2 Questions With 100% Correct Answers
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A patient's ability to move air may be hindered by factors that: - ANS ✔ - a. Limit diaphragm movement
b. Restrict chest wall movement
c. Disrupt the integrity of the thoracic cage
Emphysema - ANS ✔ - Body presentation:
a. Barrel chest
b. Muscle wasting
c. Pursed-lip breathing
d. Often tachypnea and usually without profound hypoxia and cyanosis
Chronic bronchitis - ANS ✔ - Body Presentation:
(a) Tend to be more sedentary and may be obese
(b) Often sleep upright in a chair or recliner
(c) Have a wastebasket overflowing with tissues and a cup full of spit-up secretions
(d) May have a urinal near the chair to avoid frequent bathroom trips
(e)Have medications, inhalers, or an aerosol nebulizer nearby
Rapid-onset dyspnea may be caused by - ANS ✔ - a. Acute bronchospasm
b. Anaphylaxis
c. Pulmonary embolism
d. Pneumothorax
Hyperventilation - ANS ✔ - This occurs when people breathe in excess of metabolic need by increasing the
rate or depth of respiration.
a. Expel more carbon dioxide than normal
, i. Results in alkalosis
b. When triggered by emotional distress or panic attack, may be called hysterical hyperventilation or
hyperventilation syndrome
2. Respiratory alkalosis causes numbness or tingling in the hands and feet and around the mouth.
a. Patients may complain of chest pain.
b. Respiratory alkalosis will ultimately lead to carpopedal spasm, during which the hands and feet are
clenched into a clawlike position.
3. The traditional therapy of having the patient rebreathe his or her own carbon dioxide from a paper bag
or from a partial rebreathing mask can be dangerous.
a. Patients quickly exhaust the oxygen in the gas they are breathing.
i. Rebreathing carbon dioxide can cause hypoxia.
b. Hyperventilation in a patient with acidosis may be the body's attempt to raise the pH level to normal.
i. Examples: Kussmaul respirations, sepsis, and shock
ii. Should not be treated by rebreathing carbon dioxide
iii. Important to rule out all possible causes
4. Treatment may include sedation if the patient is truly hysterical and hyperventilating.
a. Extreme measure rarely taken in the field
5. Help the patient understand that hyperventilation may occur if the behavior precipitating the episode
is repeated.
6. Psychological support techniques include:
a. Breathing with the patient
b. Having the patient count to two between breaths, gradually increasing to higher numbers
c. Distraction techniques
d. Having the patient sing a song
Hypoventilation - ANS ✔ - Carbon dioxide accumulates in the blood when the lungs fail to work properly.
It combines with water to form bicarbonate ions and hydrogen (H+) ions (carbonic acid) --> Results in
*acidosis*
-Impaired ventilation is caused by a variety of factors.
-Carbon dioxide level is directly related to pH.
--> Hypoventilating patients usually have respiratory acidosis ---> As carbon dioxide levels rise, pH levels
drop.