Lindsay Jones: Pathology Review Exam 109 Questions with Verified Answers
PICKWIKIAN SYNDROME:
1: Defined: _______sleep apnea due to _______.
2:
... [Show More] WHAT TO EXPECT: This simulation is treated like most ________sleep apnea cases. - CORRECT ANSWER 1: obstructive
2: obesity
3: obstructive
INFECTIOUS PNEUMONIA:
1: Definition: pneumonia caused by _______/_____ infection.
2: WHAT TO EXPECT: Treated like ____ regardless of source (_______vs. viral) - CORRECT ANSWER 1: bacterial
2: viral
3: pneumonia
4: bacterial
INFECTIOUS PNEUMONIA: (cont'd)
INFORMATION GATHERING:
LEVEL ONE:
a. Increased _______ rate
LEVEL TWO:
a. high temp: __________pneumonia
b. low grade temp: ________pneumonia
LEVEL THREE:
a. Chest Xray: _______in lung fields
b. Increased WBC: _________pneumonia
c. Decreased WBC: _____pneumonia
LEVEL FOUR (IV):
a. ELISA test: positive for _________
b. Acid-fast sputum culture to check for _________ - CORRECT ANSWER 1: heart
2: bacterial
3: viral
4: consolidation
5: bacterial
6: viral
7: HIV
8: TB
INFECTIOUS PNEUMONIA:
DECISION MAKING:
a. ______culture and sensitivity to identify ______ and the appropriate antibiotic.
b. _________ ventilation as needed. - CORRECT ANSWER 1: sputum
2: bacterial
3: mechanical
TRANSIENT TACHYPNEA: TYPE _____ RDS:
1: Defined: Condition related _____ distress within ____-48 hours after birth. May be related to ____- section delivery.
2: WHAT TO EXPECT: This is increasingly rare on the exam, but really has no real complexity. The exam will try to tempt you to make _________ reactions when the real therapy is to simply be supportive of the __________. - CORRECT ANSWER 1: II (TWO)
2: respiratory
3: 24
4: C
5: drastic
6: symptoms.
TRANSIENT TACHYPNEA: TYPE _____ RDS:
INFORMATION GATHERING:
LEVEL ONE:
a.___________, retractions, grunting.
b. Often normal gestational age (___-40 weeks)
c. Initially appears___, but deteriorates after a day or two
LEVEL TWO:
a. __________from secretions.
LEVEL III:
a. Chest X-ray: starts out ______but deteriorates to show increased pulmonary _________ within a day or two.
LEVEL IV (four):
a. blood glucose: >______ mg (normal __-120 mg) - CORRECT ANSWER 1: II (TWO)
2: Cyanosis
3: 38
4: okay
5: rhonchi
6: normal
7: congestion
8: >100
9: >160 mg
10: 80 mg
TRANSIENT TACHYPNEA: TYPE _____ RDS:
DECISION MAKING:
1: Manage symptoms of __________distress.
2: Support ________ if needed.
3: Oxygen therapy by ___________(?)
4: Treat with _______ therapy (CPAP) if hypoxemia is significant on increased _________. - CORRECT ANSWER 1: II
2: respiratory
3: ventilation
4: oxyhood
5: shunt
6: FiO2
BRONCHOPULMONARY DYSPLASIA:
1: Definition: Lung disease related to _________ mechanical ventilation of the newborn. Exact ______ is unknown but is usually associated wtih previous TX of _____ and fetal lung __________.
2: WHAT TO EXPECT: This simulation usually involves making a ____plan that covers all the _________, including bronchoconstriction, _________, under development of lung _____, etc. - CORRECT ANSWER 1: prolonged
2: etiology
3: IRDS
4: immaturity
5: care
6: symptoms
7: inflammation
8: tissue
BRONCHOPULMONARY DYSPLASIA:
INFORMATION GATHERING:
LEVEL ONE:
a. recent hx and tx of ______ or fetal lung _______.
b. HX of prolonged or significant use of _________ ventilation since birth.
c. HX of elevated ________.
LEVEL II:
a. ______________
LEVEL III:
a. CXR: like ______ but then appears like chronic _____-trapping with HYPERinflation and ______ changes.
LEVEL IV (FOUR):
a. ___________: may reveal right/left _______ failure. - CORRECT ANSWER 1: IRDS
2: immaturity
3: mechanical
4: FiO2
5: wheezing
6: IRDS
7: air
8: fibrotic
9: Echocardiogram
10: heart
BRONCHOPULMONARY DYSPLASIA:
DECISION MAKING:
a. ___________ therapy for wheezing
b. Keep ________ as low as possible.
c. Accept PaO2 of ____ to 65 mm Hg.
d. Keep CO2 below ____ mm Hg.
e. __________ to reduce inflammation. - CORRECT ANSWER 1: bronchodilator
2: FiO2
3: 55 mm Hg
4: 60 mm Hg
5: Corticosteroids
FOREIGN BODY ASPIRATION:
1: Defined: the accidental _____ of a foreign body, including ________/an object, in to the lungs.
2: WHAT TO EXPECT: Must differentiate between ________ body aspiration and pulmonary ___________. Foreign body aspiration is characterized by a ________, acute development of a ______. A _________mass in the bronchials results in non-__________ cough over weeks or months. - CORRECT ANSWER 1: aspiration
2: food
3: foreign
4: carcinoma
5: recent
6: cough
7: cancerous
8: productive
FOREIGN BODY ASPIRATION (CONT'D):
INFORMATION GATHERING:
LEVEL I:
a. softened _________ or voice if _________ obstruction.
b. ________(no sounds if complete obstruction)
c. recent HX of _______/playing with toys
d. onset is ____________
e. cough is _______-productive
LEVEL II:
a. __________: visualize the foreign body (may also remove at that time).
b. _______Xray: may be clear b/c food and other objects are likely ___________. - CORRECT ANSWER 1: cough
2: partial
3: quiet
4: food
5: sudden
6: non
7: bronchoscopy
8: chest
9: radiolucent
FOREIGN BODY ASPIRATION: (CONT'D):
DECISION MAKING:
a. PRIMARY TREATMENT: ______________
b. Supportive therapy as needed: _______ therapy, etc. - CORRECT ANSWER 1: bronchoscopy
2: bronchodilator
AIDS:
1: Definition: Disease of the immune system. Commonly resulting in ___________ carinii, a type of pneumonia.
2: WHAT TO EXPECT: Increasing in frequency on the exam. Sometimes it is combined with__________, hypothermia, and others. Suspect them all. - CORRECT ANSWER 1: pneumocystis
2: TB
AIDS:
INFORMATION GATHERING:
LEVEL 1:
a. previous hx of ________ positive test.
b. _______, unexplained weight _______, diarrhea, low grade __________, night _________.
c. Commonly _________activity or _____ usage is admitted. - CORRECT ANSWER 1: HIV
2: emaciation (bonyness: extreme leanness (usually caused by starvation or disease)
3: loss
4: fever
5: sweats
6: homosexual
7: drug
AIDS:
INFORMATION GATHERING (CON'TD):
SPECIAL ASSESSMENTS: (What level is this?)
