79 Questions
What is the primary cause of Metabolic Acidosis in the ICU?
Sepsis
What is the effect of vomiting on pH levels?
Increase in pH due to decreased H+ ions
What is the treatment for Contraction Alkalosis?
Stopping diuretics
What is the characteristic of Respiratory Acidosis?
pH below 7.35 with PCO2 above 45
What is the effect of hyperventilation on PaCO2 levels?
Decrease in PaCO2
What is the treatment for Respiratory Failure?
Using a ventilator to balance out CO2 and O2 levels
What is the characteristic of Metabolic Alkalosis?
pH above 7.45 with HCO3 above 26
What is the effect of excessive antacid use on pH levels?
Increase in pH due to decreased H+ ions
When removing a chest tube, what is the most important step to take?
Turn off the suction before clamping the tube
What is the term for a blood clot in the pulmonary artery or its branches?
Pulmonary Embolism (PE)
What is a common cause of Pulmonary Embolism?
Atrial Fibrillation
What is the term for a blood clot in the veins and a blood clot in the lungs?
Venous Thrombotic Event (VTE)
Why is it important to move patients out of bed in the hospital?
To prevent Deep Vein Thrombosis
What is a risk factor for Pulmonary Embolism?
Age > 50
What is the origin of a blood clot that causes Pulmonary Embolism?
Venous system
What is the consequence of a blood clot on the right side of the heart?
Pulmonary Embolism
What is the most likely complication of an untreated tension pneumothorax?
PEA or cardiac arrest
What is the primary purpose of a water seal in a chest tube system?
To provide a visual indication of air leaks
What is the recommended suction pressure for a chest tube?
-20 mmHg
Why is it important to use cloth tape to secure the chest tube?
It is less likely to separate over time
What is the purpose of xeroforming the gauze on the chest tube insertion site?
To provide a secure seal
What is the responsibility of the healthcare provider in relation to the chest tube drainage?
To record the drainage
What is the indication for removing the chest tube from the wall suction?
When the drainage is almost nothing
What is the term for manipulating the chest tube to promote drainage?
Milking the tube
What is the primary consequence of fluid accumulation in the lungs due to ARDS?
Reduced lung compliance and decreased oxygenation
What is the characteristic chest x-ray finding in ARDS?
Bilateral infiltrates
What is the primary mechanism of alveolar damage in ARDS?
Inflammation-mediated injury to the alveolar capillary membrane
What is the distinguishing feature between ARDS and pulmonary embolism (PE)?
Release of BNP enzyme
What is the usual complication of ARDS that leads to death?
Non-pulmonary multi-system organ failure
What is the primary cause of small airway constriction in ARDS?
Inflammation
What is the role of surfactant in ARDS?
Inactivated surfactant levels impair lung function
What is the most common cause of ARDS?
Pneumonia
What is the purpose of sedation before paralytic therapy?
To prevent the patient from experiencing fear and discomfort
What is the indication of 2 twitches when using a tranophor?
The patient is 80% blocked
Why is it important to check the tranophor every hour?
To detect any changes in the patient's response to the paralytic
What is the purpose of Extracorporeal Membrane Oxygenation (ECMO)?
To provide oxygen to the patient's body
What is the significance of ARDS in relation to ECMO?
ARDS is a condition that requires ECMO therapy
Why is it important to continue sedation after the paralytic is stopped?
To allow the paralytic to metabolize out of the patient's body
What is the role of the dial on the side of the tranophor?
To increase the electrical impulse
Why is it important to provide good eye care during paralytic therapy?
To prevent eye damage from the paralytic
What is the primary purpose of assessing the saturation level in an arterial blood gas sample?
To identify if the sample is venous or arterial
What is the function of the upper respiratory tract?
To warm and filter the air
Why is the right lung more likely to be intubated by mistake?
Because the left bronchus is at a more direct angle
What is the purpose of a biopsy in relation to respiratory status?
To assess respiratory status post-bloodwork if abnormal
What is the significance of the right side of the heart in EKG readings?
It shows distress due to COPD
Why is the left lung smaller than the right lung?
Because it is compressed by the heart
What is the purpose of bloodwork in assessing respiratory status?
To tell what's going on in the body
What is the primary difference between the right and left lungs?
The number of lobes
What is the primary location where a blood clot from a DVT can lodge and cause a Pulmonary Embolism?
Pulmonary artery or its branches
What is a common risk factor for developing a Pulmonary Embolism?
Prolonged immobility
What is the term for a blood clot in the veins and a blood clot in the lungs?
VTE
What is the correct sequence of steps when removing a chest tube?
Turn off suction, open the clamp, then remove the tube
What is the primary consequence of a blood clot on the right side of the heart?
Pulmonary Embolism
What is a common cause of Atrial Fibrillation in patients admitted to the hospital?
Newly diagnosed
What is the primary reason for advocating for patient medication adjustments during chest tube removal?
To regulate blood pressure
What is the purpose of changing the receptacle of a chest tube drainage system?
To replace a full receptacle
What is the primary purpose of Intermittent Mandatory Ventilation (IMV)?
To allow the patient to use their own muscles for ventilation
What happens when a patient on IMV breathes above the prescribed rate?
The patient only receives oxygen, but not tidal volume or PEEP, for the extra breaths
What is the benefit of allowing patients to use their own muscles for ventilation on IMV?
It promotes weaning and reduces the need for mechanical support
What is the primary issue associated with Mandatory Ventilation?
It can lead to 'bucking' the ventilator
What is the role of the patient in determining tidal volume on IMV?
The patient determines the tidal volume for spontaneous breaths only
What is the significance of the prescribed amount of ventilations on IMV?
It determines the number of breaths the patient will receive machine support for
How does IMV promote weaning?
By allowing the patient to breathe spontaneously and use their own muscles
What is the primary advantage of using IMV over other ventilation modes?
It allows for a combination of assisted and spontaneous breaths
What is the primary indication for extubation?
The indications for the original placement of the artificial airway no longer exist
What is the typical PaO2 level for a patient with lung disease?
Greater than 60 mm Hg
What is the primary focus of the Finnegan guidelines for adequate pulmonary function?
Rapid shallow breathing index less than 105
What is the primary indication for terminal wean?
The patient is no longer responsive
What is the purpose of giving tylenol suppository to a patient during terminal wean?
To reduce fever
What is the primary focus of the healthcare provider during terminal wean?
To keep the patient comfortable and advocate for their wishes
What is the characteristic of a patient who is a candidate for chronic ventilation?
The patient has a neurological condition that affects their breathing
What is the primary goal of chronic ventilation?
To sustain life
What is the primary reason people delay seeking treatment for blunt chest trauma?
They think they don't need it
What is a common cause of blunt chest trauma?
Motor vehicle accidents
What is the goal of educating patients with sternal/rib fractures?
To be mindful of excessive activities
What is the priority in managing blunt chest trauma?
Manage pain and ensure oxygenation
What is the complication that older people with three or more rib fractures are at increased risk for?
Atelectasis and pneumonia
What is the purpose of a chest binder in treating sternal/rib fractures?
To be used with caution
What is the primary goal of managing pain in sternal/rib fractures?
To promote deep breathing
Test your knowledge on acid-base imbalance, including respiratory alkalosis and acidosis, and metabolic alkalosis. Learn about the causes and effects of pH and PCO2 levels, and how to identify and manage these conditions.
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