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NSG4330 Weeks 1-4 (Resp Failure, ACS, HF, Renal Failure) Exam And Correct Answers.

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What are the 3 processes of effective gas exchange? - Answer Ventilation, perfusion, diffusion - any problems can result in Hypoxemia or Hypercarbia What is Respiratory failure? - Answer -one of both gas exchanging functions are inadequate - amount of O2 transferred to blood is insufficient (hypoxemia) or amount of CO2 removed from lungs is inadequate (hypercapnia) Definition of hypoxemic Resp failure? - Answer PaO2 60mmHg on 60% O2 (FiO2 .60) Definition of hypercapnic Resp failure? - Answer PaCO2 45mmHg in combination with academia pH 7.35 Types of ventilation-perfusion relationships - Answer Normal, VQ mismatch, absolute shunt, deadspace, diffusion limitation, alveolar hypoventilation Diagnostic studies for Resp failure? - Answer ABGs, CXR, CBC, Lytes, Urinalysis, ECG Specific manifestations for Hypoxemia - Answer decreased SPO2, dyspnea, intercostal muscle retraction, prolonged expiration, tachypnea, cyanosis (late), paradoxical (late) Specific manifestations of hypercapnia? - Answer Dysnpea, decreased minute ventilation, decreased resp rate or increased rate with shallow resps, decreased tidal volume. Primary goal of O2 therapy? - Answer Correct hypoxemia What are the indications for mechanical ventilation? - Answer Apnea or impending inability to protect airway, acute respiratory failure, severe hypoxia, respiratory muscle fatigue What is ARDS? - Answer Sudden and progressive acute respiratory failure - see progressive symptomology, worsening PaO2/FiO2 ratio and whiteout/white lung 300 = mild ARDS 200 = moderate ARDS 100 = severe ARDS - Answer divide PaO2 / FiO2

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NSG4330 Weeks 1-4 (Resp Failure, ACS,
HF, Renal Failure) Exam And Correct
Answers.
What are the 3 processes of effective gas exchange? - Answer Ventilation, perfusion, diffusion
- any problems can result in Hypoxemia or Hypercarbia



What is Respiratory failure? - Answer -one of both gas exchanging functions are inadequate -
amount of O2 transferred to blood is insufficient (hypoxemia) or amount of CO2 removed from
lungs is inadequate (hypercapnia)



Definition of hypoxemic Resp failure? - Answer PaO2 <60mmHg on 60% O2 (FiO2 .60)



Definition of hypercapnic Resp failure? - Answer PaCO2 >45mmHg in combination with
academia pH <7.35



Types of ventilation-perfusion relationships - Answer Normal, VQ mismatch, absolute shunt,
deadspace, diffusion limitation, alveolar hypoventilation



Diagnostic studies for Resp failure? - Answer ABGs, CXR, CBC, Lytes, Urinalysis, ECG



Specific manifestations for Hypoxemia - Answer decreased SPO2, dyspnea, intercostal muscle
retraction, prolonged expiration, tachypnea, cyanosis (late), paradoxical (late)



Specific manifestations of hypercapnia? - Answer Dysnpea, decreased minute ventilation,
decreased resp rate or increased rate with shallow resps, decreased tidal volume.



Primary goal of O2 therapy? - Answer Correct hypoxemia



What are the indications for mechanical ventilation? - Answer Apnea or impending inability to
protect airway, acute respiratory failure, severe hypoxia, respiratory muscle fatigue



What is ARDS? - Answer Sudden and progressive acute respiratory failure - see progressive
symptomology, worsening PaO2/FiO2 ratio and whiteout/white lung

, <100 = severe ARDS - Answer divide PaO2 / FiO2



Manifestations of pnehmothorax - Answer No breath sounds over affected area with or
without hyperresonance. CXR shows air and or fluid in pleura space.



S&S of pleural effusion - Answer progressive dyspnea, decreased chest wall movement,
pleuritic pain, absent or distant breath sounds, dullness on percussion, CXR>250mL



VTE signs and symptoms - Answer Unilateral leg edema, pain in the extremity, sense of
fullness, paresthesia, warm skin, ehythema, fever



Tests of blood coagulation - Answer INR

Normal: 0.75-1.25, therapeutic 2-3

aPTT 25-35 sec. Therapeutic 46-70 sec

ACT 70-120 sec. Therapeutic >300 sec



PAtients taking anticoagulants should avoid taking - Answer ASA (Aspirin) and NSAIDs



Clinical manifestations of a pulmonary embolism - Answer Classic triad: Dyspnea, chest pain,
hemoptysis (coughing up blood)



Also anxiety, feeling of impending doom, sudden onset of unexplained
dyspnea/tachypnea/tachycardia



Diagnostic tests for a PE? - Answer spiral CT, V/Q (ventilation perfusion scan), pulmonary
angiogram, ABGs, d-dimer



BLOOD GAS NORMALS - Answer pH 7.35 - 7.45

PaCO2 45-35 mmHg

HCO3 22 - 26



What is Coronary Artery Disease? - Answer type of blood vessel disorder that is included in
the general category of atherosclerosis. Affects the coronary arteries by reducing the flow of

oxygen and nutrients to the myocardium. A consequence of CAD is Acute Coronary Syndrome

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