Respiratory System Questions and Answers - Key Points

Systemic Lupus Arthemius and Prednisone

• Abruptly stopping Prednisone can cause acute adrenal cortical insufficiency
  • Prednisone is a corticosteroid that affects the HPA axis
  • Gradual tapering of dose is essential
  • Other side effects of corticosteroids include hyperglycemia, GI bleeding, restlessness

Chronic Obstructive Pulmonary Disease (COPD)

• Theophylline is used for COPD management
  • Therapeutic range: 10 to 20 mcg/mL
  • Mechanism: Bronchodilation, phosphodiesterase inhibition
  • Monitoring necessary for toxicity

Oxygen Delivery Methods

• High-Flow and Low-Flow Oxygen Systems
  • Low-Flow: Nasal cannula, simple mask, partial and non-rebreather masks
  • Non-rebreather mask can deliver the highest FiO2 (up to 1.0)
  • High-Flow: Venturi mask, HFNC, mechanical ventilation
  • Specific devices for tracheostomy patients e.g., trach collar

Acute Pulmonary Edema

• Selecting Oxygen Delivery Method
  • Non-rebreather mask recommended for severe hypoxia
  • Provides high oxygen concentration
• Acute Respiratory Responses
  • Hypoxemia requires immediate intervention
  • Actions include use of Bronchodilators (e.g., Salbutamol) over other medications

Respiratory Alkalosis and Acidosis

• Respiratory Alkalosis
• Often caused by hyperventilation from anxiety
• Corrective action: rebreathing exercises using a paper bag
• Respiratory Acidosis
• Seen in conditions causing hypoventilation
• e.g., COPD due to CO2 retention

Arterial Blood Gas (ABG) Analysis

• Important for assessing respiratory functions
• Critical values for respiratory conditions
  • pH <7.35 indicates acidosis
  • PaCO2 >45 mm Hg indicates respiratory acidosis
  • Elevated PaO2 persistence in high-flow O2 settings indicates possible ARDS

Chest Tube Management

• In case of disconnection: Submerge the tube in sterile saline
• Fluid fluctuation in water seal chamber: Indicates a patent drainage system
• Key priority: Keep collection chamber below chest level

Tuberculosis (TB) Precautions

• A positive TB skin test (PPD) post BCG vaccination may indicate prior exposure
• Airborne precautions necessary
  • Negative pressure room, respiratory protection

Asthma Management

• Bronchodilators: Short-acting for acute relief (e.g., Albuterol)
• Corticosteroids reduce inflammation
• Educate patients on medication use, including holding breath post-inhalation

Acute Respiratory Distress Syndrome (ARDS)

• Key indicator: