Pulmonary Pathologies
Acute Respiratory Distress Syndrome is what category of pulmonary pathology?
Restrictive
What two things would you instruct your patient when teaching them to use an incentive spirometer?
1. take a large breath in (inhale) trying to get to your goal parameter
2. slow and controlled - keep the button mid-range
Spiriva is what type of drug ???
Bronchodilator
What symptoms are present in a patient with Stage D or NYHA class IV heart failure?
A reduced FVC/FEV1 Ratio is indicative of which pathology?
Obstructive
An FEV1 of 60 is what severity on the GOLD Staging Scale for COPD ?
GOLD stage 2
What technique can be used to reduce pain with coughing in a post-surgical patient?
Splinting with a pillow
If you are dehydrated with decreased plasma fluid, what happens to your hemoglobin and hematocrit?
Hemoglobin - stays the same
Hematocrit is increased (less plasma volume - higher percentage of RBCs)
What percentage would classify as reduced Ejection Fraction?
< 40 %
7.49 pH / 60 PaO2 / 40 CO2 / 29 HcO3
Metabolic Alkalosis with Hypoxemia
What is a normal Mean Pulmonary Arterial Pressure?
Normal < 15 mmHg
What inhale/exhale ratio would you instruct your patient when teaching pursed lip breathing?
1:4 - 1:6 inhale / exhale
What is the maximum Liters / min and/or FiO2 through High Flow / Optiflow / Max Venturi O2 device ?
60 L/min or 100% FiO2
What heart and lung sounds might you hear if you have overworked someone with Heart Failure?
S3 and crackles
Describe a paradoxical breathing pattern?
What restrictive pathology commonly requires very high supplemental O2 ?
Pulmonary Fibrosis / Interstitial Lung disease
This breathing technique can be used for restrictive and obstructive pathologies and is great for reducing dyspnea.
PACED breathing
What lab value may be a contraindication to manual percussion?
or
High INR
What is needed to diagnose a myocardial infarction?
2 out of the 3 following:
1. History of ischemic chest pain
2. ECG changes
3. Rise and fall of cardiac enzymes
Describe the difference between Pressure Support (PSV) and Continuous Mandatory Ventilation (CMV) vent settings.
CMV - total support / set rate and volume
PSV - Patient controls rate and volume, pressure support given to augment volume if needed
Name two other systems that are affected in patient with cystic fibrosis ?
reproductive
liver
pancreas
intestines
gallbladder
Describe the correct postural drainage position for someone with consolidation in the superior segments of the lower lobes of the lungs
Prone, bed flat, pillow under hips
What drug class is often used to reduce anxiety in pulmonary patients?
Benzodiazepines
What class of Pulmonary Hypertension (1-5) is due to Left Heart Failure ?
Class 2
Describe the posture of a patient with COPD
Barrel chest
flattened diaphragm
wide costal angle