Chapter 40 Worksheet - Aerosol Drug Therapy Flashcards
why is particle size so important in aerosol therapy
the ability of aerosols on travel through the air, enter the airways, and deposit in the lung is largely based on particle
particles between 5 and 10 microns tend to deposit in what part of the respiratory tract
deposit in the upper and large airways
In what part of the lung would you like to deliver bronchodilator drugs? What particle size is needed to accomplish this goal?
A. in the lower airways
B. particles 1 to 5 microns in size
Name the hazards of aerosol drug therapy?
a) the primary hazard of aerosol drug therapy is an adverse
b) infection
c) airway reactivity
d) systemic effects of bland aerosols
e) drug concentration changes during nebulization
f) eye irritation
g) secondhand exposure to aerosol drug
What group (s) of patients is most prone to harm from bland aerosols?
Bland aerosols may cause bronchospasm in patients with preexisting respiratory disease
Eye irritation or drug reactions are most likely to occur under what circumstances?
when you use a face mask
What could happen to a therapist who inhales bronchodilator exhaust from nebulizers?
occupational asthma
what is meant by priming the MDI
activating a wasted dose to fill the metering chamber; used for new inhalers and those that have not been used for > 4 to 6 hours; old dose may have evaporated
what propellant was used in most MDI’s and why was it a problem? What new propellant is safer for patients and the environment?
A. CFCs are a problem because they may cause adverse reactions in patients and have adverse environmental effects
B. the safer choice for a propellant is HFA
what percentage of the drug in an MDI is actually deposited in the lung? Why is there so much variability?
About 10% to 20%; it varies because patient mastery of MDI technique varies significantly
what is the optimal open mouth MDI delivery in order
- warm and shake the canister
- take off the cap
- actuate the canister (prime)
- hold the MDI two fingers from mouth
- breathe out normally
- actuate canister (dose)
- slowly inhale as deeply as you can
- hold your breath for up to 10 seconds
- wait 60 seconds
what is the difference between a spacer and a holding chamber? Does it matter?
A. a spacer is a simple valveless extension device that reduces oropharyngeal deposition and improves particle size. Holding chambers incorporate a valve to prevent the chamber from being cleared on exhalation
B. Holding chambers improve delivery to patients with small tidal volumes. Holding chambers improve delivery over simple spacers
what is DPI? What’s the big deal?
A. it is a breath-activated dosing system that patents prefer for ease of use.
B. The drug is in a powder form that the patient aerosolizes with inspiratory flow
how does DPI breathing technique differ from that recommended with an MDI
for DPI, inhalation must be RAPID to generate sufficient flow to aerosolize the dry powder. With MDI the key is a slow, deep inspiration
what patient cannot use DPIs
children under 4 and patients unable to generate high air flow. They also may not work as well in high humidity environments
what is meant by nebulizer “sputter” and why is it important to RTs
“sputter” is a sound heard at the onset of inconsistent nebulization that is an appropriate cue that the treatment is complete
what is the ideal flowrate and amount of solution to put in an SVN for a typical albuterol treatment
A. 6 to 10 lpm, all depends on manufacturer
B. >4ml
Explain what is meant by the “blow-by” technique used with infants, and discuss the effectiveness of this technique.
A. Blow-by is directing the mist by the baby’s mouth and nose without direct application to the face via a mask.
B. it is not very effective
What potential clinical problem may exist with continuous bronchodilator therapy
Adverse Drug response. Consequently, the patient needs to be monitored closely.
What is the SPAG unit? When is it indicated?
A. Small Particle Aerosol Generator
B. It is normally used to deliver Ribavirin for the treatment of severe RSV. It is quite controversial, so it is seldom used.
After performing the inhalation with an MDI, the RT instructs the patient to perform a breath holding maneuver. The purpose of the maneuver is to
A. promote a strong cough
B. improve venous return
C. improve inertial impaction
D. increase medication delivery—CORRECT
- In addition to an inhaler, what other equipment would be needed to instruct a patient on proper technique
I. Spacer device
II. Pulse oximeter
III. Peak Flowmeter
A. I only —CORRECT
B. I and II only
C. I and III only
D. II and III only
While attempting to administer albuterol via SVN to a patient who has had a recent CVA (cerebral vascular accident), the RT notes that the patient is unable to hold the nebulizer or keep her lips sealed on the mouthpiece. The RT should recommend?
A. switching to an MDI
B. utilizing an aerosol mask for delivery—CORRECT
C. discontinuing the medication
D. subcutaneous administration of the medication
An alert adult patient with asthma is receiving bronchodilator therapy via small volume nebulizer during a hospitalization. What recommendations should the RT make in regard to this therapy when the patient is ready for discharge
A. Recommend MDI instruction—CORRECT
B. Recommend oral administration of the medication
C. Recommend training in home use of the SVN
D. Recommend administration of the drug via IPPB
Which of the following devices is most suitable for delivery of Virazole (Ribavirin)?
A. Continuous large volume nebulizer
B. Small Particle Aerosol Generator—CORRECT
C. Ultrasonic nebulizer
D. Atomizer
