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RESP 101, Assessment and Caring for a Respiratory Patient > Control Comp #3 (Med Records Review, NC, SM-NRB-PRB Masks, AEM Mask, HFNC Optiflow-Vapotherm, Bubbler) > Flashcards

Control Comp #3 (Med Records Review, NC, SM-NRB-PRB Masks, AEM Mask, HFNC Optiflow-Vapotherm, Bubbler) Flashcards

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1
Q

Medical Records Review/Documents (Comp 3)
(20 Steps)

A

PROCEDURAL STEPS
1. Confirms correct patient medical record
2. Ensures compliance with HIPPA regulations regarding personal health information
ASSESSMENT AND IMPLEMENTATION
3-12. Locates and evaluates:
-Patient demographics
-Chief complaint/diagnosis
-History of present illness
-Smoking history (packs years)
-Past medical history
-Allergies
-Current Medications
-Psycho/social history
-Occupational history and exposures
-Family history
13. Locates and evaluates the physician’s orders or protocols
14. Review physical examination results
15. Reviews results of current diagnostic procedures, including CXR, EKG, PFT, ABGs, labs
16. Reads and evaluates most recent progress notes
DOCUMENTATION
17. Identifies the proper section to chart respiratory services
18. Charts the respiratory care procedure according to facility policy
19. Signs note with appropriate credential and has preceptor/instructor countersign
20. Returns chart to proper location or closes the record and logs off the computer

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2
Q

Medical Records Review/Documents
(Steps 1-2)

A

PROCEDURAL STEPS

  1. Confirms correct patient medical record
  2. Ensures compliance with HIPPA regulations regarding personal health information
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3
Q

Medical Records Review/Documents
(Steps 3-12)

A

ASSESSMENT AND IMPLEMENTATION
3-12. Locates and evaluates:

  1. Patient demographics
  2. Chief complaint/diagnosis
  3. History of present illness
  4. Smoking history (packs years)
  5. Past medical history
  6. Allergies
  7. Current Medications
  8. Psycho/social history
  9. Occupational history and exposures
  10. Family history
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4
Q

Medical Records Review/Documents
(Steps 13-16)

A

ASSESSMENT AND IMPLEMENTATION

  1. Locates and evaluates the physician’s orders or protocols
  2. Review physical examination results
  3. Reviews results of current diagnostic procedures, including CXR, EKG, PFT, ABGs, labs
  4. Reads and evaluates most recent progress notes
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5
Q

Medical Records Review/Documents
(Steps 17-20)

A

DOCUMENTATION

  1. Identifies the proper section to chart respiratory services
  2. Charts the respiratory care procedure according to facility policy
  3. Signs note with appropriate credential and has preceptor/instructor countersign
  4. Returns chart to proper location or closes the record and logs off the computer
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6
Q

Oxygen Devices: Nasal Cannula (Comp 3)
(15 Steps) LOW FLOW Device

A

PROCEDURAL STEPS
1. Gathers and assembles appropriate equipment
2. Checks physician orders
3. Verifies facilities protocol
4. Introduces self and department and identifies patient
5. Utilizes and maintains standard precaution as required
6. Explains purpose of O2 therapy
7. Assesses patient before and after oxygen therapy (HR, RR, SpO2, and Color)
8. Assembles humidifier (if indicated) and attaches flowmeter (Checks equipment function)
9. Adjusts the flowmeter to appropriate level before placing on patient and verify flow t/o device
10. Places the device properly and comfortably on the patient
11. Instructs patient in oxygen safety precautions and reinforces patient instruction in us of oxygen therapy
12. Correctly cares for equipment following procedure
13. Thanks patient and ensures safety and needs
14. Disposes of PPE; washes/gel hands
15. Documents

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7
Q

Oxygen Devices: Nasal Cannula
(Steps 1-7)

