FISDAP Airway Exam Review, Exams of Medicine

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FISDAP AIRWAY EXAM REVIEW

(Pharmacology) Questions and Answers

What is pharmacology? - Correct Answer the study of drugs and their interactions with living systems What is pharmodynamics? - Correct Answer what effects the drug has on the body what is an agonist? - Correct Answer It is a drug that is capable of binding to, and activating, a receptor what is anotognist? - Correct Answer binds to a receptor to block medications Considerations when deciding dosage - Correct Answer - patients weight

• patients age
• desired action of the meds Action Pharmacokinetics - Correct Answer Therapeutic affects expected on body onset of action - Correct Answer The time required for a drug to elicit a therapeutic response after dosing. duration - Correct Answer (n.) the length of time that something continues or lasts peak - Correct Answer point when maximum clinical effect is activated Genaric Name - Correct Answer simple, clear, nonpriorietary name Trade name - Correct Answer The commercial name given to a drug product by its manufacturer; also called the proprietary name. Cheyne-Stokes respiration - Correct Answer breathing with increased rate/depth followed by apnea
• stroke/head injury patients

ataxic - Correct Answer irregular, unpredictable pattern with periods of apnea

• head injuries Kussmal breathing - Correct Answer Very deep gasping type of respiration associated with severe diabetic acidosis and coma. eupnea - Correct Answer normal breathing apnoea - Correct Answer absence of breathing Tachyponea - Correct Answer Increased respiratory rate, usually > 20 per minute Bradyponea - Correct Answer Slow Breathing (Respirations <10) head tilt-chin lift maneuver - Correct Answer A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients. jaw-thrust maneuver - Correct Answer Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury. Technique for opening airway - Correct Answer place tips of index finger(s) on patients roof of mouth to open airway for clearer inspection Wheezing respirations - Correct Answer associated with lower respiratory problems caused by narrowing of the airway due to airway obstruction via swelling.
• lower lungs
• mainly exhalation
• ie asthma fine crackles - Correct Answer high-pitched, discrete, discontinuous crackling sounds heard during the end of inspiration; not cleared by a cough
• lower lungs
• inhalation

• ie pneumonia, congestive heart failure, atecletasis course crackles - Correct Answer low pitched bubbling inspiration to expiration
• lower lungs
• ie congestive heart failure, severe pulmonary edema, pneumonia, bronchitits squawks - Correct Answer short inhalation wheezes in end of inhaling process, preceeded by crackles,
• middle of thoracic cage
• end of inhalation
• ie pulmonary fibrosis, allergic aveolitis, pneumonia, bronchitis stridor - Correct Answer Harsh or high-pitched respiratory sound, caused by an obstruction of the air passages
• upper respiratory tract
• biphasic in respiration
• ie airway obstruction pleural rub - Correct Answer scratchy sound produced by pleural surfaces rubbing against each other Suctioning Airway - Correct Answer - PHARYNX: Indicated to maintain a patent airway + to remove saliva, pulmonary secretions, blood, vomitus or foreign material
• no more than 15 seconds
• If CYANOSIS, an excessively SLOW or RAPID heart rate or suddenly BLOODY secretions are noted STOP IMMEDIATELY abdominal thrusts - Correct Answer Quick inward and upward pulls into the diaphragm to force an obstruction out of the airway
• PATIENT MUST BE CONSCIOUS reassess apneic state of unconscious patients (process) - Correct Answer cpr (30/2) -> check if object was pushed up -> repeat
• NEVER do a blind sweep of the oropharynx What does gurgling indicate? - Correct Answer fluids in airway/suction airway; prompt transport

vacuum pressure for suctioning - Correct Answer 300 mm Hg Suctioning time for adult, child, infant - Correct Answer 15, 10, 5 What do you do for airway obstruction caused by vomit> - Correct Answer roll patient assisted ventilation's with frothy secretions process - Correct Answer suction (15) -> vent (2) -> repeat beta-2 side effects - Correct Answer trembling, nervous tension, muscle cramps, palpitations, headaches, tachycardia, metabolic effects Chronic Bronchitis (COPD) - Correct Answer Defined by a long-term cough with mucus. Shortness of breath and wheezing. Cigarette smoking is the main cause. Long exposure to: chemical fumes, dust, etc

• "dry" cough Pneumonia (can lead to COPD) - Correct Answer An inflammation/infection of lung tissue, where the alveoli in the affected areas fill w/fluid
• typically secondary infection to uri
• bacterial: come on quickly / higher fevers
• viral: more gradual / less severe
• ie chronically ill Pulmonary chest pain - Correct Answer - pressure/fullness in chest, crushing/searing pain that spreads, pain that lasts more than a few minutes
• ie pulmonary embolism, pneumonia, pneumothorax pulmonary edema - Correct Answer accumulation of fluid in the lungs (aveoli/lung tissue)
• FROTHY pink sputum
• left side of heart cannot remove blood from lungs as fast as the right side delivers MDI (metered dose inhaler) - Correct Answer instrument that delivers a controlled dose of medication to narrowed airways with each compression of the canister

