EMTC Chapter 19 - Complete Basic Worktext - Patients with Respiratory Distress
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| define pathophysiology | the study of how disease affects normal body processes
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| Respirator distress can be the presenting problem in a variety of serious conditions such as | heart attack, fluid in the lungs (conjestive heart failure), and worsening of long term lung conditions such as emphysema
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| what is the primary function of the respiratory system? | Moving oxygen into the bloodstream and to the tissues and the removal of waste products generated by the body. This is essential to life.
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| parietal pleura | membrane that is attached to the chest wall
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| viscreal pleura | membrane that is attached to the lung surface
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| dead space | areas of the lungs outside the alveoli where gas exchange with the blood does not take place
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| foreign substances entering the lungs is referred to as | aspiration
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| alveoli are often described as | grape-like clusters
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| hypoxia is a reduced level of | oxygen in the blood.
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| hypercarbia | excessive carbon dioxide in the blood
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| the area that is posterior to the moutn and above the larnyx is called the | oropharynix
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| oxygen is transferred to the blood and waste products are removed in the | alvioli
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| The _______ is the tissue that folds over the tracheal opening to prevent solids and liquids from entering the lungs | epiglottis
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| the lung has two pleura the _______ pleura is attached to the chest wall; the _________ pleura is attached to the surface of the lungs | Parietal; visceral
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| Areas where no transfer of oxygen takes place in the lungs are called | dead space
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| Questions on scene size up of a resperatory patients | do you see home oxygen devices? medications? What position is the patient in.
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| indicates a patient in serious condition | anxiety, restlessness, or altered mental status
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| define hypoxia | an insufficiency of oxygen in the bodys tissues
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| define hypercarbia | excessive carbon dioxide in the blood
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| define tripod position | position that may be assumed during respiratory distress to facilitate breathing. the patient usually sits or may stand or crouch leaning forward with hands placed on the bed, chair, table or knees
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| define accessory muscles | in the neck chest back and abdomen used to assist ventilations in respiratory distress
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| wheezing | high pitched musical lung sounds created by air moving through constricted air passages
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| gurgling | intermittent low pitched sounds indicative of fluids in the upper airway
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| snoring | intermittent low pitched sounds heard coming during inhalation. Often indicative of partial upper airway obstruction caused by the tounge and associated soft tissue
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| stridor | a harsh high-pitched sound that generally occurs during ihalation but can also occur during exhalation. indicatactive of partial upper airway obstruction
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| work of breathing | effort needed for adequite ventellation
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| respiratory problems are often a sign of underlying _______ problems | Cardiac
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| pertinent negatives | questions that are important to know the answers to even if the answer is no.
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| Pertinent negatives for respiratory distress patients | Do you have chest pain or discomfort
do you have pain or discomfort in your neck jaw or arms
have you ever had a heart problem
have you noticed swollen ankles, or weight gain recently
have you had to sleep on more pillows recently?
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| pulse oximetry | use of an electronic device to determine the amount of oxygen carried by the hemoglobin in the blood. Known as the oxygen saturation or SpO2
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| Cheyne-Stokes respirations | deep respirations alternating with very shallow respirations there may also be a period of apnea in the cycles. Seen in patients who have brain injury or end-stage brain tumors
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| Apnea | absence of any breathing or respiratory effort
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| Hyperventilation | breathing that is abnormally rapid or deep
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| Centeral neurogenic hyperventilation | very rapid deep respirations usually caused by head injuries or strokes that involve the brain stem
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| Kussmaul’s respirations | rapid deep ventilations usually caused by very acidic blood such as some diabedic conditions and aspirin overdose
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| Asthma | a disease that has attacks involving bronchoconstriction and mucus production with significant difficulty breathing
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| Bronchoconstriction | constriction of the bronchioles in the lungs caused by allergies, respiratory infections, exersize or emotion
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| Triggers | allergies, respiratory infections , exersize, or emotaion that may cause bronchoconstriction
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| Mucus | slippery secretion that lubricates and protects airway surfaces
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| Status asthmaticus | prolong life threating asthma attack often not responding to the patients own medications
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| Chronic bronchitis | condition where the lining fo the bronchiole is inflamed. Excess mucus is formed and remains in the airway. The accumulations become severe as the body is unable to clear the mucus from the airway
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| Emphysema | condition where the walls of the alveoli break down and lose surface area
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| Stale Air | Air that remains in the alveoli increasing carbon dioxide levels in the lungs
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| Drive to breathe | stimulation to breathe. Usually related to the level of carbon dioxide in the blood.
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| Hypoxic drive | when the stimulus to breathe is the amount of oxygen in the blood rather than the normal drive to breathe that is related to the amount of carbon dioxide in the blood
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| Auscultation | assessment techniquie of listening usually with a stethoscope
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| Midaxillary | a line drawn vertically from the middle of the armpit to the ankle
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| Pulmonary edema | a condition of fluid in the lungs
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| Crackles | lung sounds created in pulmonary edema when alveoli closed because of fluid open they are usually heard on inspiration as fine crackling sounds
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| Rhonchi | low pitched snoring or rattling sounds caused by secretions in the larger airways these may be seen in chronic lung diseases and possibly pneumonia
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| When you get a quiet chest you should | assess for adequate respiration
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| Nebulizers | devices that continuously administer a vaporized medication as opposed to the inhaler that provides a one time dose.
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| Croup | viral illness charachterized by inspiratory and expiratory stridor and a seal bark like cough.
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| Sign of inadequate oxygen (hypoxia) in children | an abnormally low pulse rate
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| True or false is it inappropriate to have a respiratory patient walk to the stretcher? | true
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| Metered dose inhaler | device that patients use to breathe in medication
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| Examples of medications used in emergencies to improve breathing | albuterol (combivent, proventil, ventolin), pirbuterol acetate (maxair), iprotropium bromide (atrovent)
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| Examples of medications that are used for long term prevention of breathing problems | flunisolide (AeroBid), beclomethasone dipropioate (Vanceril), fluticasone and salmeterol (Advair)
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| Sympathetic nervous system | part of the nervous system that activates the “fight or flight” response
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| Small volume nebulizer (SVN) | method of continuously administering a vaporized medication as opposed to the inhaler that provides a one time dose.
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