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FISDAP Paramedic Airway and Breathing Exam V
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What relaxes bronchial smooth muscles? - ANSWER -beta agonists A 47-year old male complains of chest discomfort and difficulty breathing. He has had a fever, chills, and a productive cough for 3 days. Crackles are present upon auscultation. What is the most likely cause? - ANSWER -Bacterial Pneumonia A 45 year old male was assaulted and you note a small, localized area on the chest that is edematous. You hear crackling when the skin palpated. What should you expect? - ANSWER -Subcutaneous Emphysema While ventilating an intubated patient, you notice a shark fin waveform on capnography. Ventilations become increasingly difficult. What should you do? - ANSWER -Administer albuterol A 28 year old female is complaining of gradual-onset dyspnea after being released from the hospital. She was hospitalized for 1 day following thoracic trauma and a lung contusion. Lung sounds present with crackles in both bases. Vital signs are BP 130/80, P 110, R 32 shallow, SpO2:88%. You should - ANSWER -apply oxygen via non-rebreather and transport emergently What is the volume of air that a patient inhales during each breath referred to as? - ANSWER -Tidal Volume
When you hear wheezing, where is the obstruction located? - ANSWER -Lower Airway a 68 year old female complains of shortness of breath and is sitting in a tripod position and has pink sputum in the corners of her mouth. Vital signs are BP 165/110, P88, R22 with crackles, SpO2 82% on 3lpm. What should you do? - ANSWER -Increase oxygen A 71 year old mle with a tracheostomy tube is cyanotic. You hear audible gurgling during inspiration and crackles in the base of the lungs. Vital signs are BP 148/100, P 94, R 24, SpO2 88%. What should you do? - ANSWER -Suction the lumen with a soft tip catheter A 19 year old male was extricated from a structure fire. He is actively coughing and complains of pain due to burns on his chest, arms and stomach. What is the priority? - ANSWER - Laryngeal swelling a 62 year old female complains of shortness of breath. She is sitting upright in bed with multiple pillows behind her back. She has history of COPD and diabetes. Skin is warm to the touch. BP 166/100, P 84 irregular, R 20 with crackles, SpO2 95%. What should you do? - ANSWER -Administer 2.5mg of Albuterol A 29 year old male inhaled an unknown chemical. His voice is now horse and its difficult to understand him. Vital signs P136, R28, SpO2 78%. What should you do? - ANSWER -Place the patient on a nasal cannula and lie the patient supine
An 81 year old male has breathing difficulties with a nonproductive cough. He has a history of smoking and barrel shaped chest. Nursing home staff states his dyspnea has increased over the last 8 hours. Vital signs are BP 136/82, P 122, R28, and SpO2 89%. What should you suspect? - ANSWER - Emphysema A 62 year female has frequent respiratory infections. She has a long-term cough and peripheral cyanosis. Auscultation of the chest reveals rhonchi. What should you suspect? - ANSWER - Chronic Bronchitis What structure in the brain controls ventilations? - ANSWER - Medulla What is the location of the bifurcation in the trachea? - ANSWER - Carina A 84 year old male is in respiratory arrest after pulling out his tracheostomy tube. You feel air leaking around the bag-valve mask when ventilating through the stoma. No chest rise is noted. What should you do? - ANSWER -Reposition head and attempt ventilation A 51 year old male with history of COPD is having difficulty breathing. Vital signs are BP 158/74, P 100, R 22, SpO2 86%. What should you do? - ANSWER -Administer oxygen by non- rebreather mask
While transporting an intubated patient, it is becoming increasingly difficult to assist ventilations. What should you suspect? - ANSWER -Deflated cuff A 23 year old male was snowmobiling without a helmet when he was hit in the throat and knocked from his vehicle. He is unresponsive and your partner is unable to ventilate him with a BVM. You are unable to visualize the vocal chords. What should you do? - ANSWER -Perform a needle cricothyrotomy A 31 year old female was trampled by a horse. She is unresponsive and you are unable to ventilate after multiple attempts. Upon direct visualization, the vocal cords are unrecognizable. What should you do? - ANSWER -Perform a needle cricothyrotomy A 21 year old female is unresponsive. Her jaw is clenched and she has rapid, shallow respirations. Her mouth and nose are covered in wet vomitus. What should you do? - ANSWER -Place in a lateral recumbent position You find an awake 63 year old thin male with barrel chest and pink skin. What disease process should you suspect? - ANSWER - Emphysema Which of the following procedures can lead to aspiration? - ANSWER -Bag Mask Ventilation What is the name of the tracheal cartilage that sits directly inferior to the larynx? - ANSWER -Cricoid
