Respiratory and Metabolic Acid-Base Imbalance
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Questions and Answers

What is the primary cause of Metabolic Acidosis in the ICU?

  • Chronic Kidney Disease
  • Sepsis (correct)
  • Aspirin Overdose
  • Diabetic Ketoacidosis

    • What is the effect of vomiting on pH levels?

  • Increase in pH due to decreased H+ ions (correct)
  • Decrease in pH due to increased H+ ions
  • Initially decreases pH, then increases it
  • No effect on pH levels

    • What is the treatment for Contraction Alkalosis?

  • Encouraging hyperventilation
  • Administering more diuretics
  • Stopping diuretics (correct)
  • Increasing antacid use

    • What is the characteristic of Respiratory Acidosis?

    <p>pH below 7.35 with PCO2 above 45</p> Signup and view all the answers

    What is the effect of hyperventilation on PaCO2 levels?

    <p>Decrease in PaCO2</p> Signup and view all the answers

    What is the treatment for Respiratory Failure?

    <p>Using a ventilator to balance out CO2 and O2 levels</p> Signup and view all the answers

    What is the characteristic of Metabolic Alkalosis?

    <p>pH above 7.45 with HCO3 above 26</p> Signup and view all the answers

    What is the effect of excessive antacid use on pH levels?

    <p>Increase in pH due to decreased H+ ions</p> Signup and view all the answers

    When removing a chest tube, what is the most important step to take?

    <p>Turn off the suction before clamping the tube</p> Signup and view all the answers

    What is the term for a blood clot in the pulmonary artery or its branches?

    <p>Pulmonary Embolism (PE)</p> Signup and view all the answers

    What is a common cause of Pulmonary Embolism?

    <p>Atrial Fibrillation</p> Signup and view all the answers

    What is the term for a blood clot in the veins and a blood clot in the lungs?

    <p>Venous Thrombotic Event (VTE)</p> Signup and view all the answers

    Why is it important to move patients out of bed in the hospital?

    <p>To prevent Deep Vein Thrombosis</p> Signup and view all the answers

    What is a risk factor for Pulmonary Embolism?

    <p>Age &gt; 50</p> Signup and view all the answers

    What is the origin of a blood clot that causes Pulmonary Embolism?

    <p>Venous system</p> Signup and view all the answers

    What is the consequence of a blood clot on the right side of the heart?

    <p>Pulmonary Embolism</p> Signup and view all the answers

    What is the most likely complication of an untreated tension pneumothorax?

    <p>PEA or cardiac arrest</p> Signup and view all the answers

    What is the primary purpose of a water seal in a chest tube system?

    <p>To provide a visual indication of air leaks</p> Signup and view all the answers

    What is the recommended suction pressure for a chest tube?

    <p>-20 mmHg</p> Signup and view all the answers

    Why is it important to use cloth tape to secure the chest tube?

    <p>It is less likely to separate over time</p> Signup and view all the answers

    What is the purpose of xeroforming the gauze on the chest tube insertion site?

    <p>To provide a secure seal</p> Signup and view all the answers

    What is the responsibility of the healthcare provider in relation to the chest tube drainage?

    <p>To record the drainage</p> Signup and view all the answers

    What is the indication for removing the chest tube from the wall suction?

    <p>When the drainage is almost nothing</p> Signup and view all the answers

    What is the term for manipulating the chest tube to promote drainage?

    <p>Milking the tube</p> Signup and view all the answers

    What is the primary consequence of fluid accumulation in the lungs due to ARDS?

    <p>Reduced lung compliance and decreased oxygenation</p> Signup and view all the answers

    What is the characteristic chest x-ray finding in ARDS?

    <p>Bilateral infiltrates</p> Signup and view all the answers

    What is the primary mechanism of alveolar damage in ARDS?

    <p>Inflammation-mediated injury to the alveolar capillary membrane</p> Signup and view all the answers

    What is the distinguishing feature between ARDS and pulmonary embolism (PE)?

    <p>Release of BNP enzyme</p> Signup and view all the answers

    What is the usual complication of ARDS that leads to death?

    <p>Non-pulmonary multi-system organ failure</p> Signup and view all the answers

    What is the primary cause of small airway constriction in ARDS?

    <p>Inflammation</p> Signup and view all the answers

    What is the role of surfactant in ARDS?

    <p>Inactivated surfactant levels impair lung function</p> Signup and view all the answers

    What is the most common cause of ARDS?

    <p>Pneumonia</p> Signup and view all the answers

    What is the purpose of sedation before paralytic therapy?

    <p>To prevent the patient from experiencing fear and discomfort</p> Signup and view all the answers

    What is the indication of 2 twitches when using a tranophor?

    <p>The patient is 80% blocked</p> Signup and view all the answers

    Why is it important to check the tranophor every hour?

    <p>To detect any changes in the patient's response to the paralytic</p> Signup and view all the answers

    What is the purpose of Extracorporeal Membrane Oxygenation (ECMO)?

    <p>To provide oxygen to the patient's body</p> Signup and view all the answers

    What is the significance of ARDS in relation to ECMO?

    <p>ARDS is a condition that requires ECMO therapy</p> Signup and view all the answers

    Why is it important to continue sedation after the paralytic is stopped?

    <p>To allow the paralytic to metabolize out of the patient's body</p> Signup and view all the answers

    What is the role of the dial on the side of the tranophor?

    <p>To increase the electrical impulse</p> Signup and view all the answers

    Why is it important to provide good eye care during paralytic therapy?