1: positive ________III (three)
2: ________Test: positive for HIV
3: _________: from lung washings or biopsy may show _____________ carinii. - CORRECT ANSWER 1: HTLV
2: Elisa
3: Bronchoscopy
4: pneumocystis
AIDS:
DECISION MAKING:
1: Exercise ___________ Precautions
2: Aerosolized ____________: usually done ______
a. administer in ______-fowlers position.
b. when administering Pentamadine, use _____
way valves and filters.
c. Staff/Visitors should use _________.
3: May administer ________ after the TX. - CORRECT ANSWER 1: Universal
2: Pentamadine
3: monthly
4: semi
5: one
6: masks
7: MINT
CYSTIC FIBROSIS:
1: Defined: An inherited disorder resulting in the mass production of thick ___________in the lungs.
2: WHAT TO EXPECT: Not commonly seen on exam. Tests your ability to recognize ___________ removal therapies and may check your understanding of when and how to modify therapy. EX., when _______ doesn't work, use PEP therapy or __________ nebulization (?review) - CORRECT ANSWER 1: mucus
2: secretion
3: CPT
4: ultrasonic
CYSTIC FIBROSIS (CONT;D):
INFORMATION GATHERING:
LEVEL ONE:
a. family _____of disease, siblings may have it.
b. _________ in appearance, and body frame may be _______ for age.
c. sputum production of thick voluminous _______ secretions.
d. can look like a young _________pt., ______ chested.
LEVEL TWO:
a. decreased flow rates, such as ______1. - CORRECT ANSWER 1: HX
2: emaciated
3: small
4: purulent
5: COPD
6: barrel
7: FEV1
CYSTIC FIBROSIS:
INFORMATION GATHERING (CON'TD):
LEVEL III:
a. _______Xray: looks like _____, hyperinflation, increased ____-____ diameter, diaphragm ______.
LEVEL IV (FOUR):
a. ________chloride test: show sweat chloride >____mEq/L. - CORRECT ANSWER 1: chest
2: COPD
3: A-P
4: flattened
5: sweat
6: >60mEq/L
CYSTIC FIBROSIS (CONTD):
DECISION MAKING:
a. primary TX relates to the need to mobilize and _________ secretions.
b. Secretion removal promotion therapies include:
1: _________therapy devices.
2: chest ____________ with postural _________
3: Hydration devices such as _________
aerosol or _____________ nebulizations.
4: _____________ therapy.
c. ___________ as needed.
d. ___________therapy when infection is present: often is.
e. medications used commonly include __________ and ___________(Dornase _________) - CORRECT ANSWER 1: remove
2: PEP
3: physiotherapy
4: drainage
5: heated
6: ultrasonic
7: Vibration
8: oxygen (low flow: copd type--double check though)
9: antibiotic
10: Tobramycin (antibiotic)
11: Pulmozyme
12: (Alpha)
HYPOTHERMIA:
1: Defined: Exposure to ______, such that the body temperature falls ___________.
2: WHAT TO EXPECT: Not very common. However, when seen, may be seen in conjunction with other problems such as ______ or ________. - CORRECT ANSWER 1: cold
2: significantly
3: AIDS
4: TB
HYPOTHERMIA:
INFORMATION GATHERING:
LEVEL I:
a. HX of exposure to _______. May be seen in _________ persons.
b. _________ and unconsciousness
c. _____________, bradypnea
LEVEL II:
a. body temperature less than _____ degrees C.
LEVEL IV (FOUR):
a. _______________neck Xray: ________sign or ____________point. - CORRECT ANSWER 1: cold
2: homeless
3: lethargy (A lack of energy; sleepiness)
4: bradycardia
5: 36 degrees C
6: lateral
7: thumb
8: pencil
HYPOTHERMIA:
DECISION MAKING:
1: O2 via a __________ aerosol at ___ to 100%
2: Keep resuscitation efforts going until body __________ is normal.
3: __________Ventilate as needed.
4: Keep in mind that blood ______ values may be altered b/c of the difference in ______temperature and __________temperature. Watch out for __________(PaO2). In cold, uncorrected _____ PaO2 may appear ________ than it actually is. - CORRECT ANSWER 1: heated
2: 40%
3: temp
4: mechanically
5: gas
6: blood
7: analyzed
8: oxygen
9: blood
10: higher
BRONCHIOLITIS/RSV:
1: Defined: Acute _______ infection of lower respiratory tract usually occuring in infants less than ____ months old. Commonly caused by the respiratory _____________ virus.
2: WHAT TO EXPECT: There is nothing particularly difficult about this case. You must be prepared to recommend the use of a ______ unit. Not commonly seen on the exam. - CORRECT ANSWER 1: viral
2: 18
3: synctial
4: SPAG (small particle aerosol generator)
BRONCHIOLITIS/RSV:
INFORMATION GATHERING:
LEVEL ONE:
a. general signs of respiratory _____________ including _____ and ________ muscle use.
b. _____________and tachycardia.
c. HX of recent sicknesses from age _____ months to ____ years old.
LEVEL II:
a. Low grade ___________.
b. _____________, rales (abnormal rattling sound heard when examining unhealthy lung), and ____________
LEVEL III:
a. ___________Xray: shows scattered infiltrates and ________________. - CORRECT ANSWER 1: distress
2: retractions.
3: accessory
4: tachypnea
5: 2 months
6: 3 years
7: fever
8: wheezing
9: rhonchi
10: Chest
11: hyperlucency
BRONCHIOLITIS/RSV: (CONT'D):
DECISION MAKING:
a. primary TX is delivery of the drug ____________ which must be administered via a _____ unit (small volume particle aerosol).
b. Utilize a _______ system, filters, and _______ - CORRECT ANSWER 1: Ribavirin
2: SPAG
3: scavenger
4: masks
LARYNGOTRACHEOBRONCHITIS/_________:
1: Define: Otherwise known as _________. Results from a __________ infection that illicits inflammation of the _______airway.
2: WHAT TO EXPECT: You will likely be tempted to treat this like acute ___________ in an emergency fashion. Repeated racemic___________ TX may make you feel uncomfortable. - CORRECT ANSWER 1: croup
2: Croup
3: viral
4: upper
5: epiglottitis
6: epi
LARYNGOTRACHEOBRONCHITIS/_________:(cont'd):
INFORMATION GATHERING:
LEVEL I:
a. HX of _______ in past few days.
b. _________cough
c. age is ____ months to 3 years.
d. ___________ at rest.
e. _____________
LEVEL IV (FOUR):
a. __________neck Xray: swelling _________ the glottis (___________swelling) sometimes described as ________-sign, pencil point, or _______ BELOW the glottis. - CORRECT ANSWER 1: cough
2: barking
3: 5
4: stridor
5: tachypnea
6: lateral
7: below
8: subglottic
9: steeple
10: haziness
LARYNGOTRACHEOBRONCHITIS/_________:(cont'd):
DECISION MAKING:
a. prority: placement in an oxygen ________ with _____ to 40%.(??review)
b. Aerosolized ____________- epi
c. ____________if pt. is described as _________, markedly __________breath sounds, severe or marked ____________, extreme accessory _____ use.
d. _______ should be done when swelling has ceased. - CORRECT ANSWER 1: tent
2: 30%
3: racemic
4: intubation
5: lethargic
6: diminished
7: stridor
8: muscle
9: extubation.
