N424-Exam 2 study guide (ch 7, 11 ,12, 34) Questions With
Complete Solutions
2 tools used to dx PE Correct Answers Wells Score and the
Geneva score, the higher the score , the higher the probability of
PE
3 Classifications of PNA Correct Answers 1. HAP- (hospital
acquired pneumonia), which develops within 48 hrs or more of
admission to the hospital , highest increase in morbidity and
mortality of all healthcare associated infections, increases
hospital stay.
2. VAP- (ventilator associated pneumonia) develops at least 48
hrs after intubation for mechanical ventilation, highest risk
within 5 days on mechanical ventilator, risk for developing PNA
is 6-20x times greater in ventilated pt than in other hospitalized
pt.
3. Healthcare associated PNA (HCAP)- PNA that occurs in a
non hospitalized pt who: lives in LTC facility, hospitalized
within 90 days, long term hemodialysis, home infusion, chemo,
or wound care within previous 30 days
3 factors that affect pulmonary perfusion: Correct Answers Hgb
concentration, affinity of O2 Hgb et blood flow
,a compensated acid-base state is one in which what? Correct
Answers in which the pH has returned to WNL, c the acid-base
imbalance being neutralized but NOT corrected
a decrease in H+ concentration blanks pH and increases what?
Correct Answers increases pH; increases alkalinity
A direct measurement of cardiac output requires what? Correct
Answers invasive catheterization of the pulmonary artery
A low SvO2 means what? Correct Answers less O2 is returning
to to the right heart; cells are not getting enough O2 to meet
their needs
A mechanical ventilator is able to deliver a wide range of FiO2,
from blank to blank Correct Answers 0.21 to 1 (21-100%)
a normal pH is maintained if the ratio of bicarbonate (HCO3) to
carbon dioxide (CO2) remains approx blank Correct Answers
20:1
a partially compensated acid-base state is one in which the pH is
what Correct Answers abnormal, however the body buffers and
regulatory mechanisms have begun to respond to the imbalance
,A person with a chronic respiratory insufficiency issue would
have ABGs to look normal or abnormal pH, low or high PaCO2,
low or high HCO3, and low or high PaO2? Correct Answers
normal pH, high PaCO2, high HCO3, and normal to low PaO2
A pt with chronic lung disease may have a PaO2 of blank and a
PaCO2 of blank as a normal baseline. Attempts to return this pt
to individual ABG value of a healthy person, would have serious
consequences Correct Answers 60mmHg, 50 mmHg
A state of ARF exists when pt meets or exceeds what clinical
criteria? Correct Answers PaCO2 greater than 50mmHg with a
pH of less than 7.30 and/ or PaO2 of less than 60 mmHg when
pt is breathing on room air
ABGs provide... Correct Answers info on the pt's acid-base and
oxygenation status
AC mode is commonly used initially as a resting mode,
particularly in what types of pt? Correct Answers pt with acute
resp failure or respiratory muscle fatigue bc it takes over the
work of breathing, therey by resting the resp muscles and
reducing O2 consumption
, Action and use of anticholinergic bronchodilators Correct
Answers bronchodilation, blockade of cholinergic-induced
bronchoconstriction; maintenance therapy for COPD pt
primarily
action and use of corticosteroids Correct Answers anti-
inflammatory agents, reduce airway edema assoc with asthma,
COPD; used as controller for asthma and COPD to reduce
airway inflammation; additional higher doses given IV for acute
exacerbation
Action and use of pulmonary vasodilators Correct Answers
specialized tx (Rescue therapy for life-threatening hypoxemia)
and pulmonary HTN; selective vasodilate pulmonary
vasculature, reduce pulmonary HTN, improve oxygenation
Action and uses for mucolytics Correct Answers decrease
viscosity of resp secretions, used chronically in some diseases
(cystic fibrosis)
Acetylcysteine : used acutely to improve airway clearance in
diseases c thick mucous production and during bronchoscopy to
clear mucous plug.
