112 Therapeutic Modalities Exam 1 Flashcards
2 learning domains and what they mean
Traditional= Instructor controlled, lectures, exams
Problem Based (PBL)= Critical Thinking, Student centered, group projects
Indications a Pt may have low health literacy
Non Compliance
Too busy, too tired statements
lost the reading info
nervous, anxious, confused
topic avoidance
incomplete paperwork
Teach Adults vs. Teaching Childrens
Adults: Internally motivated
Children: externally motivated
Adults: Self directed
Children: Directed by others
Adults: Questions teacher
Children: Trusts teacher
Adults: Learns for the present
Children: Learn for the future
Adults: Slow learner
Children: Quick learner
Adults: Problem Oriented
Children: Subject oriented
Adult: Many experiences
Children: Limited experiences
The goal of Health Education
Behavior Change
Help individuals make good decision and take responsibility for their health
3 levels of disease prevention
- Prevention (immunizations)
- Early Protection (mammograms)
- Tertiary Prevention to minimize acceleration of disease (Pulmonary Rehab)
7 essential skills for critical thinking
- Prioritize
2 Anticipate - Troubleshoot
- Communicate
- Negotiate
- Decision making
- Reflection
7 Abilities and characteristics of critical thinkers
- Inquisitive
- alert
- well informed
- open-minded
- honest
- flexible
- reasoned
Humidity vs. Aerosol
Humidity= water in gas phase
Aerosol= particles suspended in a gas
7 indications for bland aerosol
- upper airway edema
- Subglottic edema
- post extubating edema
- post operative management of upper airway
- bypassed upper airway
- croup
- need for sputum speciman
2 contraindications for bland aerosol
- Bronchospasms
- History of airway hyperresponsivness
6 Hazards and complications of bland aerosol
- Wheezing or bronchospasms
- bronchoconstriction with artificial airway
- infection
- overhydration
- pt. discomfort
- caregiver exposure to airborne contagions
8 Assessments for determining the need of bland aerosol
- Stridor
- Croup like cough
- Diagnosis of LTB or Croup
- Hoarseness after extubating
- History of upper airway irritation and increased WOB
- Pt discomfort with airway instrument
- Need for sputum induction
- Bypassed upper airway
7 Assessments of the outcome with bland aerosol
- Decreased WOB
- Decreased Stridor
- Decreased Dyspnea
- Improved Vital Signs
- Improved ABGs
- Improved O2 Sats
- Production of Sputum
Where are the:
1. Oropharynx
2. Nasopharynx
3. Laryngopharynx
- Oropharynx= between soft palate and base of tongue
- Nasopharynx= Between soft palate and posterior portion of nasal cavity
- Laryngopharynx= between base of tongue and entrance to esophogus
How to open an airway (2 techniques)
- head tilt, chin lift
- Jaw thrust- when spinal or neck injuries suspected
When to use an Oral Airway
- unconscious pt
- used after successful BLS methods
4 Contraindications for oral airways
- Conscious pt
- trauma to oral cavity
- trauma to jaw
- lesions or foreign body obstruction
When to use a Nasal airway
- When oropharyngeal airway is not possible
- Semi or conscious pt
3 Contraindications of nasal airway
- Trauma to nasal passage
- space occupying lesions
- foreign body in nasal passage
When is an LMA used
During intubation in place of an ET tube
2 limitations of an LMA
- only provides airtight seal when airway pressure is less than 20 mmhg
- excessive volume in the cuff may cause laryngeal damage
4 Complications of using an LMA
- Vomiting or aspiration
- gastric distension
- air leak around mask
- stimulation of pharyngeal and laryngeal reflexes
3 Contraindications of LMA
- High Risk of aspiration
- High airway pressure required to achieve adequate ventilation
- Disease affecting mouth, pharynx and larynx
5 reasons to use BVM or MRBs
- Before and after suctioning
- during pt transport
- during ventilator circuit change or malfunction
- during special procedures
- CPR
BVM pressure relief valves:
- Not recommended for adults
- must have lock out mechanism
- children and infant devices must have inline manometer
> child 40 +/- 10 cmH2o
> infant 40 +/- 5 cmH2o
BMV non rebreathing valve
- allows for fresh gas to pt
- exhaled air is not rebreathed
- pt may or may not breath spontaneously through valve
- Need to know mechanism of action for both inspiration and expiration
- all have standard anesthesia adapter 15mm ID 22/mm OD
6 things that affect the delivery capabilities of O2
- Flowrate (15 LPM)
- Stroke volume
- Bag refill time
- Rate
- Presence of a reservoir
- PEEP
4 hazards/troubleshooting of BVM
- unrecognized equipment failure
- foreign material obstruction in pt valve
- improper assembly
- equipment check (occluded pt outlet, squeeze bag, bag should retain shape, strong resistance to compression with no gas leak)
BVM Masks
Should be transparent in material, seal tightly to pt face, have 22mm port
Advantages and disadvantages of self inflating BVM
Advantages:
- Will always refill
- no compression gas required
Disadvantages:
- Unable to determine leak
- needs O2 reservoir for high O2 concentrations
- cannot deliver free flow O2 with mask
- cannot provide CPAP
- Extra valve for PEEP
Advantages and disadvantages of Flow inflating BVM
Advantages:
- Can deliver 100% O2
- can determine good seal on pt face
- can deliver free flow O2
Disadvantages:
- Required tight seal to remain inflated
- Needs gas source
- Needs pressure gauge
BMV Bag sizes
- Adult= 1600 mL
- Peds= 500 mL
- infants= 250 mL