ACUTE EPIGLOTTITIS:
1: Defined: condition where the epiglottis and ________ upper airway tissues are infected with a ________ causing inflammation and commonly threatening ___________patency.
2: WHAT TO EXPECT: This case will test your immediate ability to realize that it is an __________. _________may tempt you to treat it more casually like Croup. There is a good chance you will see _______ or _________ on the test. - CORRECT ANSWER 1: adjacent
2: bacteria
3: airway.
4: emergency
5: Stridor
6: croup
7: epiglottitis
ACUTE EPIGLOTTITIS (CONT'D):
INFORMATION GATHERING:
LEVEL I:
a. sudden onset of ______, within ____ hours, often occurs in the evening.
b. general appearance may show _______, hoarseness, ________cough.
c. may hear a softened inspiratory ___________.
d. ___________ and tachycardia
LEVEL II:
a. pt. unable to __________, will usually not be crying, eyes are _____.
b. significantly elevated body ____________, taken ___________ or tympanically.=NOT ORALLY!!!!!
LEVEL IV (FOUR):
a. __________ neck Xray will show __________ inflammation. - CORRECT ANSWER 1: sickness
2: 12
3: drooling
4: quiet
5: stridor
6: tachypnea
7: swallow
8: big
9: temperature
10: axillary
11: lateral
12: suprraglottic
ACUTE EPIGLOTTITIS:
DECISION MAKING:
a. Primary and immediate concern is establishing an ___________ as complete closure from inflammation is possible. Since inadvertent stimulation from ______ intubation attempts could immediately illicit an _________ response, intubating in a ________ environment is very helpful. There may be need to place a ___________ tube. - CORRECT ANSWER 1: airway
2: oral
3: inflammatory
4: surgical
5: tracheostomy
ACUTE EPIGLOTTITIS:
DECISION MAKING: (cont'd):
b. May need to immediately get an ___________. Should intubate with a __________ or send to _________ for a tracheostomy.
c. _____ therapy to correct bacterial infection.
d. oxygen therapy at _____ to 50%
e. extubate only when ___________is GONE!! - CORRECT ANSWER 1: airway.
2: bronchoscope
3: surgery
4: antibiotic
5: 30%
6: inflammation
CHOANALE ATRESIA:
1: Defined: infant is born with an anatomical closure of the __________ passage.
2: WHAT TO EXPECT: Your skills in recognizing common __________ heart problems will be tested. Otherwise, you will be simply providing supportive care until ___________. - CORRECT ANSWER 1: nasal
2: congenital
3: surgery.
CHOANALE ATRESIA:
INFORMATION GATHERING:
LEVEL ONE:
a. Normal appearing, normal _________, __________ during feeding. (no way to breathe)
LEVEL II:
a. During _____/bottle feeding, baby becomes _______ and ______.
b. Slight inspiratory _____________.
LEVEL IV(FOUR):
a. Neck and chest xrays rule out airway _________
b. Diagnosis by attempting to pass a _______ catheter via the nares.
c. if unable to pass, then _____________. - CORRECT ANSWER 1: color
2: cyanosis
3: breast
4: apneic
5: cyanotic
6: stridor
7: inflammation
8: suction
9: positive
CHOANALE ATRESIA (CONT'D):
DECISION MAKING:
a. care in ____________.
b. correct with _________.
c. keep ventilatory pressures ________!! - CORRECT ANSWER 1: feeding
2: surgery
3: LOW!!!!
CONGENITAL HEART DEFECTS (INFANT):
1: Defined: infant is born with an anatomical ________(disease or ailment) of the heart or the __________ that emanate (Originate from; be produced by) from the HEART.
2: WHAT TO EXPECT: Your skills in recognizing common ___________ heart problems will be tested. Otherwise, you will be simply providing ___________ care until surgery. - CORRECT ANSWER 1: malady
2: vessels
3: congenital
4: supportive
CONGENITAL HEART DEFECTS (CONT'D):
INFORMATION GATHERING
LEVEL ONE:
a. HX of ___________birth
b. general signs of respiratory __________( grunting, _________flaring, retractions).
c. ______that persists in spite of high ______.
LEVEL II (TWO):
a. heart sounds are _________ upon auscultation (____________ present)=extra or unusual sound heard during a heartbeat.
LEVEL IV (FOUR):
a. __________ is the best DIAGNOSTIC!! test for all the cardiac defects. - CORRECT ANSWER 1: preterm
2: distress
3: (nasal)
4: abnormal
5: murmur
6: Echocardiogram
CONGENITAL HEART DEFECTS (INFANT): CONT'D:
DECISION MAKING:
a. Specific _________ Attributes
b. ____________of the Aorta (________of aorta):
1: ____________ in the upper extremities,
_________ in the lower extremities.
c. ____________of the Great Vessels:
1:__________and pulmonary artery are
switched.
2: "Aorta rising from the ___________ heart,
pulmonary artery rising from the ________
heart."
3: "________-shaped heart" on Xray. - CORRECT ANSWER 1: Defect
2: Coarction
3: narrowing
4: HypeRtension
5: hypOtension
6: Transposition
7: Aorta
8: right
9: left
10: "Egg"
CONGENITAL HEART DEFECTS (INFANT): CONT'D:
DECISION MAKING:
d. _________Ductus Arteriosus (Ductus arteriosus never _________):
1: diagnosed by comparing blood ______ from
the ________/brachial artery and the _______
artery. Positive for _____ if difference is
greater than _____ torr. (PDA with a ______ to
left shunt).
e. OTHER PROBLEMS:
1: _________of Fallot: __________ shaped heart,
overriding __________.
2: _________septal defect (ASD).
3: ________septal defect (VSD).
4: __________arteriosis (pulmonary artery same as __________--combined ____________) - CORRECT ANSWER 1: Patent
2: closes
3: gases
4: radial
5: umbilical
6: PDA
7: 15 torr
8: right
9: Tetralogy
10: boot
11: atrial
12: ventricular
13: truncus
14: aorta
15: vessel
CONGENITAL HEART DEFECTS (Infant):
DECISION MAKING: (CONT'D):
f. All _________defects are treated with ______!!!!
g. Prior to surgery, simply provide ______ care such as:
1: ______to keep PaO2 between ___-80mmHg
2: ______ventilation when ventilatory failure is
shown by _______. - CORRECT ANSWER 1: CONGENITAL
2: SURGERY!!!
3: supportive
4: oxygen
5: 60 mm Hg
6: mechanical
7: ABG's.