What is the function of chemoreceptors? - ANSWER -Determine pH of the blood Assessment of a patient with respiratory distress reveals that expiration is 4 times longer than inspiration. What should you suspect? - ANSWER -Bronchospasm A 30 year old female was choking. When you arrive, she asks for your help. What should you do? - ANSWER -Encourage her to cough An unresponsive 26 year old female is slumped over her steering wheel in a parking lot. There are used needles and empty beer bottles in the front seat. Vital signs are P 130, R 6 and snoring. What should you do? - ANSWER -Manually open the airway A ventilator dependent patient's SpO2 level decreases from 94% to 80%. You hear coarse, wet sounds coming from the ET tube. What should you do? - ANSWER -Perform deep tracheal suctioning Where does the stimulus to breathe come from? - ANSWER - Brainstem A 22 year old female is apneic. You have been attempting to place the ET tube for the past 30 seconds without success. Vital signs are P 46, SpO2 67%. What should you do? - ANSWER -Stop and assist ventilations with a BVM
A 72 year old male complains of sudden onset of pain in his upper right chest. He states he recently had hernia surgery. Vital signs are BP 140/80, P 102, R 26. What is the most likely cause? - ANSWER -Pulmonary Embolism A 68 year old female is supine in bed and responds only to painful stimuli. Vital signs are BP 108/64, P 52, R 6 and shallow, SpO 78%. What should you do? - ANSWER -Assist ventilations with aa bag-valve mask What is the name of the smooth, moist epithelial layer that covers the lungs? - ANSWER -Visceral pleura After attempting ventilations of both ports of a dual lumen airway device, you are unable to see chest rise and fall. What should you do? - ANSWER -Remove the device and re-oxygenate The air that we exhale contains approximately how much oxygen?
- ANSWER -16% An unresponsive patient has a tracheostomy tube. How should you assist ventilations? - ANSWER -Use an adult BVM with a pediatric mask and ventilate through the stoma An adult patient was short of breath with a productive cough with yellowish-green secretions. He is now apneic and lung compliance is poor after endotracheal intubation. What should you do? - ANSWER -Perform tracheal suctioning
A 59 year old diabetic male is lying unresponsive in bed. He has shallow, snoring respirations. What should you do? - ANSWER - Assist ventilations with a bag mask An 18 year old male with altered level of consciousness starts the vomit after you ventilate him during transport. What should you do? - ANSWER -Roll him on his side An 81 year old female is unconscious. She aspirated oatmeal. Initial attempts at providing ventilations have been unsuccessful. Vital signs are P 45, R 0. What should you do? - ANSWER -Attempt to clear the airway An elderly male complains of difficulty breathing that has worsened over the past two weeks. He is breathing through pursed lips and is on home oxygen at 2 lpm. Wheezes are present in all lung fields. Vital signs are BP 100/60, P 120, R 28 and shallow, SpO2 88%. What should you administer? - ANSWER - Nebulized albuterol What type of receptors are located predominantly in the lung tissue? - ANSWER -Beta- An elderly male is choking at a restaurant. An employee tells you that she "tried abdominal thrusts but nothing came out". The patient is unconscious on the floor. What should you do? - ANSWER -Start chest compressions Which of the following patients is at greatest risk of aspiration? - ANSWER -A 20 year old intoxicated male who is responsive to pain
While providing ventilations to a patient you are unable to see chest rise. What should you do? - ANSWER -Reposition the patient's head A 82 year old male complains of difficulty breathing. He is receiving a continuous nebulizer treatment. Nursing home staff state he has had increasing dyspnea today with wheezing and a non-productive cough. Vital signs are BP 136/82, P 122, R 28, SpO2 89%, skin is pink warm and dry. What should you suspect? - ANSWER -Emphysema What results from hyperventilating a patient? - ANSWER - Inhibited preload and hypotension A very large man in restaurant is clutching his throat and unable to speak. You are unable to reach your arms around his abdomen. What should you do? - ANSWER -Encourage him to cough A patient is in status asthmaticus. Initial treatments and medications are ineffective. You note use of accessory muscles to breathe. Vital signs are SpO2 70%, ETCO2 55 mmHg. What should you do? - ANSWER -Prepare for intubation What is the semi-stiff, cartilage-containing flap of tissue covering the opening of the trachea? - ANSWER -Epiglottis You are transporting a chemically sedated male who is ventilator dependent and he becomes cyanotic. ETCO2 decreases from 33