A
  1. Gathers and assembles appropriate equipment
  2. Checks physician orders
  3. Verifies facilities protocol
  4. Introduces self and department and identifies patient
  5. Utilizes and maintains standard precaution as required
  6. Explains purpose of O2 therapy
  7. Assesses patient before and after oxygen therapy (HR, RR, SpO2, and Color)
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8
Q

Oxygen Devices: Nasal Cannula
(Steps 8-12)

A
  1. Assembles humidifier (if indicated) and attaches flowmeter (Checks equipment function)
  2. Adjusts the flowmeter to appropriate level before placing on patient and verify flow t/o device
  3. Places the device properly and comfortably on the patient
  4. Instructs patient in oxygen safety precautions and reinforces patient instruction in us of oxygen therapy
  5. Correctly cares for equipment following procedure
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9
Q

Oxygen Devices: Nasal Cannula
(Steps 13-15)

A
  1. Thanks patient and ensures safety and needs
  2. Disposes of PPE; washes/gel hands
  3. Documents
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10
Q

Oxygen Devices: Nasal Cannula Normal
FiO2 Range
Flow Rate

A

FiO2 = 24% - 44% Variable stability
Flow = 1/4 - 6 L/min Adult

2 - 4 L/min with 28% O2 is what is norm for Nasal Cannula at the hospital setting

If flow rate is greater than 4 L/min or Patient complains of dryness, you will utilize a humidifier.

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11
Q

Humidification - Bubbler (Comp 3)
(15 Steps)

A

PROCEDURE STEPS
1. Verifies protocol
2. Gathers and assembles appropriate equipment
3. Utilizes and maintains standard precautions as required
4. Introduces self and department and identifies patient
5. Explains procedure to patient and confirms patient’s understanding
6. Handles prefilled equipment aseptically and attaches humidifier to flowmeter
7. Attaches oxygen tubing to humidifier
8. Turns flowmeter on to ordered or assessed liter flow
9. Checks Pop-off valve
10. Verifies gas flow through the humidifier and oxygen device
11. Positions oxygen device properly on patient
12. Cleans area
13. Ensures the patient’s safety, comfort, and needs, Thanks patient
14. Disposes of PPE; washes/gels hands
15. Documents

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12
Q

Humidification - Bubbler
(Steps 1-5)

A
  1. Verifies protocol
  2. Gathers and assembles appropriate equipment
  3. Utilizes and maintains standard precautions as required
  4. Introduces self and department and identifies patient
  5. Explains procedure to patient and confirms patient’s understanding
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13
Q

Humidification - Bubbler
(Steps 6-12)

A
  1. Handles prefilled equipment aseptically and attaches humidifier to flowmeter
  2. Attaches oxygen tubing to humidifier
  3. Turns flowmeter on to ordered or assessed liter flow
  4. Checks Pop-off valve
  5. Verifies gas flow through the humidifier and oxygen device
  6. Positions oxygen device properly on patient
  7. Cleans area
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14
Q

Humidification - Bubbler
(Steps 13-15)

A
  1. Ensures the patient’s safety, comfort, and needs, Thanks patient
  2. Disposes of PPE; washes/gels hands
  3. Documents
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15
Q

Humidification - Bubbler
When to use
Pop off Test

A

If flow rate is GREATER than 4 L/min or Patient complains of dryness, you will utilize a humidifier.

The Pop off test is conducted to ensure patient is getting flow from the bubbler. Cover the hose opening and listen for a loud noise. Once you get it let go.