NEONATAL DIAPHRAGMATIC HERNIA:
INFORMATION GATHERING:
LEVEL ONE:
a. general respiratory _________, ex. _______, nasal flaring, _________.
b. ___________
c. __________chest and ___________-abdomen ( condition in which the anterior abdominal wall is sunken and presents a concave rather than a convex contour).
d. ___________ shift.
LEVEL II (TWO:
a. breath sounds _________ (usually on left), increased on the _________.
LEVEL III:
a. ______Xray: shows _______ parts in the chest area. Also may see a _________ shift away from the affected side.
b. _______: poor. - CORRECT ANSWER 1: distress
2: grunting
3: retractions.
4: cyanosis
5: barrel
6: scaphoid: look at definition on other side
7: mediastinal
8: absent
9: right
10: chest
11: intestinal
12: mediastinal
13: ABG'ss
NEONATAL DIAPHRAGMATIC HERNIA:
DECISION MAKING:
a. TREATMENT is __________!!!!
b. Use low ventilatory ____________.
c. do NOT use __________ bag and resuscitation if possible.
d. May use _____tube to decompress stomach and __________.
e. all other care is ___________. - CORRECT ANSWER 1: SURGERY!!!
2: pressures
3: manual
4: gastric
5: intestines
6: supportive
SUDDEN INFANT DISTRESS SYNDROME:
1: Defined: sudden ________ occurring in the newborn as a result of an immaturity ________ control of ventilation.
2: WHAT TO EXPECT: Somewhat rare case on the test. Nothing particularly challenging. - CORRECT ANSWER 1: apnea
2: central
SUDDEN INFANT DISTRESS SYNDROME:
INFORMATION GATHERING:
LEVEL I:
a. HX of ____-______birth.
b. Family _________ predisposition.
c. observed, irregular ________, _______ may increase risk of SIDS.
LEVEL II:
a. _____air on infants face may induce apnea.
b. diminished or absent ____ and ____ reflexes. (Moro reflex - The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his/her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him/her and begin this reflex. This reflex lasts about five to six months.) AND..(Babinski reflex - When the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex up to about 2 years of age). - CORRECT ANSWER 1: pre-term
2: genetic
3: respirations.
4: bradycardia
5: cold
6: moro
7: babinski
SUDDEN INFANT DISTRESS SYNDROME:
DECISION MAKING:
a. provide _____when in crisis (___% and 50%).
b. do not send infant home without an _____ monitor and parental ___________.
c. ______monitor should be used at all times (even during the_________).
d. if offered, teach parents _______. - CORRECT ANSWER 1: oxygen
2: 30%
3: apnea
4: education.
5: apnea
6: day
7: CPR
INFANT RESPIRATORY DISTRESS SYNDROME:
1: Defined: condition in infants where ______ maturity is below normal.
2: WHAT TO EXPECT: This is a common case on the test. Key is remembering to address ________ maturity. Also, if prolonged ventilation is required, Bronchopulmonary __________ (chronic lung disorder that is most common among children who were born prematurely, with low birthweights and who received prolonged mechanical ventilation to treat respiratory distress syndrome.) may develop. Be patient and treat ______to moment. - CORRECT ANSWER 1: lung
2: lung
3: Dyplasia
4: moment
INFANT RESPIRATORY DISTRESS SYNDROME:
INFORMATION GATHERING:
LEVEL I:
a. HX may show _____-term infant.
b. onset can be _______after birth, or within a few _____.
c. general respiratory _______, ex. grunting, ____ flaring, retractions.
d. _________.
LEVEL II:
a. APGAR score between _____ and ______. - CORRECT ANSWER 1: pre
2: immediately
3: hours.
4: distress
5: nasal
6: 0 and 6
INFANT RESPIRATORY DISTRESS SYNDROME:
INFORMATION GATHERING (CONT'D):
LEVEL III:
a. ________Xray: radiological description such as _____ glass, honeycomb, ___________.
b. _____: persistent hypoxemia in spite of elevated ______.
LEVEL IV (FOUR):
a. ___/___ ratio: ___:____ or higher is normal. Less than that shows lung __________. - CORRECT ANSWER 1: Chest
2: ground
3: reticulogranular
4: ABGs
5: FiO2
6: L/S
7: 2:1
8: immaturity.
INFANT RESPIRATORY DISTRESS SYNDROME:
DECISION MAKING:
a. Help lung maturity via ______ therapy with agents like __________ or _________:
1: ___ to 5ml/kg split among ___-4 doses.
2: administer directly down the _______
3: change infants ______after every _____ for
_____ seconds to distribute the agent.
b. Provide oxygen via a _________. May use ______ to oxygenate.
c. Mechanically ventilate with ventilatory _______, use ____ mode on ALL infants. May consider reverse ___:___ratio. - CORRECT ANSWER 1: surfactant
2: Exosurf
3: Survanta
4: 2
5: 2
6: airway
7: position
8: dose
9: 30
10: hood(REVIEW)
11: CPAP
12: failure
13: SIMV
14: I:E
IRDS==ANOTHER ONLINE DEFINITION:
hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. - CORRECT ANSWER no info
IRDS:
DECISION MAKING (CONT'D):
d. NOTE: if Xray changes from signs of IRDS to ______ and fibrosis, then the problem may have developed into Bronchopulmonary ________. Treat as prolonged ________by:
1: maintaining pH of _____ to ______, PaCo2 ____ to 60, PaO2: ____ to 70 torr.
2: use low ______.
3: keep mean airway pressures at __________.
4: wean only _________ and as tolerated, often____ initial attempts.
5: ________if RR are between _____-15 BPM. - CORRECT ANSWER 1: hyperinflation.
2: Dysplasia
3: IRDS
4: 7.25 to 7.40
5: 45
6: 55
7: FiO2
8: minimum
9: gradually
10: fails
11: extubate
12: 5
MECONIUM ASPIRATION:
1: Defined: Infant born having __________ in ventilation spaces. Occurs most often in ______ or _______-term infants. Gestational age greater than ____weeks.
2: WHAT TO EXPECT.
a. this is a very COMMON CASE!!!! on the test! It is fairly straight forward and ____________ recognized. The key to this is repeated _______ and clearing of the ___________. - CORRECT ANSWER 1: meconium
2: term
3: post
4: 40
5: easily
6: suctioning
7: airway
MECONIUM ASPIRATION:
INFORMATION GATHERING:
LEVEL I:
a. HX of __________-colored amniotic fluid.
b. Often with ______-term infants.
c. infant may have _____staining about the body.
d. may demonstrate _________, retractions, _____ flaring.
e. poor ______(cyanosis).
