Clo 4 Flashcards
Which therapy would bring down the patients CoHb (carboxyhemoglobin) down the fastest and most efficient
Hyperbaric chamber
What is isothermic saturation boundary (ISB)
Lower airways and alveoli need to have humidified gas that have been saturated with water vapor and warmed to body temp before reaching carina
What is the genetic name fir the name brands like proventil proair and ventolin
Albuterol
What is an adrenergic
Sympathomimetic
What is an anticholinergic
Parasympatholytic
What is a Peak expiratory flow rate PEFR
Diagnostic tool that monitors and manage asthma
How to use a PEFR
Take deep breath in filling lungs to total lung capacity, blast out air as hard and fast in single blow and record the highest out of all 3 readings
What is aerosol output
The mass of fluid or drug contained in aerosol produced by the nebulizer
What is emitted dose
The mass of drug leaving the mouthpiece of a nebulizer or inhaled aerosol
What is mass median diameter MMD or mass median aerodynamic diameter MMAD
Diameter at which 50% of particles by mass are larger and 50% are smaller
What is the amount of aerosol output that is being delivered
Only a fraction
What size and where do large particles deposit
Large particles are greater than 5-10 um and deposit in upper airways
What does a 10 second breath hold do
Can increase aerosol deposition by 10% through this sedimentation principle
What are the primary hazard of aerosol therapy
An adverse reaction like tachycardia, when pt HR is increased by >20 BPM
What affect can ipratropium bromide to ( anticholinergic)
Meds can worsen glaucoma, increase intraocular pressure
What is metered dose inhaler
Pressurized, breath actuated, dose counters
DPI( dry powdered inhaler)
Unit dose, multi dose, multi dose reservoir
Nebulizers
Pneumatic jet neb ( SVN, BAN, LVN)
Ultrasonic neb ( USN)
Vibrating mesh( VM)
Hand bulb atomizer
What does MDI contain
Propellant and drug ( most of the spray is propellant)
Technique for MDI with no spacer
Breathe out fully to FRC( functional residual capacity)
Breath in slowly and deeply into MDI
Hold for 5-10 seconds
If repeat, wait 30-60 seconds
When to use masked spacers/ chambers for MDI
Used to children or infants and certain adults
Technique for using MDI with spacer
Exhale to FRC, slow and deep breath, hold for 5-10 sec. If another dose needed, repeat after 30-60 sec
When using a DPI what is expected by the patient
Drug delivery depends on patients ability to generate adequate inspiratory flow. They must generate inspiratory flow of 40-60 L/Min
Technique for DPI
Exhale to FRC away from mouthpiece, then deeply and rapidly inhale with rate of 40-60 L/Min
What is a commune side effect for DPI
Oral thrush- prevent by rinse and spit
What does it mean is aerosol mist isn’t seen when using a nebulizer
The baffle may be missing or compromised
What to do when patient isn’t awake/ alert but still needs aerosol therapy
They get a small volume nebulizer treatment
When using a SVN what flow is needed
8-10
When using an SVN what does sputtering indicate
Treatment is finished, lasts about 10 min
When should SVN be needed
-When patient lacks coordination( semi-conscious)
-Tingling sensation is common side effect- can be coached by breathing slowly and deeply
- if SOB during SVN stop immediately
- SVN must be held upright to absorb treatment solution
What treatment is toxic to clinicians
Respirgard nebulizer for pentamidine
Techniques for using SVN
Set 8 L/Min
Patient must be in high Fowler position
Normal breathing with occasional deep breaths known as sustained maximal inhalation SMI
When teaching patients what should they do
Repeat demonstration
