Clinical simulation style decision points for asthma, COPD, cardiac failure, neuromuscular disease and trauma, linking assessment findings to the best next action.
40 cards · basic cards · AI-written, checked twice. Edit anything.
- Severe asthma exacerbation with a silent chest (no audible wheezing) signals what?
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Impending respiratory failure (airflow too poor to generate a wheeze)- Status asthmaticus unresponsive to beta-agonists and corticosteroids: what pharmacologic agent is added next?
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IV magnesium sulfate- An asthma patient's PaCO2 rises from low toward normal during a severe attack. What does this mean?
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Respiratory muscle fatigue and impending failure, not improvement- What is the first-line bronchodilator for an acute asthma exacerbation?
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A short-acting beta-2 agonist (albuterol) by nebulizer- A mechanically ventilated severe asthmatic suddenly becomes hypotensive with high peak pressures. First action?
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Disconnect the patient from the ventilator to relieve breath-stacking (auto-PEEP)- What ventilator strategy minimizes air trapping and auto-PEEP in status asthmaticus?
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Permissive hypercapnia with a low respiratory rate and prolonged expiratory time- Which anticholinergic bronchodilator is added alongside albuterol for severe asthma exacerbations?
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Ipratropium bromide- A COPD patient on home O2 becomes drowsy with a headache after flow was increased to 5 L/min. Next action?
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Reduce the FiO2/flow and assess for CO2 narcosis- In a COPD patient at risk of CO2 retention, the target SpO2 range is ____.
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88-92%- A COPD exacerbation patient has pH 7.28, PaCO2 68, and is alert and cooperative. What is the best next intervention?
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Noninvasive positive pressure ventilation (BiPAP)- Name an absolute contraindication to NPPV in a COPD exacerbation.
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Decreased level of consciousness/inability to protect the airway- Chronic compensated COPD classically shows a nearly normal pH, elevated PaCO2, and ____.
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elevated HCO3- A COPD patient on BiPAP still has persistent hypercapnia. What ventilator adjustment is made next?
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Increase the IPAP (pressure support)- How does pursed-lip breathing help a COPD patient?
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It creates back-pressure that prevents small airway collapse during exhalation- Barrel chest with diminished breath sounds on exam of a COPD patient suggests what?
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Hyperinflation/air trapping from emphysema
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