LEVEL II:
a. APGAR score between ____ and _____. - CORRECT ANSWER 1: Meconium
2: full
3: meconium
4: grunting
5: nasal
6: color
7: 0 and 6
MECONIUM ASPIRATION:
INFORMATION GATHERING: (CONT'D):
LEVEL III:
a. ________: hypoxemia with __________ acidosis, _________ acidosis, or MIXED.
b. ________Xray: bilateral __________ and widespread __________. - CORRECT ANSWER 1: ABGs
2: respiratory
3: metabolic
4: Chest
5: densities
6: atelectasis
MECONIUM ASPIRATION:
DECISION MAKING:
a. Remove the __________from the airway. If possible, ___________the baby as soon as the head appears from the _____canal.
b. __________to facilitate suctioning. Use of a _____ suction catheter, specially made from suctioning thick ___________.
c. Reintubate if tube becomes _________for any reason.
d. mobilize secretions with chest _____________.
e. ___________ventilate only if needed.
f. apply supplemental __________ as needed. - CORRECT ANSWER 1: meconium
2: suction.
3: birth
4: intubate
5: Delee
6: meconium
7: clogged
8: physiotherapy
9: Mechanically
10: oxygen1
PULMONARY EMBOLI:
1: Defined: situation where the pulmonary _____ becomes _____ and _____-space ventilation results. Sometimes called ____________ disease.
2: WHAT TO EXPECT: This case primarily involves recognizing the pulmonary ________ and treating it with ___________ meds. You will likely have to monitor ______times, PTT, or ____ (REVIEW!)
a. otherwise, involves general ______ therapy. - CORRECT ANSWER 1: artery
2: obstructed
3: dead
4: deadspace
5: emboli
6: anticoagulation
7: clotting
8: PT (REVIEW)
9: respiratory
PULMONARY EMBOLI:
INFORMATION GATHERING:
LEVEL I:
a. HX of recent major _____ or trauma (________, clotted massive _______ sites).
b. complaint of _____pain and dyspnea.
LEVEL II:
a. elevated _____including pulse, ________rate, and blood ____________.
b. breath sounds: _____ and______rales.
c. PECO2 (capnography) decreasing ____ during normal ______.
LEVEL III:
a. _____: persistent _______ in spite of increasing Fi02
LEVEL IV (FOUR):
a. ____/____ scan will show ventilation without adequate ________. - CORRECT ANSWER 1: surgery
2: amputation
3: bleeding
4: chest
5: vitals
6: respiratory
7: pressure
8: wheezing
9: medium
10: PECO2
11: PaCO2
12: ABGs
13: hypoxemia
14: V/Q
15: perfusion
PULMONARY EMBOLI (CONT'D):
DECISION MAKING:
a. Anticoagulation therapy with ____ or ________.
*NOTE: Must monitor ______Tests.
1: ____for Heparin
2: ____for Coumadin
b. ____-Busting Meds such as __________. May also use a bolus of ______.
c. __________ventilation as needed.
d. emergency level oxygen: _____% - CORRECT ANSWER 1: Heparin
2: Coumadin
3: clotting
4: PTT
5: PT
6: clot
7: streptokinase
8: Heparin
9: mechanical
10: 100%
NEWBORN ASSESSMENT:
1: No definition.
2: WHAT TO EXPECT: Will commonly have to do an _________score. You may have to pick the ___ essential elements from a list. Don't be tempted by any tests other than _____ criteria, unless they can be done simply by _______at the infant. Or, you may be given the elements, and asked what you want to do about it. - CORRECT ANSWER 1: APGAR
2: 5
3: APGAR
4: looking
NEWBORN ASSESSMENT:
INFORMATION GATHERING:
APGAR:
A. COLOR:
1: pink: ____points
2: pink body, blue extremities: ____point
3: blue/pale all over: ____points
b. PULSE:
1: above 100: ______ points
2: below 100: _______point
3: none: ________points
c. GRIMACE (___________Irritability):
1: cough/sneeze: ____points
2: facial grimace: _____point
3: none: _____points
**MORE TO IT** - CORRECT ANSWER 1: 2
2: 1
3: 0
4: 2
5: 1
6: 0
7: (Reflex)
8: 2
9: 1
10: 0
NEWBORN ASSESSMENT:
INFORMATION GATHERING:
APGAR: (CONT'D):
d. ACTIVITY (__________):
1: active movement: ____points
2: some flexion of limbs: ____point
3: limp/no movement: ____points
e. RESPIRATORY EFFORT:
1: strong cry: _____points
2: weak cry: ____point
3: no cry: ____ points. - CORRECT ANSWER 1: Flexion
2: 2
3: 1
4: 0
5: 2
6: 1
7: 0
NEWBORN ASSESSMENT:
INFORMATION GATHERING (CONT'D):
B. HISTORY: if poor _____, may be ____-term, congenital heart problems, ______ aspiration, IRDS, ______tachypnea.
C. OTHER HELPFUL ASSESSMENTS:
1: _______age and ___________. - CORRECT ANSWER 1: APGAR
2: pre
3: meconium
4: transient
5: gestational
6: weight
NEWBORN ASSESSMENT:
DECISION MAKING:
1: If APGAR score is:
a. 0 to 3: perform _________
b. 4 to 6: administer _____, place infant in _____, neutrally ______ environment, generally _______ the baby.
c. 7 to 10: monitor ________. - CORRECT ANSWER 1: CPR
2: oxygen
3: warm
4: thermal
5: stimulate
6: normally
PULMONARY EDEMA/CHF:
1: Defined: significant reduction in cardiac ______. Involvement of ____ penetrating the _____ capillary membrane into the lungs.
2: WHAT TO EXPECT: This case may feel complicated b/c it involves the _____ and ______ values. It is usually easily identified by ______ frothy secretions and ______ pattern on Chest Xray.
You may need to make the distinction between pulmonary _______caused by cardiac problems and that which is caused by _____capillary membrane problems (ARDS). If it is cardiac, then you must treat the ______. - CORRECT ANSWER 1: output.
2: fluid
3: alveolar
4: heart
5: hemodynamic
6: pink
7: butterfly
8: edema
9: alveolar
10: heart
PULMONARY EDEMA/CHF:
INFORMATION GATHERING:
LEVEL I:
a. HX of ____, or pulmonary__________
b. ________, tachycardia, or ________.
LEVEL II:
a. cold, ________, diaphoretic
b. _________frothy secretions.
c. ______ of fluids (esp. pedal edema).
d. breath sounds reveal _____, wet rales.
e. ________edema (+2, +3) - CORRECT ANSWER 1: CHF
2: hypertension.
3: tachypnea
4: anxiety
5: clammy
6: pink
7: edema
8: fine
9: pitting
PULMONARY EDEMA/CHF:
INFORMATION GATHERING:
LEVEL III:
a. _______: ventilatory failure with moderate to severe ____________.
b. _______Xray: ________pattern, _____ infiltrates.
LEVEL IV (FOUR):
a. increased _________ pressures (PCWP, _____, CVP). - CORRECT ANSWER 1: ABG's
2: hypoxemia
3: Chest
4: butterfly
5: fluffy
6: hemodynamic
7: PAP
PULMONARY EDEMA/CHF:
DECISION MAKING:
a. treat as an ________________!!!!!
b. ____% O2
c. administer diuretic medication __________(lasix)
d. cardiac __________stimulating drugs such as ______, digitalis, if increased _______ and PAP.
e. be prepared to treat ________ failure with mechanical ventilation.
f. instill ___________ alcohol down the ET tube if pt. is severely congested with ___________ (process that occurs suddenly and quickly, and is intense and severe to the point of lethality) edema. - CORRECT ANSWER 1: EMERGENCY!!
