BRTP 09 Aerosol Medication

Question 1

Ideal particle size for aerosol medication

Answer 1

0.01 to 3.0 microns in diameter

Question 2

Ideal concentration of aerosol medication

Answer 2

100 to 1,000 particles/mL of gas

Question 3

5 main factors effecting deposition and penetration

Answer 3

gravity, kinetic activity, particle inertia, physical nature of aerosol, and ventilatory pattern

Question 4

Best way to measure obstruction therapy

Answer 4

Peak flow meter will give you objective data….it is the best measurement

Question 5

three types of pMDI

Answer 5

conventional, breath actuated, and soft mist

Question 6

two reasons for rinsing your mouth after pMDI use

Answer 6

prevents oral thrush from steroid use, but if not using a steroid, it will still minimize systemic effects

Question 7

What accessory device is recommended between spacer vs valved holding chamber?

Answer 7

Always valved holding chamber

Question 8

Drug re-concentration

Answer 8

Main problem with LVN. Particles that become larger are re deposited in reservoir resulting in increased concentration of the administered drug.

Question 9

Nebulizers are typically ran on what gas flow?

Answer 9

6-8 lpm

Question 10

main purpose of bland aerosol therapy

Answer 10

Pulmonary toilet, it hydrates secretions to induce secretion removal.

Question 11

Size of particles to be deposited in lower airways aka bronchi

Answer 11

2-5 microns

Question 12

size of particles to be deposited in nose/ upper airway

Answer 12

5 to 50 microns

Question 13

What do we want to happen to breath sounds after aerosol therapy?

Answer 13

breath sounds such as wheezing getting louder. Diminished sounds is NOT a good thing.

Question 14

Which part of the pMDI allows for precise amount of medication?

Answer 14

The metering valve. This is what is pushed down towards the jet which then releases the medication

Question 15

Inspiration length while taking pMDI

Answer 15

you want to continue inspiration until total lung capacity is reached (TLC)

Question 16

how long is the breath hold during inhaler use?

Answer 16

10 seconds

Question 17

How long do you wait between puffs of an inhaler?

Answer 17

one minute

Question 18

main difference between holding chamber and spacer

Answer 18

Holding chamber contains valves that keeps medication from coming out of the wrong area if you breath back into it. **Decreases oral deposition

Question 19

What is the patient feedback involved with using a holding chamber with an inhaler?*****

Answer 19

It will make a musical sound if the patient is inhaling too quickly

Question 20

two common causes for little aerosol coming out of a pDMI

Answer 20

Check for debris blocking the mouth piece AND OR check if it is empty….some inhalers do not have a meter counter on the back

Question 21

what are baffles?

Answer 21

they are located in Jet nebulizers and they help decrease the number or large particles

Question 22

two types of jet nebs

Answer 22

sidestream or mainstream

Question 23

small volume neb treatments take how long and how much solution can they hold in them?

Answer 23

5 to 30 min long and can contain 2-6 mL of solution

Question 24

how long is the reservoir tubing for LVN vs SVN

Answer 24

small volume neb uses 50 mL (not always needed tough) while LVN uses 250mL

Question 25

a small volume neb can be driven by what?

Answer 25

oxygen OR just air

Question 26

If a patient is tachypneic, what type of therapy is indicated?

Answer 26

This is usually an adverse effect from use of MDI and DPI, and should be switched to a SVN

Question 27

Breathing teaching to someone who is doing a SVN

Answer 27

generally just breath using normal tidal volume

**Helps prevent nose from filtering out medication

Question 28

What delivery system works well with COPD pt

Answer 28

If they are on 4L NC, you would want to pull down their NC and instead run the SVN on air NOT O2

Question 29

SVN

Answer 29

a little bit better for someone with respiratory distress

Question 30

example of a sidestream nebulizer

Answer 30

LVN

Question 31

why do you ideally want to use a mouth piece rather than a mask

Answer 31

Using a mask during SVN doesn’t create the great seal and the medication can leak into their eyes.

Question 32

Coordination necessary for nebulizer vs inhaler

Answer 32

You don’t need great coordination for SVN unlike the inhalers.
***This is why SVN can be recommended for children over an inhaler

Question 33

The peak flow meter is measured using what units?

Answer 33

Meters per min

Question 34

what position is ideal for the pt to in when performing the PERF test

Answer 34

Want them to be standing up if possible but at least sitting up

Question 35

Q4 vs q.d

Answer 35

Q4 is giving treatment every 4 hours. q.i.d. is giving it four tiems in one day aka q 6 hours

Question 36

If someone that recently had a CVA, what route should they use for a SVN?

Answer 36

You want them to to use an aerosol mask.

***but make sure they avoid breathing in through the nose.