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Questions and Answers
What is the primary purpose of obtaining a pulse oximetry reading during the assessment of a patient with a respiratory emergency?
Which of the following is NOT a general treatment for patients with respiratory distress?
What type of capnography reading should be obtained during the assessment of a patient with a respiratory emergency?
What is the primary goal of airway management protocol in patients with respiratory distress?
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Which of the following is a common presentation of a patient in respiratory distress?
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What is the significance of obtaining a waveform capnography reading in patients with respiratory emergencies?
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What is included in the universal initial adult patient assessment for patients with respiratory distress?
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What is the primary focus of the airway management protocol in patients with respiratory distress?
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What is the significance of repeated vital signs assessment in patients with respiratory distress?
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What is the purpose of initiating ventilation in patients with respiratory distress?
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What is the most useful assessment tool in determining whether a patient's respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes?
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Which of the following is a characteristic of congestive heart failure (CHF)?
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What is the initial treatment for a patient with cardiac pulmonary edema?
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What is the dose of nitroglycerin to administer if the systolic BP is between 90 mmHg and 160 mmHg?
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Why should nitroglycerin be avoided in certain patients?
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What is the emphasis of treatment in cardiac pulmonary edema?
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What is a characteristic of pulmonary edema?
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What is the purpose of administering nitroglycerin in cardiac pulmonary edema?
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What is a common finding in patients with chronic congestive heart failure?
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When can nitroglycerin be administered to a patient with cardiac pulmonary edema?
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What is the primary focus of treatment in cardiac pulmonary edema?
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What is a characteristic of acute pulmonary edema?
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Why should nitroglycerin be avoided in certain patients?
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What is the dose of nitroglycerin to administer if the systolic BP is between 90 mmHg and 160 mmHg?
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What is a characteristic of congestive heart failure?
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What is the initial treatment for a patient with cardiac pulmonary edema?
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Study Notes
Medical Respiratory Emergencies
- Obtain and document pulse oximetry reading and waveform capnography reading during assessment and after treatment for all patients with respiratory emergencies.
- Treat any problems as per protocol(s) to address respiratory distress.
Common Presentations of Respiratory Distress
- Rales/Rhonchi
- Wheezing
- Unilateral absence of breath sounds
General Treatment for Respiratory Distress
- Perform Universal Initial Adult Patient Assessment / Care
- Implement Airway Management Protocol
- Initiate ventilation, oxygen, vascular access, and monitoring
- Monitor ECG rhythm, pulse oximetry, waveform capnography, and repeated vital signs assessment.
Medical Respiratory Emergencies
- Obtain and document pulse oximetry reading and waveform capnography reading during assessment and after treatment for all patients with respiratory emergencies.
- Treat any problems as per protocol(s) to address respiratory distress.
Common Presentations of Respiratory Distress
- Rales/Rhonchi
- Wheezing
- Unilateral absence of breath sounds
General Treatment for Respiratory Distress
- Perform Universal Initial Adult Patient Assessment / Care
- Implement Airway Management Protocol
- Initiate ventilation, oxygen, vascular access, and monitoring
- Monitor ECG rhythm, pulse oximetry, waveform capnography, and repeated vital signs assessment.
Respiratory Distress with Rales and/or Rhonchi
- A patient's history is the most useful assessment tool in determining whether respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes.
Congestive Heart Failure (CHF)
- Usually a chronic illness with acute exacerbations.
- Patients typically experience SOB for days rather than hours.
- May present with swelling of both lower extremities.
- May be taking diuretics and cardiac medications.
- Patients are frequently more comfortable sitting up.
Cardiac Pulmonary Edema
- Acute pulmonary edema may develop within minutes.
- Patients may have watery, frothy sputum.
- Lung sounds will be progressively absent starting from the bases up as Pulmonary Edema develops.
Treatment for CHF and Cardiac Pulmonary Edema
- Place the patient on CPAP mask device as soon as possible, if available and if the patient is cooperative.
- Administer nitroglycerin:
- 0.4 mg SL if systolic BP is between 90 mmHg and 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 90 mmHg or until relief of signs or symptoms.
- 0.8 mg SL (two tabs) if systolic BP is greater than 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 160 mmHg or until relief of signs or symptoms.
- Do not administer nitroglycerin if the patient is known or suspected to have taken sexually enhancing drugs and/or drugs prescribed for pulmonary hypertension within the specified time frames (e.g., Viagra/Revatio, Levitra, Cialis/Adcirca).
- Administer furosemide (Lasix) if the patient remains symptomatic after initial interventions and the systolic BP remains above 90 mmHg.
- Administer normal saline, 500 mL IV bolus if the systolic BP is less than 90 mmHg.
- Administer premix dopamine, 400 mg in 250 mL D5W IV/IO, if systolic BP is still below 90 mmHg.
Respiratory Distress with Rales and/or Rhonchi
- A patient's history is the most useful assessment tool in determining whether respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes.
Congestive Heart Failure (CHF)
- Usually a chronic illness with acute exacerbations.
- Patients typically experience SOB for days rather than hours.
- May present with swelling of both lower extremities.
- May be taking diuretics and cardiac medications.
- Patients are frequently more comfortable sitting up.
Cardiac Pulmonary Edema
- Acute pulmonary edema may develop within minutes.
- Patients may have watery, frothy sputum.
- Lung sounds will be progressively absent starting from the bases up as Pulmonary Edema develops.
Treatment for CHF and Cardiac Pulmonary Edema
- Place the patient on CPAP mask device as soon as possible, if available and if the patient is cooperative.
- Administer nitroglycerin:
- 0.4 mg SL if systolic BP is between 90 mmHg and 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 90 mmHg or until relief of signs or symptoms.
- 0.8 mg SL (two tabs) if systolic BP is greater than 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 160 mmHg or until relief of signs or symptoms.
- Do not administer nitroglycerin if the patient is known or suspected to have taken sexually enhancing drugs and/or drugs prescribed for pulmonary hypertension within the specified time frames (e.g., Viagra/Revatio, Levitra, Cialis/Adcirca).
- Administer furosemide (Lasix) if the patient remains symptomatic after initial interventions and the systolic BP remains above 90 mmHg.
- Administer normal saline, 500 mL IV bolus if the systolic BP is less than 90 mmHg.
- Administer premix dopamine, 400 mg in 250 mL D5W IV/IO, if systolic BP is still below 90 mmHg.
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Description
This quiz assesses the responder's knowledge of respiratory distress emergencies, including initial assessment, treatment protocols, and common presentations of respiratory distress.