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16
Q

Oxygen Devices: Simple, Partial Breathing, Non-Breathing Masks (Comp 3)
(14 Steps) LOW FLOW Devices

A

PROCEDURAL STEPS
1. Verifies facilities protocol
2. Scans chart for diagnosis and any other pertinent data
3. Gathers and assembles appropriate equipment
4. Utilizes and maintains standard precautions as required
5. Introduces self and department and identifies patient
6. Explains purpose of O2 Therapy
7. Assesses patient before and after oxygen therapy
8. Adjust the flowmeter to the appropriate level before placing on patient and verify flow t/o device
9. Verifies flow through the device
10. Places the device properly and comfortably on the patient
11. Correctly cares for equipment following procedure
12. Thanks patient and ensures safety and needs
13. Disposes of PPE; washes/gel hands
14. Documents

17
Q

Oxygen Devices: Simple, Partial Breathing, Non-Breathing Masks
(Steps 1-7)

A
  1. Verifies facilities protocol
  2. Scans chart for diagnosis and any other pertinent data
  3. Gathers and assembles appropriate equipment
  4. Utilizes and maintains standard precautions as required
  5. Introduces self and department and identifies patient
  6. Explains purpose of O2 Therapy
  7. Assesses patient before and after oxygen therapy
18
Q

Oxygen Devices: Simple, Partial Breathing, Non-Breathing Masks
(Steps 8-11)

A
  1. Adjust the flowmeter to the appropriate level before placing on patient and verify flow t/o device
  2. Verifies flow through the device
  3. Places the device properly and comfortably on the patient
  4. Correctly cares for equipment following procedure
19
Q

Oxygen Devices: Simple, Partial Breathing, Non-Breathing Masks
(Steps 12-14)

A
  1. Thanks patient and ensures safety and needs
  2. Disposes of PPE; washes/gel hands
  3. Documents
20
Q

Oxygen Devices: Simple Mask
FiO2 Range
Flow Rate

A

FiO2 = 35% - 50% Variable stability
Flow = 5 - 10 L/min

Flow rate of 5 L/min minimum so that CO2 gas can get flushed out of the mask.

21
Q

Oxygen Devices: Partial Breathing Mask
FiO2 Range
Flow Rate

A

FiO2 = 40% - 70% Variable stability
Flow = Minimum of 10 L/min

Flow rate of must be at least 10 L/min to prevent the bag from collapsing during inspiration

22
Q

Oxygen Devices: Non-Breathing Mask
FiO2 Range
Flow Rate

A

FiO2 = 60% - 80% Variable stability
Flow = Minimum of 10 L/min

Flow rate of must be at least 10 L/min to prevent the bag from collapsing during inspiration

23
Q

Oxygen Devices: Venturi Mask (Comp 3)
(14 Steps) HIGH FLOW Device

A

PROCEDURAL STEPS
1. Verifies facilities protocol
2. Scans chart for diagnosis and any other pertinent information
3. Gathers and assembles appropriate equipment
4. Utilizes and maintains standard precaution as required
5. Introduces self and department and identifies patient
6. Explains purpose of O2 therapy
7. Assesses patient before and after oxygen therapy
8. Adjusts the flowmeter to appropriate level before placing on patient and verify flow t/o device
9. Place the device properly on patient
10. Confirms FiO2 and patient comfort
11. Correctly cares for equipment following the procedure
12. Thanks patient and ensures safety and needs
13. Disposes of PPE; washes/gel hands
14. Documents

24
Q

Oxygen Devices: Venturi Mask
(Steps 1-7)

A
  1. Verifies facilities protocol
  2. Scans chart for diagnosis and any other pertinent information
  3. Gathers and assembles appropriate equipment
  4. Utilizes and maintains standard precaution as required
  5. Introduces self and department and identifies patient
  6. Explains purpose of O2 therapy
  7. Assesses patient before and after oxygen therapy
25
Q

Oxygen Devices: Venturi Mask
(Steps 8-11)

A
  1. Adjusts the flowmeter to appropriate level before placing on patient and verify flow t/o device
  2. Place the device properly on patient
  3. Confirms FiO2 and patient comfort
  4. Correctly cares for equipment following the procedure
26
Q

Oxygen Devices: Venturi Mask
(Steps 12-14)

A
  1. Thanks patient and ensures safety and needs
  2. Disposes of PPE; washes/gel hands
  3. Documents
27
Q