2: 100%
3: furosemide
4: inotropic
5: digoxin
6: PCWP
7: ventilatory
8: ethyl
9: fulminating
MYOCARDIAL INFARCTION/ARRHYTHMIA:
1: Defined: ______to the heart causing muscle damage and potential __________.
2: WHAT TO EXPECT: Will likely need to treat _______ with appropriate meds and/or _________. - CORRECT ANSWER 1: ischemia
2: failure
3: arrhythmias
4: defibrillation.
MYOCARDIAL INFARCTION/ARRHYTHMIA:
INFORMATION GATHERING:
LEVEL I:
a. HX of ______pain, radiating pain down the ______ arm.
b. family __________ of disease.
c. ________
d. history of nausea
e. ____________
f. _________
LEVEL II:
a. cold, _________ and _________ to the touch.
b. __________. - CORRECT ANSWER 1: chest
2: left
3: history
4: diaphoretic
5: tachycardia
6: nausea
7: diaphoretic
8: clammy
9: Dyspnea
MYOCARDIAL INFARCTION/ARRHYTHMIAS:
INFORMATION GATHERING (CONT'D):
LEVEL III:
a. ABGs: ______________
b. ______(EKG): prounounced ____ waves and ____-____ segment elevation.
LEVEL IV (FOUR):
a. cardiac _________ including CPK, _____, _____ are elevated. - CORRECT ANSWER 1: hypoxemia
2: ECG
3: Q
4: S-T
5: enzymes
6: LDH
7: SGOT
MYOCARDIAL INFARCTION/ARRHYTHMIAS:
DECISION MAKING:
a. Emergency: _________% O2.
b. Oxygen at adult _______ level (___% to 60%) upon suspicion or first presentation of _____ and/ or symptoms.
c. Treat __________
1: bradycardia with________/________
2: PVCs: _____ or ________
3: ______Ventricular Tachycardia with
________ with synchronization _________.
4: ________fibrillation with defibrillation. - CORRECT ANSWER 1: 100%
2: therapeutic
3: (40%)
4: signs
5: arrhythmias
6: atropine/isuprel
7: lidocaine/oxygen
8: pulseless
9: defibrillation
10: OFF
11: ventricular
MYOCARDIAL INFARCTION/ARRHYTHMIAS:
DECISION MAKING (cont'd):
*NOTE: for ________ fibrillation, defibrillate at ascending watt/sec or ____ settings:
1: ________joules-______ PRN
2: do NOT exceed _____ joules
*NOTE: for ________ fibrillation or flutter, do ______________ cardioversion: start at _____ joules. - CORRECT ANSWER 1: ventricular
2: joules
3: 360
4: repeat
5: 360
6: atrial
7: synchronized
8: 50
SHOCK:
1: Defined: condition where _______oxygenation is in jeopardy due to a sudden decrease in _____ flow
2: WHAT TO EXPECT: Shock will test your ability to recognize it and monitor the pt. for ________ failure. Most of the simulation is dealing with typical __________ considerations such as ventilator ____________. - CORRECT ANSWER 1: tissue
2: blood
3: ventilatory
4: ventilatory
5: manipulation.
SHOCK:
INFORMATION GATHERING:
LEVEL I:
a. __________evidence of an event, massive _________, or __________, etc.
b. general appearnce: cold, _______, dusky, __________.
c. _________, tachypnea
LEVEL II:
a. ____________
b. temp may be below ____________
c. reduction in ___________ output.
LEVEL III:
a. ABG's: __________ and ventilatory failure.
LEVEL IV (FOUR):
a. reduction in common ____________ values, (CVP, _____, PCWP) and cardiac _______. - CORRECT ANSWER 1: historical
2: trauma
3: hypothermia
4: clammy
5: cyanotic
6: tachycardia
7: hypotensive
8: normal
9: urine
10: hypoxemia
11: hemodynamic
12: (PAP)
13: output.
SHOCK:
DECISION MAKING:
a. __________ ventilate with ventilatory failure.
b. ________ is key. Start it as evidence of shock is presented.
c. administer __________ if needed to treat anemia
d. use oxygen at least _____% but may use up to ____%.
e. main TX involves treating the original problem (that which caused the _________). This can be highly variable. - CORRECT ANSWER 1: mechanically
2: oxygen
3: blood
4: 40%
5: 100%
6: shock.
GUILLAN-BARRE SYNDROME:
1: Defined: an insidious (Proceeding in a gradual, subtle way, but with harmful effects) ________ problem involving muscle ___________. Paralysis begins in the lower _____ and moves upward, including the ____________muscles.
2: WHAT TO EXPECT: Like most neuromuscular cases, you will be tested in your ability to recognize deterioration in ________ muscles. In this case, onset can be ________, so don't jump-the-gun and _______ventilate too early. Only do so as _____ falls below _______L. Otherwise, you will be manipulating the ________ and possibly weaning. - CORRECT ANSWER 1: neuromuscular
2: paralysis
3: extremities
4: ventilatory
5: ventilatory
6: slow
7: mechanically
8: VC (VITAL CAPACITY: 2X VT)
9: 1.0L
10: ventilator
GUILLAN BARRE' SYNDROME:
DECISION MAKING:
1: Be primarily concerned with loss of _________, monitor ventilatory _______ (VC, and ____) and _____. Begin mechanical ventilation when VC falls below _____L.
2: Be patient about ________ and mechanical ventilation. Onset can be _____.
3: Anti-_________therapy and _______ leg stockings to prevent clot development. - CORRECT ANSWER 1: ventilation.
2: volumes.
3: (Vt)
4: MIP
5: 1.0L
6: intubation
7: slow
8: coagulant
9: pressure
GUILLAN BARRE' SYNDROME:
DECISION MAKING: (cont'd):
4: pRIMARY tx will involve_________ventilation and letting the syndrome run its __________.
5: Therapies to __________ secretions.
6: _________(removal, treatment, and return of (components of) blood plasma from blood circulation), immunosuppressor medications.
7: higher propensity for pulmonary ______ due to clot formation in the _____ body due to ______. - CORRECT ANSWER 1: mechanical
2: course
3: mobilize
4: plasmapheresis
5: embolism
6: lower
ADULT RESPIRATORY DISTRESS SYNDROME:
1: Defined: a condition that results in significantly decrease lung _________ and consequent profound _____________.
2: WHAT TO EXPECT: ARDS can be very disquieting (Inducing feelings of anxiety or worry) case to deal with. Usually persistent increases in _____ are needed. Do not be afraid to increase ______ significantly. - CORRECT ANSWER 1: compliance
2: hypoxemia
3: PEEP
4: PEEP
ARDS:
INFORMATION GATHERING:
LEVEL I:
a. Record may show a variety of insults to the lung including massive ______, near ________, inhalation of __________, hyp___thermia, and others.
b. rapid ___________rate.
c. ________________.
