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FISDAP FINAL EXAM/202 Q’S AND A’S
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FISDAP FINAL EXAM/202 Q’S AND A’SBVM Respiratory Rates..How do we determine adequate respiration? - --
theoretically less than 8 or more than 25-ish
- assess via adequate chest rise/fall, skin signs, respiratory status.
- is patient getting job done on their one or do they need hel?
-Wheezing - -High pitched on exhale
Lower airway obstruction (bronchioles)
Asthma + allergic reaction/anaphylaxis
-RONCHI - -Denser fluid in lungs (pneumonia, cystic fibrosis, chronic
bronchitis)
-CRACKLES (RALES) - -Fluid in lungs ("underwater")
Blood or water
CHF, PE
-STRIDOR - -High pitched during inspiration
Upper airway obstruction
Croup, epiglottitis, anaphylaxis
-Corrective action if no longer see chest rise/fall during PPV ventilations? - -
Reposition airway
-Supplemental O2 Flow Rates - -NC: 2-6 l/min
NRB: 10-15 l/min
BVM: 15-25 l/min
Nebulized breathing treatment: 6-8 l/min
-Witness patient collapse..airway obstruction..first objective? - -Check
breathing pulse —> begin compressions (active 911/AED if possible)
-What to ask chokng patient? How to approach? - -"Are you choking?"
"Can you cough?" Keep coughing
Approach from front and go to back if need to perform abdominal thrusts
-How to treat pt w/ Stoma with inadequate respirations? - -BVM
Pediatric mask w/ adult bag
Attach directly to stoma tube
-Humidified oxygen candidates - -Croup
Epiglottitis
Adults - long transport time, long term o2 therapy
"Hoarse" "dry" "something is stuck"
, -How to ask questions to patient w/ extreme SOB and what to ask? - -Simple
yes/no questions
How long has this been going on?
Acute vs chronic - acute more emergent
-NPA - -Tip of nose to ear lobe
IND: semiconscoius or conscious w/ intact gag reflex, any patient who
doesn't tolerate OPA
CI: severe head injury w/ bleeding in nose, history of nasal fracture
-OPA - -Corner of moth to ear lobe
IND: unresponsive w/o gag reflex, apneic patients being ventilated w/ BVM
CI: conscious pt, intact gag reflex, heavy oral trauma
-TENSION PNEUMOTHORAX - -Results from ongoing/uncorrected
pneumothorax
Increasing respiratory difficulty
Diminished/absent lung sounds on affected side
JVD + tracheal deviation to opposite side
-SPONTANEOUS PNEUMOTHORAX - -Acute SOB
Diminished/absent lung sounds on affected side
Tall, thin males w/ history of smoking, asthma
Trauma, non-traumatic, exertion (i.e. heavy lifting)
-PNEUMONIA - -Infection causing pus/mucous blocking bronchioles
Fever, productive cough (green/brown/yellowish)
Ronchi, wheeze, diminished lung sounds in affected lobes
Starts in one lobe and progresses
Chest pain (increased respiratory effort)
Back pain, body aches, night sweats
Dyspnea
Often in elderly, SNF, close quarters living
-S/S CHRONIC BRONCHITIS - -Excessive mucuous productive — airway
obstruction
"Blue bloaters"
Sputum production
Difficulty w/ inspiration
Overweight + cyanotic
Easily fatigued
-S/S COPD - -Emphysema - "pink puffers"
Barrel chest
Increased accessory muscle use
, Thin appearance + tripod position
Digital clubbing, non productive cough
Wheezing + pursed lip breathing
Prolonged expiratory time
Easily fatigued
Constant fatigue
History of smoking!!!
***more likely to be on home oxygen therapy
-Systole - -Pressure during ventricular contraction (ejecting blood)
*you feel pulse during systole
-Diastole - -Pressure during heart relaxation (refilling with blood)
-Pt regains pulses after use of AED, what do you assist with? - -Ventilations
(BVM)
-Nitroglycerin contradindications - -5 - 5 mins apart
3 - no more than 3 doses
B - BP < 100 mmHg
A - altered LOC
S - sexual enhancement drugs w/in 48 hours
H - head injury
-Possible stroke patient, what questions important to ask? - -When was the
last time patient was "normal"?
How long ago did this start?
-Agonal respirations...course of action? - -Check for airway obstruction
BVM assistance
-Shock position - -Supine
Blankets over/under to retain body heat
-What chamber fails that causes pulmonary edema? - -Left ventricle
-S/S CHF - -L - pulmonary edema (crackles/rales)
R - JVD, peripheral edema
Coughing, pink frothy sputum
PCD skin signs
Orthopnea
symptoms worse w/ exertion
-2 arrythmia's AED will shock? - -V-fib
V-tach
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