• 2 puff MAX Asthma exacerbation - Correct Answer - suction prep, assist with inhaler, aggressive airway managment: o2 -> prompt transport
• children: blow by blow o ventilation rates for apneic patients - Correct Answer adult: 1 breath per 6 seconds child: 1 breath per 2-3 seconds infant: 1 breath per 2-3 seconds assessment for adequate ventilations (3p) - Correct Answer - resp rate 12-
• clear breathing sounds
• equal rise and fall of the chest cavity lower airway construction (signs/symptoms) - Correct Answer - mainly during exhalation
• ie asthma bronchitis
• cough, retractions, tachypnea, wheezing, nasal flaring, prolonged expiatory phase techniques for ventilating apneic patient (2p) - Correct Answer - bag mask
• oropharyngl airway (unconscious) vent rates for apenic adult - Correct Answer - 1 breath every 5 - 6 seconds
• 10 / 12 per minute, 12+ can be detrimental anatomy/physiology aveoli - Correct Answer air travels through the trachea -> lungs -> bronchi -> bronchioles -> alveoli o2 admin for COPD patients - Correct Answer - ventori mask: o2 at 24% (2-3lmin) or 28% (4lmin)
• nasal cannula: 1-2 lmin
• 88-92% o2 is the desired aim for COPD dyspneic - Correct Answer - ALWAYS some form of obstruction mucus secretions
• ie cold, diptheria swelling of tissue (upper airway)

• ie epiglottitis, croup impaired exchange of gas
• ie pneumonia *treatment: adequate oxygen/ventilation, supplemental o2, mechanical ventilation treatment for hyperventilating patient - Correct Answer 1. complete primary assessment (history taking)

2. DO NOT have patient breath into bag
3. reassure the patient and provide supplemental O
4. transport promptly Vital Capacity (VC) - Correct Answer amount of air exhaled after a maximal inspiration Alert and conscious vs. decreased mental stat and reduced tidal volume - Correct Answer supplemental o2 vs. bag mask ventilation Acute pulmonary edema should not - Correct Answer - lie down, can become increasingly hypoxic initial and second ventilation attempt tip - Correct Answer first, reposition and reattempt to ventilation second, assume severe airway obstruction and perform 30 chest compressions Emphysema - Correct Answer a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness.

• barrel shaped, pursed lip breathing Signs of acute pulmonary embolism - Correct Answer acute dyspnea, tachycardia, refractory hypoxemia
• risk factors: obesity, immobility snoring indicates: - Correct Answer (anatomic)upper airway obstruction signs of respiratory failure - Correct Answer - fatigue
• labored/shallow breathing
• rapid/weak pulse

which of the following would cause a decreased level of carbon dioxide in the arterial blood> - Correct Answer deep, rapid breathing non-rebreather mask - Correct Answer 70-100% o need high concentration o2 but dont need help breathing 10-15 lmin 80-90% o BVM - Correct Answer bag valve mask

• any patient requiring ventilation with evidence of blunt trauma from the clavicles to the head 6-10 lmin 35- Nassal cannula use - Correct Answer - low/medium o2 concentration is needed, patient is stable 2-6 lmin 25-40% o 30-60 lmin 100% o When to use venturi mask? - Correct Answer acute respiratory failure hypoxic drive but need supplemental o COPD most effective way to assess tidal volume - Correct Answer rise and fall of chest intrapulmonary shunting - Correct Answer blood entering the lungs from the right side of the heart bypasses the alveoli and returns to the left side of the heart in an unoxygenated state reduced tidal volume would present with breathing that is: - Correct Answer shallow which of the following assessment findings would indicate that a patient with a foreign body airway obstruction has poor air exchange? - Correct Answer STRIDORRRRRR signs of poor air exchange - Correct Answer - weak cough
• progressive respitory distress
• stridor
• cyanosis
• decreased loc

passive o2 devices - Correct Answer - nonrebreathing mask

• simple face mask
• nasal cannula CHF - Correct Answer ELEVATE active muscular part of breathing - Correct Answer inhalation lateral recumbent - Correct Answer lying on the side
• unresponsive
• breathing on his/her own
• not injured which of the following would most likely cause a rapid drop in a patients blood glucose level? - Correct Answer taking too much prescribed insulin hypercarbia - Correct Answer Increased carbon dioxide level in the bloodstream. hypocarbia - Correct Answer insufficient carbon dioxide Alkalosis - Correct Answer pH above 7. Acidosis - Correct Answer excessive acidity of body fluids when do you administer high flow oxygen (s) - Correct Answer - patients who have seized or are actively seizing Acidosis and Alkalosis - Correct Answer too much co2 /vs not enough co negative pressure ventilation - Correct Answer diaphragm and intercostal muscles contract positive pressure ventilation - Correct Answer diaphragm and intercostal muscles expand in adults, what is tachycardia a compensatory response to? - Correct Answer hypoxemia

signs and symptoms of cocaine - Correct Answer - hypertension, tachycardia, agitation, and combativeness the method by which you administer supplemental oxygen to a hypoexmic patient mostly depends on: a. patients level of consciousness and heart rate b. severity of hypoxemia and adequacy of breathing - Correct Answer B BABBBBYY when ventilating an unresponsive apneic adult with a bag mask device you should ensure that: - Correct Answer an airway adjunct has been inserted medications such as albuterol relieve respiratory distress by: - Correct Answer relaxing the smooth muscle of the bronchioles insulin shock - Correct Answer the result of too much insulin which causes a dangerous drop in blood glucose. when is o2 via a nonbreathing mask appropriate> - Correct Answer patient is breathing adequately but suspected of being hypoxic when should the o2-powered ventilator NOT be used - Correct Answer in patients with chest trauma

• Correct Answer acute myocardial infarction - Correct Answer heart attack as the heart beats faster it demands WHAT? - Correct Answer OXYGEN after administering nitroglycerin to a patient with chest discomfort, it is MOST important for you to: - Correct Answer reassess the patient's blood pressure within 5 mins bradycardia is not typically associated with... - Correct Answer hyper/hypoglycemia excited delirium - Correct Answer A serious behavioral condition in which a person exhibits agitated behavior combined with disorientation,

hallucinations, or delusions; also called agitated delirium or exhaustive mania. Epigastrium - Correct Answer name of abdominal region between the costal margins