LEVEL II:
a. Decreased lung __________ as manifested by increased __________ pressures (REVIEW) (decreased __________ compliance). - CORRECT ANSWER 1: surgery.
2: drowning
3: gasoline
4: HYPOTHERMIA
5: respiratory'
6: cyanosis
7: compliance
8: plateau
9: static
ARDS:
INFORMATION GATHERING: (CONT'D):
LEVEL III:
a. _____: persistent hypoxemia in spite of elevated _____ (may be ___________).
b. __________Xray: shows granular, ______ glass, reticulogranular, or _______ patterns. Often accompanied by _________ infiltrates.
LEVEL IV:
a. all ___________ values could deteriorate when _____ ventilatory pressures become SIGNIFICANT. - CORRECT ANSWER 1: ABG's
2: FiO2
3: (refractory)
4: chest
5: ground
6: honeycomb
7: diffuse
8: hemodynamic
9: positive
ARDS:
DECISION MAKING:
1: As positive pressure is required ________, negative effects may be seen. All should be done to minimize the ____ pressure being put on the pulmonary system, while trying to balance the need to ventilate with higher ________ and utilize _____ to maintain oxygenation.
2: After emergency situation is past, keep FiO2 no more than _______ and use _______.
3: Keep increasing ______ until an obvious degradation in _____ values is witnessed. - CORRECT ANSWER 1: increasingly
2: mean
3: pressures
4: PEEP
5: 0.6
6: PEEP
7: PEEP
8: hemodynamic
ARDS:
DECISION MAKING (CONT'D):
4: As ventilatory pressures become higher, OK to consider __________ methods of ventilation including ______ control, high __________, _____, inverse ___:___ ratio, etc.
5: If pt. is described as having ARDS before being placed on a ventilator, initial vent settings should include a PEEP of at least ____. It is also appropriate to start right off at _______/________ ventilation as an initial setting. - CORRECT ANSWER 1: alternate
2: pressure
3: high
4: APRV
5: I:E
6: 10
7: Pressure/control
LARYNGECTOMY:
1: Defined: surgery done to address or remove ______ of the ________.
2: WHAT TO EXPECT: In this case, you are always looking for post-_______ complications like blood ______ in the laryngeal tube. Often, you will have to __________ ventilate this pt. via the _________ tube. - CORRECT ANSWER 1: cancer
2: larynx
3: surgical
4: clots
5: mechanically
6: laryngectomy
LARYNGECTOMY:
INFORMATION GATHERING:
LEVEL I:
a. ________record: surgery radical (entire _____) or simple (_____removal).
b. medical __________: will show _______ in upper airway.
LEVEL II:
a. signs of airway _______ after surgery. Usually caused by _______ within a few hours after the surgery. - CORRECT ANSWER 1: surgical
2: larynx
3: cord
4: history
5: cancer
6: obstruction
7: blood
LARYNGECTOMY:
DECISION MAKING:
a. if radical surgery (entire _____ removed) then the tracheostomy becomes _________.
b. If not _________, then a temporary ________ tube is placed but must be replaced in ____ to 6 weeks.
c. Prevent __________!!!! Wait at least a week before ________ingestion of liquid and longer for ______. Thorough ________hygiene via suctioning.
d. use ________ aerosol or ________ nebulizer to keep secretions _______ and hydrated.
e. Once the surgery is done, you can no longer _____ intubate the pt. Even if the ________ laryngectomy tube is in place, you must intubate and/or _____ via the tube!! - CORRECT ANSWER 1: larynx
2: permanent
3: radical
4: laryngectomy
5: 3
6: ASPIRATION!!!!
7: oral
8: food
9: pulmonary
10: cool
11: ultrasonic
12: thin
13: orally
14: temporary
15: ventilate
HEMOTHORAX/PNEUMOTHORAX:
1: Defined: loss of adherence of the lung to the _____ wall causing the space to be filled with _____ or _______(bloody).
2: WHAT TO EXPECT: ___________, Hemothorax, ___________pneumothorax occurs VERY FREQUENTLY ON EXAM!!
a. may include the troubleshooting of chest _____
drainage device. (REVIEW!) - CORRECT ANSWER 1: Pleural
2: air
3: fluid
4: pneumothorax
5: tension
6: tube
HEMOTHORAX/PNEUMOTHORAX:
INFORMATION GATHERING:
LEVEL I:
a. rapid and ______ respirations.
LEVEL II:
a. _______: _________ if pneumothorax, _____ if hemothorax.
b. ___________shift: to affected side if ________, away if _______pneumothorax.
c. severe _____________
d. very ________or absent breath sounds.
e. pulses __________
LEVEL III:
a. ________Xray: shows ________, tracheal or __________ shift. - CORRECT ANSWER 1: shallow
2: percussion
3: hypERresonant
4: dull
5: tracheal
6: pneumothorax
7: tension
8: dyspnea
9: diminished
10: paradoxus
11: Chest
12: hypERlucency
13: mediastinal
Pneumothorax is the result of an injury where air gets into the chest cavity. It can result from an open wound in the chest, such as by being stabbed, or it can occur from a closed wound such as broken ribs.
Tension pneumothorax is the buildup of air in the chest cavity collapses the lung and puts pressure on the heart, which then can't pump blood effectively. - CORRECT ANSWER no more info
HEMOTHORAX/PNEUMOTHORAX:
DECISION MAKING:
a. usual TX is insertion of chest _________:
1: upper _____chest tube placement for
________(involving air)
2: _________chest tube placement for ______
(involving ____and body fluid).
b. TX partial _________if greater than ___%: insert chest tubes.
c. TX ________, with chest _____/____________
d. TX ______pneumothorax with _____ bore needle. - CORRECT ANSWER 1: tubes
2: anterior
3: pneumothorax
4: lower
5: hemothorax
6: blood
7: pneumothorax
8: 20%
9: hemothorax
10: tubes/thoracentesis
11: tension
12: LARGE
THORACIC SURGERY:
1: Defined: can have a variety of_____ from _______ surgery.
2: WHAT TO EXPECT: Your ability to deal with and troubleshoot _____tubes maintenance is tested in this simulation. Sometimes this case is combined with_______trauma. - CORRECT ANSWER 1: complications
2: thoracic
3: chest
4: chest
THORACIC SURGERY:
INFORMATION GATHERING:
LEVEL I:
a. Always monitoring chest ______drainage adequacy:
b. looking for potential complications:
1: ________shock, low ________ values
including blood _________.
2: __________emphysema.