Oxygen Devices: Venturi Mask (AEM)
FiO2 Range
Flow Rate

A

FiO2 = 24% - 50% Fixed stability
Flow = Varies; should provide output flow >60 L/min

28
Q

Oxygen Devices: HFNC: Optiflow (Comp 3)
(16 Steps/Condensed Version)
HIGH FLOW Device

A

PROCEDURE STEPS
1. Check physician’s orders/Verify facilities protocols
2. Scan patient chart for pertinent data
3. Gather equipment
4. Perform Standard Precautions
5. Introduce Self/Dep and Verify Identity of Pt
6. Explain purpose of visit/procedure
7. Assess Vitals prior to and after therapy
8. Plug in air (Yellow) and Oxygen (Green) cords to wall
9. Put heater pot on heater and plug heater pot and turn on
10. Attach circuit (tubes) to heater pot and flow meter. Then plug in heater wires to the circuit. Spike water bag
11. Select appropriate prongs for Pt and attach to circuit. Make sure not to occlude more than 50% of Pts nares.
12. Set appropriate liter flow (5-60 LPM) and FiO2 (21% to 100%). VERIFY FLOW
13. Put cannula on Pt. and use safety strap or clip. REASSESS VITALS on Pt
14. Ensure Pt’s comfort, safety and needs are met. Clean up area
15. Dispose of PPE, Wash/Gel hands
16. Record/Report

29
Q

Oxygen Devices: HFNC: Optiflow
(Steps 1-7)

A
  1. Check physician’s orders/Verify facilities protocols
  2. Scan patient chart for pertinent data
  3. Gather equipment
  4. Perform Standard Precautions
  5. Introduce Self/Dep and Verify Identity of Pt
  6. Explain purpose of visit/procedure
  7. Assess Vitals prior to and after therapy
30
Q

Oxygen Devices: HFNC: Optiflow
(Steps 8-13)

A
  1. Plug in air (Yellow) and Oxygen (Green) cords to wall
  2. Put heater pot on heater and plug heater pot and turn on
  3. Attach circuit (tubes) to heater pot and flow meter. Then plug in heater wires to the circuit. Spike water bag
  4. Select appropriate prongs for Pt and attach to circuit. Make sure not to occlude more than 50% of Pts nares.
  5. Set appropriate liter flow (5-60 LPM) and FiO2 (21% to 100%). VERIFY FLOW
  6. Put cannula on Pt. and use safety strap or clip. REASSESS VITALS on Pt
31
Q

Oxygen Devices: HFNC: Optiflow
(Steps 14-16)

A
  1. Ensure Pt’s comfort, safety and needs are met. Clean up area
  2. Dispose of PPE, Wash/Gel hands
  3. Record/Report
32
Q

Oxygen Devices: HFNC: Optiflow
FiO2 Range
Flow Rate

A

FiO2 = 21% - 100% Fixed stability
Flow = 5 - 60 L/min

The flowmeter on the optiflow can go up to 70 L/min

33
Q

Oxygen Devices: HFNC: Vapotherm (Comp 3)
(31 Steps) Part 1of 2 (Steps 1-16)

A

PROCEDURE STEPS
1. Verifies physician’s orders
2. Scans chart for any other pertinent data and notes
3. Gathers and assembles equipment (Precision flow unit set-up, water bag, high or low flow disposable patient circuit kit, nasal cannula)
4. Washes hands and applies appropriate PPE
5. Identifies patient, introduces self to family/patient
6. Explains purpose of therapy and confirms family/patient understanding
7. Assesses patient before therapy
8. Ensure O2 sensor in place
9. Check air/oxygen high pressure hoses are in place and plugged into wall
10. Install cartridge into disposable water path
11. Secure delivery tube into bottom of disposable water path
12. Slide open unit door & slide disposable patient circuit into place
13. Hang sterile water above unit, remove spike with alcohol pad and insert spike into port of sterile water
14. Plug in power cord, allow unit to “self-test” & identify any error codes
15. Rotate setting control know to light up display panel
16. Press run / Standby button to initiate gas flow, pump & heater