    <p>To prevent eye damage from the paralytic</p> Signup and view all the answers

    What is the primary purpose of assessing the saturation level in an arterial blood gas sample?

    <p>To identify if the sample is venous or arterial</p> Signup and view all the answers

    What is the function of the upper respiratory tract?

    <p>To warm and filter the air</p> Signup and view all the answers

    Why is the right lung more likely to be intubated by mistake?

    <p>Because the left bronchus is at a more direct angle</p> Signup and view all the answers

    What is the purpose of a biopsy in relation to respiratory status?

    <p>To assess respiratory status post-bloodwork if abnormal</p> Signup and view all the answers

    What is the significance of the right side of the heart in EKG readings?

    <p>It shows distress due to COPD</p> Signup and view all the answers

    Why is the left lung smaller than the right lung?

    <p>Because it is compressed by the heart</p> Signup and view all the answers

    What is the purpose of bloodwork in assessing respiratory status?

    <p>To tell what's going on in the body</p> Signup and view all the answers

    What is the primary difference between the right and left lungs?

    <p>The number of lobes</p> Signup and view all the answers

    What is the primary location where a blood clot from a DVT can lodge and cause a Pulmonary Embolism?

    <p>Pulmonary artery or its branches</p> Signup and view all the answers

    What is a common risk factor for developing a Pulmonary Embolism?

    <p>Prolonged immobility</p> Signup and view all the answers

    What is the term for a blood clot in the veins and a blood clot in the lungs?

    <p>VTE</p> Signup and view all the answers

    What is the correct sequence of steps when removing a chest tube?

    <p>Turn off suction, open the clamp, then remove the tube</p> Signup and view all the answers

    What is the primary consequence of a blood clot on the right side of the heart?

    <p>Pulmonary Embolism</p> Signup and view all the answers

    What is a common cause of Atrial Fibrillation in patients admitted to the hospital?

    <p>Newly diagnosed</p> Signup and view all the answers

    What is the primary reason for advocating for patient medication adjustments during chest tube removal?

    <p>To regulate blood pressure</p> Signup and view all the answers

    What is the purpose of changing the receptacle of a chest tube drainage system?

    <p>To replace a full receptacle</p> Signup and view all the answers

    What is the primary purpose of Intermittent Mandatory Ventilation (IMV)?

    <p>To allow the patient to use their own muscles for ventilation</p> Signup and view all the answers

    What happens when a patient on IMV breathes above the prescribed rate?

    <p>The patient only receives oxygen, but not tidal volume or PEEP, for the extra breaths</p> Signup and view all the answers

    What is the benefit of allowing patients to use their own muscles for ventilation on IMV?

    <p>It promotes weaning and reduces the need for mechanical support</p> Signup and view all the answers

    What is the primary issue associated with Mandatory Ventilation?

    <p>It can lead to 'bucking' the ventilator</p> Signup and view all the answers

    What is the role of the patient in determining tidal volume on IMV?

    <p>The patient determines the tidal volume for spontaneous breaths only</p> Signup and view all the answers

    What is the significance of the prescribed amount of ventilations on IMV?

    <p>It determines the number of breaths the patient will receive machine support for</p> Signup and view all the answers

    How does IMV promote weaning?

    <p>By allowing the patient to breathe spontaneously and use their own muscles</p> Signup and view all the answers

    What is the primary advantage of using IMV over other ventilation modes?

    <p>It allows for a combination of assisted and spontaneous breaths</p> Signup and view all the answers

    What is the primary indication for extubation?

    <p>The indications for the original placement of the artificial airway no longer exist</p> Signup and view all the answers

    What is the typical PaO2 level for a patient with lung disease?

    <p>Greater than 60 mm Hg</p> Signup and view all the answers

    What is the primary focus of the Finnegan guidelines for adequate pulmonary function?

    <p>Rapid shallow breathing index less than 105</p> Signup and view all the answers

    What is the primary indication for terminal wean?

    <p>The patient is no longer responsive</p> Signup and view all the answers

    What is the purpose of giving tylenol suppository to a patient during terminal wean?

    <p>To reduce fever</p> Signup and view all the answers

    What is the primary focus of the healthcare provider during terminal wean?

    <p>To keep the patient comfortable and advocate for their wishes</p> Signup and view all the answers

    What is the characteristic of a patient who is a candidate for chronic ventilation?

    <p>The patient has a neurological condition that affects their breathing</p> Signup and view all the answers

    What is the primary goal of chronic ventilation?

    <p>To sustain life</p> Signup and view all the answers

    What is the primary reason people delay seeking treatment for blunt chest trauma?

    <p>They think they don't need it</p> Signup and view all the answers

    What is a common cause of blunt chest trauma?

    <p>Motor vehicle accidents</p> Signup and view all the answers

    What is the goal of educating patients with sternal/rib fractures?

    <p>To be mindful of excessive activities</p> Signup and view all the answers

    What is the priority in managing blunt chest trauma?

    <p>Manage pain and ensure oxygenation</p> Signup and view all the answers

    What is the complication that older people with three or more rib fractures are at increased risk for?

    <p>Atelectasis and pneumonia</p> Signup and view all the answers

    What is the purpose of a chest binder in treating sternal/rib fractures?

    <p>To be used with caution</p> Signup and view all the answers

    What is the primary goal of managing pain in sternal/rib fractures?

    <p>To promote deep breathing</p> Signup and view all the answers

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