3: elevated ventilatory _____________
LEVEL III (THREE):
a: ______Xray: to confirm proper re-______ of the lung and proper __________ of chest tubes. - CORRECT ANSWER 1: tube
2: hypOvolemic
3: hemodynamic
4: pressure
5: subcutaneous
6: pressures
7: chest
8: re-inflation
9: placement
THORACIC SURGERY:
DECISION MAKING:
a. anything that promotes ________ of the lungs including _______ spirometry, IPPB, and ______ pressure mechanical ventilation.
b. if a ________/pneumonectomy, ventilatory volumes should be set _________.
c. _______therapy if volume is a problem (often is)
d. if mechanical ventilation is used, use VT of ___-____ mL/kg to reduce vent pressures. - CORRECT ANSWER 1: expansion
2: incentive
3: positive
4: lobectomy
5: lower
6: fluid
7: 8-9 mL/kg
NECK/SPINAL INJURY:
1: Defined: Any trauma threatening the physical structure of the ______. Can include ______/_______ surgery.
2: WHAT TO EXPECT: Your knowledge of special _________techniques is what is being tested in this type of simulation. - CORRECT ANSWER 1: neck
2: neck/spinal
3: intubation
NECK/SPINAL INJURY:
INFORMATION GATHERING:
LEVEL I:
a. __________ relevance, some sort of accident such as _____, automobile, etc.
b. ________damage to the neck.
c. altered __________level.
LEVEL II:
a. ________, VC, _______, and other ventilatory _________may quickly deteriorate.
LEVEL III:
a. _______xray: will show injury. - CORRECT ANSWER 1: historical
2: diving
3: visible
4: conscious
5: Vt
6: PEFR
7: volumes
8: Neck
NECK/SPINAL INJURY:
DECISION MAKING:
a. always be prepared to quickly ___ and/or promote ___________.
b. if intubation is required, always use _________ jaw thrust.
c. if given option, always intubate with ________ so damage can be ______ and care can be taken to avoid inflicting further damage.
d. Alternatively, a ________ nasal intubation is acceptable to prevent neck ________ and further injury. - CORRECT ANSWER 1: assist
2: ventilation.
3: MODIFIED
4: bronchoscope
5: visualized
6: blind
7: manipulation.
ABDOMINAL SURGERY:
1: Defined: Surgery in the _______area for various reasons.
2: WHAT TO EXPECT: Abdominal surgery is very general, non-__________ case involving preventative care and _________-up. - CORRECT ANSWER 1: abdominal
2: complicated
3: follow
ABDOMINAL SURGERY:
INFORMATION GATHERING:
LEVEL I:
a. all general ___________ assessments.
LEVEL II:
a. all general _______ assessment including all ____________.
LEVEL III:
a. ventilatory ______________(VC, Vt, _____1) compared to pre-____________baselines. - CORRECT ANSWER 1: visual
2: bedside
3: vitals
4: volumes
5: FEV1
6: surgery
ABDOMINAL SURGERY:
DECISION MAKING:
1: Establishing baselines in _______function testing _________and volumes.
2: Start pt. on____________ spirometry prior to surgery, every ________after surgery.
3: Initial IS goal is ______ of the preoperative inspiratory ___________ value.
4: Use _________pressure (IPPB) if needed after surgery, if pt. is _____________. - CORRECT ANSWER 1: pulmonary
2: flow
3: incentive
4: hour
5: half
6: capacity
7: positive
8: unconscious.
HEART SURGERY:
1: Defined: any kind of surgery on the __________
2: WHAT TO EXPECT: This case is not too complicated. You may feel hesitant to do ______
on someone fresh out of surgery. Just do_____!!! - CORRECT ANSWER 1: heart
2: CPR
3: IT!!!!!
HEART SURGERY:
INFORMATION GATHERING:
LEVEL I:
a.Do well-rounded________prior to surgery including _____signs and family history of ______illness.
LEVEL II:
a. Preoperative assessments of _______sounds
b. Baseline data including basic_______ of all types including ____/____ and
pre and post ____________ studies
LEVEL III:
a. ABGs: __________ for baseline. - CORRECT ANSWER 1: assessment
2: vital
3: cardiac
4: breath
5: spirometry
6: FEV1/FVC
7: Bronchodilator
8: preoperative
HEART SURGERY:
DECISION MAKING:
a. Always assess ventilatory_______ and be prepared to ___________ventilate
b. Incentive spirometry every_____after surgery for lung________and ________ ventilation.
c. If unable (__________) use simple ventilatory assisting devices such as _______ or_______with mask.
d. Be on the alert for cardiac _______—perform _____ without reservation or consideration of
the _______surgery. - CORRECT ANSWER 1: volumes
2: mechanically
3: hour
4: expansion
5: alveolar
6: unconscious
7: IPPB
8: CPAP
9: arrest
10: CPR!!!
11: heart
BURN TRAUMA/CO POISONING:
1: Defined: Results from direct exposure to _____
and or _______. Directly threatens _______ and
_______ carrying capacity of the blood.
2: WHAT TO EXPECT: Fairly common case on the test. Remember to focus on the_______ and on _______ carrying capacity of the blood. Remember to employ_______ techniques.
Otherwise, provide general respiratory therapy. - CORRECT ANSWER 1: fire
2: smoke
3: airway
4: oxygen
5: airway
6: oxygen
7: isolation
BURN TRAUMA/CO POISONING:
INFORMATION GATHERING
LEVEL I:
a. Diagnosis is based largely on________—exposure to_____ or smoke. Often occurs in ________ related cases (fire fighter)
b. Visible ______ about the body and face
c. _________ nasal and or eyebrow hairs
d. "______-_____" color of face with CO poisoning
e. Patient is often __________ or unresponsive
f. _________, hoarseness
LEVEL II:
a. Breath sounds—_________, rhonchi,_____ - CORRECT ANSWER 1: history
2: fire
3: occupational
4: burns
5: singed
6: "cherry-red"
7: confused
8: stridor
9: wheezing
10: rales
BURN TRAUMA/CO POISONING:
INFORMATION GATHERING (cont'd):
LEVEL III:
a. ABGs—initially decreased ______, normal _____, decreased saturation.
b. Latter may develop into_______acidosis
c. Chest X-ray—may be _____ at first, but later may show pulmonary _________ and
markedly decreased lung __________.
LEVEL IV (FOUR):
a. COHb-______% or more - CORRECT ANSWER 1: PaCO2
2: PaO2
3: respiratory
4: clear
5: edema
6: compliance
7: 20%
BURN TRAUMA/CO POISONING:
DECISION MAKING:
a. Protect airway by establishing an _______ airway immediately. Particularly if there is respiratory distress and there are ______about the face.
b. For___poisoning—start____% oxygen immediately— even if only ______ it—do not wait
for________ results - CORRECT ANSWER 1: artificial
2: burns
3: CO
4: 100%
5: suspect
6: COHb
BURN TRAUMA/CO POISONING:
DECISION MAKING: (cont'd):
c. Continue________ therapy until COHb level is below___%.—may use_______medicine if
offered—often will not be offered.
d. Practice________ isolation (protect the patient from staff)
e. __________ventilate as needed. - CORRECT ANSWER 1: oxygen
2: 10%
3: hyperbaric
4: reverse.
5: mechanically. [Show Less]