ANSWERS|| LATEST UPDATE 2025
Red flags for airway - ANSWER - unable to complete sentences
- audible wheezing
- needs to sit in high fowlers or tripod
Red flags for breathing - ANSWER - Pale
- increased RR
- increased WOB
- decreased O2 sat
- wheezes and lung sounds
Red flags for circulation - ANSWER - irregular, fast pulse
- skin colour and temp
peripheral cyanosis - ANSWER results from peripheral vasoconstriction, reduced
cardiac output or vascular occlusion
central cyanosis - ANSWER occurs when there is an increased amount of hemoglobin
not bound to oxygen and is best assessed by observed the oral mucosa, lips, and
tongue
vesicular breath sounds - ANSWER soft, fine, breezy, low-pitched sounds when air
flows in alveoli and small bronchioles; heard on inspiration and continue without pause
through to 1/3 of expiration
bronchovesicular breath sounds - ANSWER heard in expiration and inspiration
moderate in intensity and pitch and are located over major bronchi where fewer alveoli
are located
bronchial breath sounds - ANSWER loud and high pitched and are heard around
trachea and larynx
crackles (rales) - ANSWER clicking sounds heard during inspiration caused by the
opening of closed small airways during inspiration
often heard in bronchitis, bronchiectasis and pulmonary edema and fibrosis
wheezes (Rhonchi) - ANSWER caused by flow through narrowed airways
causes of narrowing including bronchoconstriction, mucosal edema, sputum or foreign
bodies
palpation - ANSWER assessment of tracheal position, palpation of thorax, checking for
expansion, tactile fremitus
,percussion - ANSWER loud sounds indicate air and quieter sounds suggest
consolidated tissue
mild hypoxemia - ANSWER 60-79 PaO2
moderate hypoxemia - ANSWER 40-59 PaO2
severe hypoxemia - ANSWER PaO2 < 40 mmHg
typical CAP presentation - ANSWER sudden onset of fever, productive cough, SOB,
signs of pulmonary consolidation, occasional pleuritic chest pain
atypical CAP presentation - ANSWER gradual onset of dry cough, SOB, rales, general
myalgias and fatigue
two factors that determine oxygen supply - ANSWER 1. arterial oxygen
2. cardiac output
arterial oxygen - ANSWER the amount of oxygen that is present in the arterial blood
when it leaves the lungs
cardiac output - ANSWER the effectiveness of the pump to circulate blood throughout
the body
% of oxygen delivered - ANSWER NP: 1-6L -> 24-44%
SFM: 6-10L -> 50-60
NRB: 12-15L -> 60-100
oxygen demand factors - ANSWER Temperature, activity, stressors
Temperature - ANSWER an increase in body temp results in an increase cellular
demand for oxygen
same for low body temp --> drop in cellular oxygen demand
Acitivity - ANSWER increase in demand for oxygen
lack of activity results in decrease in oxygen demand
emotional stressors - ANSWER and increase in emotional stressors increases cellular
oxygen demand
ventilation - ANSWER movement of air in and out of the lungs
- primary determinant of arterial o2 content and is influenced by respiratory rate and
tidal volume
- respiratory rate and tidal volume are influenced by WOB, respiratory muscle function,
and lung compliance
, diffusion - ANSWER Exchange of respiratory gases in the alveoli and capillaries
influenced by the thickness of the membrane and difference in concentration of the
gases
perfusion - ANSWER optimal gsa exchange demands that ventilated alveoli are also
perfused. when air distrubution (ventilation) and pulmonary blood flow (perfusion) are
well matched we refer to this as V/Q matching
V/Q mismatch - ANSWER occurs when there is physiological shunts, alveolar dead
space or pulmonary embolus
impact of hypoxemia - ANSWER stimulates the respiratory center to increase both resp
rate and total volume in an effort to compensate for lack of oxygen supply
impact of hypoxemia: neuro - ANSWER less oxygen availbale to the brain
first sign is altered LOC and this can impact ability to adequately ventilate
impact of hypoxemia: cardiovascular - ANSWER will increase heart rate and
peripherally vasoconstrict (to shunt blood from non vital organs back to core)
impact of hypoxemia: GI - ANSWER absence of bowel sounds may be late indication of
blood being shunted to vital organs
can cause an ileus
consequence of AFIB - ANSWER - loss of atrial kick (15-30%)
- clot formation
- if its uncontrolled --> rate is too high and it will decrease ventricular filling time thus
decreasing CO and increased myocardial oxygen demand
cardiac output - ANSWER the quantity of blood pumped each minute into the aorta by
the ventricle
cardiac output is determined by - ANSWER HR and SV
stroke volume - ANSWER the amount of blood pumped by the left ventricle with each
heartbeat
stroke volume is determined by - ANSWER preload, afterload, strength of contraction
preload - ANSWER resting force of the myocardial muscle
preload is determined by - ANSWER volume in the ventricle prior to contraction