34
Q

Oxygen Devices: HFNC: Vapotherm (Comp 3)
(31 Steps) Part 2of 2 (Steps 17-31)

A
  1. Identify unit is in “run mode” & that all numeric displays are on & status LED is green
  2. Press & release setting control knob
  3. Identify flashing value & change it by rotating the setting control knob
  4. Repeat these steps to adjust flow, & FiO2
  5. Identify that FiO2 & flow settings are within range of gas source
  6. Ensure patient placement:
    High Flow Cartridge: 8-40 lpm Adult NC (or)
    5-20 lpm Pediatric NC
    Low Flow Cartridge: 1-8 lpm Premature, Neonate, Infant
    & Intermediate NC
  7. Ensure FiO2, flow & temperature are set
  8. Allow unit to reach set temperature & attach cannula
  9. Places cannula on patient and observe to ensure proper placement & settings; cannula occludes no more than 50% of nares
  10. Knows flow rate ranges per cannula & cartridge
  11. TROUBLE SHOOTING: Identifies alarms and is able to competently correct each; can point out “alarm mute button”; can differentiate between medium and low priority alarm.
    Unit shutdown: Press run/standby button to put unit into standby mode; clamp the water inlet tube & disconnect it by pulling out the spike; open sliding door, remove the disposable water path with the cartridge & delivery tube attached by sliding it upwards out of the docking station; unplug unit (note: there is no ON/OFF button, keep plugged into wall outlet to keep battery fully charged
  12. Reassess patient; thanks patient/family and ensure comfort
  13. Cleans up area: main unit, including docking station for disposable water path, should be wiped down with alcohol wipes; ensure transparent sensor ports are clean
  14. Disposes of PPE; washes/gel hands
  15. Documents
35
Q

Oxygen Devices: HFNC: Optiflow (Comp 3)
(23 Steps) Part 1of 2 (Steps 1-12)

A

PROCEDURAL STEPS
1.Verifies physician’s orders/protocol
2. Scans chart for any other pertinent data and notes
3. Gathers and assembles equipment (blender unit with heater, appropriately sized disposable patient circuit, cannula, and sterile water bag
4. Washes hands and applies appropriate PPE
5. Identifies patient, introduces self and department to patient/family
6. Explains purpose of therapy and confirms family/patient understanding
7. Assesses patient before therapy
8. Check air/oxygen high pressure hoses are in place and plugged into wall and ensure O2 sensor in place
9. Place non-heated tubing on one side of the water chamber and attach it to the blender and place heated circuit on other side of water chamber
10. Plug temperature probe into the circuit and plug in heater wires and connect water bag.
11. Select invasive temperature setting, set liter flow appropriately and FiO2
12. Places cannula on patient and observe to ensure proper placement & settings; cannula occludes no more than 50% of nares

36
Q

Oxygen Devices: HFNC: Optiflow (Comp 3)
(23 Steps) Part 2of 2 (Steps 13-23)

A
  1. Place strap with breakaway around patient’s neck
  2. Place strap that is connected to the prongs around the patient’s head adjusting it above the ears, on the crown, place the prongs in the patient’s nares and adjust the strap for a comfortable fit; not tight
  3. Tighten the strap around the patient’s neck to support the weight of the circuit
  4. Insert the adult cannula into the adult heated circuit
  5. Adjust liter flow and FiO2 on the blender unit. Turn on heater using the invasive mode
  6. Trach patients–place strap around patient’s neck, attach end with the blue cover to the patient’s trach and other end to the circuit. (in-line suction device may be used for patients with increased secretions
  7. Sets alarms +/- 5% to accommodate fluctuations
  8. reassess patient and ensures comfort
  9. Thanks patient/family
  10. Disposes of PPE; washes/gels hands
  11. Documents

RESP 101, Assessment and Caring for a Respiratory Patient (11 decks)

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