NSG4330 WEEKS 1-4 (RESP FAILURE, ACS, HF, RENAL
FAILURE) QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
ALREADY GRADED A+
What are the 3 processes of effective gas exchange?
Ans✓✓✓Ventilation, perfusion, diffusion - any problems can result in
Hypoxemia or Hypercarbia
What is Respiratory failure? Ans✓✓✓-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? Ans✓✓✓PaO2 <60mmHg on
60% O2 (FiO2 .60)
Definition of hypercapnic Resp failure? Ans✓✓✓PaCO2 >45mmHg in
combination with academia pH <7.35
Types of ventilation-perfusion relationships Ans✓✓✓Normal, VQ
mismatch, absolute shunt, deadspace, diffusion limitation, alveolar
hypoventilation
Diagnostic studies for Resp failure? Ans✓✓✓ABGs, CXR, CBC, Lytes,
Urinalysis, ECG
,Specific manifestations for Hypoxemia Ans✓✓✓decreased SPO2,
dyspnea, intercostal muscle retraction, prolonged expiration, tachypnea,
cyanosis (late), paradoxical (late)
Specific manifestations of hypercapnia? Ans✓✓✓Dysnpea, decreased
minute ventilation, decreased resp rate or increased rate with shallow
resps, decreased tidal volume.
Primary goal of O2 therapy? Ans✓✓✓Correct hypoxemia
What are the indications for mechanical ventilation? Ans✓✓✓Apnea or
impending inability to protect airway, acute respiratory failure, severe
hypoxia, respiratory muscle fatigue
What is ARDS? Ans✓✓✓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 Ans✓✓✓divide PaO2 / FiO2
Manifestations of pnehmothorax Ans✓✓✓No breath sounds over
affected area with or without hyperresonance. CXR shows air and or
fluid in pleura space.
, S&S of pleural effusion Ans✓✓✓progressive dyspnea, decreased chest
wall movement, pleuritic pain, absent or distant breath sounds, dullness
on percussion, CXR>250mL
VTE signs and symptoms Ans✓✓✓Unilateral leg edema, pain in the
extremity, sense of fullness, paresthesia, warm skin, ehythema, fever
Tests of blood coagulation Ans✓✓✓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 Ans✓✓✓ASA
(Aspirin) and NSAIDs
Clinical manifestations of a pulmonary embolism Ans✓✓✓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? Ans✓✓✓spiral CT, V/Q (ventilation
perfusion scan), pulmonary angiogram, ABGs, d-dimer
FAILURE) QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
ALREADY GRADED A+
What are the 3 processes of effective gas exchange?
Ans✓✓✓Ventilation, perfusion, diffusion - any problems can result in
Hypoxemia or Hypercarbia
What is Respiratory failure? Ans✓✓✓-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? Ans✓✓✓PaO2 <60mmHg on
60% O2 (FiO2 .60)
Definition of hypercapnic Resp failure? Ans✓✓✓PaCO2 >45mmHg in
combination with academia pH <7.35
Types of ventilation-perfusion relationships Ans✓✓✓Normal, VQ
mismatch, absolute shunt, deadspace, diffusion limitation, alveolar
hypoventilation
Diagnostic studies for Resp failure? Ans✓✓✓ABGs, CXR, CBC, Lytes,
Urinalysis, ECG
,Specific manifestations for Hypoxemia Ans✓✓✓decreased SPO2,
dyspnea, intercostal muscle retraction, prolonged expiration, tachypnea,
cyanosis (late), paradoxical (late)
Specific manifestations of hypercapnia? Ans✓✓✓Dysnpea, decreased
minute ventilation, decreased resp rate or increased rate with shallow
resps, decreased tidal volume.
Primary goal of O2 therapy? Ans✓✓✓Correct hypoxemia
What are the indications for mechanical ventilation? Ans✓✓✓Apnea or
impending inability to protect airway, acute respiratory failure, severe
hypoxia, respiratory muscle fatigue
What is ARDS? Ans✓✓✓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 Ans✓✓✓divide PaO2 / FiO2
Manifestations of pnehmothorax Ans✓✓✓No breath sounds over
affected area with or without hyperresonance. CXR shows air and or
fluid in pleura space.
, S&S of pleural effusion Ans✓✓✓progressive dyspnea, decreased chest
wall movement, pleuritic pain, absent or distant breath sounds, dullness
on percussion, CXR>250mL
VTE signs and symptoms Ans✓✓✓Unilateral leg edema, pain in the
extremity, sense of fullness, paresthesia, warm skin, ehythema, fever
Tests of blood coagulation Ans✓✓✓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 Ans✓✓✓ASA
(Aspirin) and NSAIDs
Clinical manifestations of a pulmonary embolism Ans✓✓✓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? Ans✓✓✓spiral CT, V/Q (ventilation
perfusion scan), pulmonary angiogram, ABGs, d-dimer