Dornase: synthetic pancreatic enzyme, breaks down DNA
material from neutrophils
Complete Solutions
2 tools used to dx PE Correct Answers Wells Score and the
Geneva score, the higher the score , the higher the probability of
PE
3 Classifications of PNA Correct Answers 1. HAP- (hospital
acquired pneumonia), which develops within 48 hrs or more of
admission to the hospital , highest increase in morbidity and
mortality of all healthcare associated infections, increases
hospital stay.
2. VAP- (ventilator associated pneumonia) develops at least 48
hrs after intubation for mechanical ventilation, highest risk
within 5 days on mechanical ventilator, risk for developing PNA
is 6-20x times greater in ventilated pt than in other hospitalized
pt.
3. Healthcare associated PNA (HCAP)- PNA that occurs in a
non hospitalized pt who: lives in LTC facility, hospitalized
within 90 days, long term hemodialysis, home infusion, chemo,
or wound care within previous 30 days
3 factors that affect pulmonary perfusion: Correct Answers Hgb
concentration, affinity of O2 Hgb et blood flow
,a compensated acid-base state is one in which what? Correct
Answers in which the pH has returned to WNL, c the acid-base
imbalance being neutralized but NOT corrected
a decrease in H+ concentration blanks pH and increases what?
Correct Answers increases pH; increases alkalinity
A direct measurement of cardiac output requires what? Correct
Answers invasive catheterization of the pulmonary artery
A low SvO2 means what? Correct Answers less O2 is returning
to to the right heart; cells are not getting enough O2 to meet
their needs
A mechanical ventilator is able to deliver a wide range of FiO2,
from blank to blank Correct Answers 0.21 to 1 (21-100%)
a normal pH is maintained if the ratio of bicarbonate (HCO3) to
carbon dioxide (CO2) remains approx blank Correct Answers
20:1
a partially compensated acid-base state is one in which the pH is
what Correct Answers abnormal, however the body buffers and
regulatory mechanisms have begun to respond to the imbalance
,A person with a chronic respiratory insufficiency issue would
have ABGs to look normal or abnormal pH, low or high PaCO2,
low or high HCO3, and low or high PaO2? Correct Answers
normal pH, high PaCO2, high HCO3, and normal to low PaO2
A pt with chronic lung disease may have a PaO2 of blank and a
PaCO2 of blank as a normal baseline. Attempts to return this pt
to individual ABG value of a healthy person, would have serious
consequences Correct Answers 60mmHg, 50 mmHg
A state of ARF exists when pt meets or exceeds what clinical
criteria? Correct Answers PaCO2 greater than 50mmHg with a
pH of less than 7.30 and/ or PaO2 of less than 60 mmHg when
pt is breathing on room air
ABGs provide... Correct Answers info on the pt's acid-base and
oxygenation status
AC mode is commonly used initially as a resting mode,
particularly in what types of pt? Correct Answers pt with acute
resp failure or respiratory muscle fatigue bc it takes over the
work of breathing, therey by resting the resp muscles and
reducing O2 consumption
, Action and use of anticholinergic bronchodilators Correct
Answers bronchodilation, blockade of cholinergic-induced
bronchoconstriction; maintenance therapy for COPD pt
primarily
action and use of corticosteroids Correct Answers anti-
inflammatory agents, reduce airway edema assoc with asthma,
COPD; used as controller for asthma and COPD to reduce
airway inflammation; additional higher doses given IV for acute
exacerbation
Action and use of pulmonary vasodilators Correct Answers
specialized tx (Rescue therapy for life-threatening hypoxemia)
and pulmonary HTN; selective vasodilate pulmonary
vasculature, reduce pulmonary HTN, improve oxygenation
Action and uses for mucolytics Correct Answers decrease
viscosity of resp secretions, used chronically in some diseases
(cystic fibrosis)
Acetylcysteine : used acutely to improve airway clearance in
diseases c thick mucous production and during bronchoscopy to
clear mucous plug.
Dornase: synthetic pancreatic enzyme, breaks down DNA
material from neutrophils
