevalent, debilitating feature associated with increased mortality and loss of muscle function.
p.14
Arterial Blood Gas (ABG) Analysis
What is the purpose of the Clark electrode?
It is used for measuring oxygen levels in blood.
p.17
Asthma Pathophysiology and Management
What family history is relevant for asthma diagnosis?
A family history of asthma.
p.9
Mechanical Ventilation Modes and Management
What can occur during Intermittent Mandatory Ventilation (IMV)?
Air-trapping or breath stacking can occur during mechanical breaths before complete exhalation of spontaneous breaths.
p.9
Mechanical Ventilation Modes and Management
What is Proportional Assist Ventilation (PAV)?
A positive-feedback control mode that provides ventilatory support in proportion to the neural output of the respiratory center.
p.4
Extracorporeal Membrane Oxygenation (ECMO)
What is Extracorporeal Membrane Oxygenation (ECMO)?
A process where blood is pumped outside the body to a heart-lung machine, known as the oxygenator.
p.30
Communication Techniques
What is a potential consequence of carbon monoxide poisoning?
It can impair oxygen delivery to tissues.
p.29
Mechanical Ventilation Modes and Management
What are extrapyramidal reactions (EPS) associated with Haloperidol?
Unilateral cervical muscle contraction, swollen tongue, jaw muscle spasm, and backward flexion of head and feet.
p.25
Chronic Obstructive Pulmonary Disease (COPD) Overview
What characterizes Group A in COPD classification?
<1 exacerbations per year, low risk, few symptoms, no hospitalizations.
p.5
Extracorporeal Membrane Oxygenation (ECMO)
What is important to manage in relation to fluid balance during ECMO?
It may compromise ECMO circuit blood flow.
p.17
Asthma Pathophysiology and Management
When do asthma symptoms typically worsen?
At night or with exposure to animal fur, aerosol chemicals, temperature changes, dust mites, drugs, exercise, pollens, respiratory infections, smoke, and strong emotions.
p.7
Renal Failure and Neurotransmitter Functions
What is the Medulla Oblongata responsible for?
It connects the brainstem and spinal cord and regulates cardiovascular and respiratory functions.
p.29
Mechanical Ventilation Modes and Management
What is Haloperidol (Haldol) used for in critically ill patients?
For the control of agitation or delirium.
p.12
Mechanical Ventilation Modes and Management
What is the Otis Equation used for?
It relates to ventilation management, specifically in Adaptive Support Ventilation.
p.18
Asthma Pathophysiology and Management
What tests are used for bronchial provocation?
<p>Methacholine test, saline</p>
p.22
Chronic Obstructive Pulmonary Disease (COPD) Overview
What is cachexia in the context of COPD?
<p> weight loss and muscle wasting.</p>
