BRTP09 Aerosol Medication Administration Flashcards

Question

Disadvantages of a metered dose inhaler

Answer 1

Hand-breath coordination required patient has to activate and properly inhale fixed drug dosage and doses often gets caught in oropharyngeal deposition difficulty determining remaining dose if theres no counter

Answer 2

``` Must shake canister Storage temp nozzle size and cleanliness timing of actuation priming ( wasting a puff) characteristics of the patient overall technique ```

Answer 3

warm and shake canister in hand assemble and uncap mouthpiece sit up straight (45-90 degrees) or stand breathe out normally open mouth technique: keep mouth open and tongue down closed mouth technique: place mouthpiece between lips with tongue out of the path

Answer 4

slowly breathe in as you activate the MDI Continue inspiration to total lung capacity (TLC) Hold breathe for 10 seconds wait 1 minute between puffs **IF TAKING STEROID PATIENT MUST RINSE MOUTH AFTER** ***RINSING MOUTH AFTER STERIOD PREVENTS ORAL THRUSH***

Answer 5

monitor patients vitals observe improvements or adverse reactions Troubleshoot absent or low aerosol output

Answer 6

once a day

Answer 7

twice a day

Answer 8

three times a day

Answer 9

four times a day

Answer 10

every 4 hours

Answer 11

reduce oropharyngeal drug impaction INCREASED DRUG ALMOST 4 TIMES MORE THAN JUST MDI ALONE no drug prep needed simplifies coordination and inhalation

Answer 12

Larger more expensive and bulky some assembly may be required patient errors (firing multiple puffs into chamber could be a source of contamination if not cleaned well

Answer 13

Valved holding chamber | Spacer

Answer 14

Incorporates one or more low resistance valves to prevent aerosol in the chamber from clearing on exhalation reduces oral deposition and increases pulmonary deposition better for coordination issues than spacer feedback if inspiratory flow too fast (device will whistle or make "musical sound")

Answer 15

simple VALVELESS extension device that adds distance between patients mouth and MDI outlet distance allows for reduction in particle size and decreases oral deposition helps with patient coordination of inhalation and actuation

Answer 16

BREATH ACTUATED dosing system. The patient creates aerosol by generating inspiratory flow and volume

Answer 17

Adequate inspiratory flow is required for medication to be delivered Can result in high pharyngeal deposition Humidity can cause powder to clump and reduce fine particle mass **PATIENT HAS TO BE ABLE TO HAVE INSPIRATORY FLOW FROM 40-60**

Answer 18

gas powered directed through a restricted orifice (the jet) Incorporates baffles to decrease the number of large aerosol particles Can be small volume neb or large volume neb due to reservoir size sidestream or mainstream

Answer 19

Valved holding chamber

Answer 20

``` Gas flow and pressure humidity and temp drug formulation gas density nebulizer design- baffle and residual drug volume breathing pattern ```

Answer 21

aerosolize several drugs can mix drugs if compatible minimal cooperation and coordination required works in several patients (age, distressed, debilitated) drug dose can be modified normal breathing pattern can be used

Answer 22

Total treatment time can be 5-30 mins equipment required power source required if using a mask, drug delivery to the eyes is possibility variability of performance can be brand dependent

Answer 23

USUALLY RUNS ON FLOW OF 6-8 LPM Can be driven on oxygen or air generally hold 2-6 ml of solution SHOULD BE USED INSTEAD OF MDI OR DPI IF PATIENT IS TACHYPNEIC

Answer 24

1. Inhale at tidal volume 2. Inhale at a normal or slow speed 3. breathe a normal pattern

Answer 25

1. Inhale through mouth 2. inhale slowly 3. Take a deep breath and hold it for a few seconds

Answer 26

Useful when traditional dosing isn't working Large volume reservoirs continuous neb (heart) can be hooked to iv pump and premixed drip in a standard reservoir Potential problem and main concern with LVN: drug reconcentration

Answer 27

Breath enhanced nebulizers Breath actuated nebulizers Vibrating mesh nebulizer Ultrasonic nebulizers

Answer 28

Breath enhanced nebulizers--- generate aerosol continuously, using vents and valves to reduce the aerosol waste

Answer 29

Breath actuated nebulizers--- synchronize aerosol generation with the inspiratory effort of the patient reducing the waste of aerosol; GIVE MORE MEDS TO PATIENTS; ENVIRONMENT IS LESS CONTAMINATED.

Answer 30

active or passive based on design can generate aerosol from small drug concentration does not generate much flow particle size created small

Answer 31

Piezoelectric crystal to generate aerosol Uses crystal transducer convert to a higher frequency creates less residual drug volume can be portable

Answer 32

***No medication/ only water/ only saline ``` Bronchial hygiene hydrate dried secretions promote cough restore mucous blanket humidity inspired gas induce sputum ```

Answer 33

rehydrated secretions causing airway obstruction bronchospasm or wheezing cross-contamination patient discomfort infection

Answer 34

Pneumatically powered, attached flow meter, and gas source a small jet orifice impacting surfaces baffles decrease large particle remaining small particles leave nebulizer Heating increases water content **NOT USED FOR MEDICATION** **HEATING MEDICINE DEGRADES IT**

Answer 35

``` age, physical and cognitive abilities patient preference (more important for home use) availability of drug convenience and durability cost and reimbursement ```