Final Flashcards
when selecting a flowmeter for oxygen delivery, the preferred type of flowmeter for clinical use is a(n)
compensated flowmeter
Mr. Brown is a COPD patient who has home oxygen concentrator and E cylinders. He wants to go out for dinner using an E cylinder. If he take a full E cylinder and uses his oxygen at 3L/m, leaving at 4:00pm, he must return by what time to avoid running out of oxygen
7:15 pm
A patient is brought to the ER and is lethargic and has the scent of smoke on her clothes. She is in need of oxygen therapy. Which of the following oxygen delivery devices is most appropriate for her at this time?
Nonrebreathing mask @ 12 L/min
A patient has a minute ventilation of 18 I/m. She is on an air entrainment mask receiving 40% oxygen with the oxygen flowmeter set at 4 L/m. Based on this information, which of the following statements are true?
I. Her delivered Fi02 will be less than 40%
I. Her delivered Fi02 will be higher than 40%
III. there is inadequate gas flow to meet her ventilatory demands.
IV. total flow to the patient is 12 L/m
I and III
I. Her delivered Fi02 will be less than 40%
III. there is inadequate gas flow to meet her ventilatory demands.
A patient in ER is in severe respiratory distress. The patient is a known COPD patient who is normally on home oxygen at 1 L/m. The patient is placed on a nasal cannula at 3 L/m. After 4 hours, the patient is lethargic and breathing slow and
shallow. ABGs reveal a Ph of 7.25, Paco2 of 70 and a Pa02 of 80 mmHg. The patient is most likely suffers from:
oxygen-induced hypoventilation
The respiratory care practitioner can reasonably suggest the use of an Fi02 above 21 & for which of the following?
I. treat hypoxemia
II. decrease the work of breathing
III. decrease myocardial work
IV. provide psychological support
I, II, and III
I. treat hypoxemia
II. decrease the work of breathing
III. decrease myocardial work
A patient is receiving 40% oxygen via an aerosol mask. The tubing to the mask is partially filled with water. How will the Fi02 and total flow be affected?
The Fi02 will increase and total flow will decrease
The percentage of oxygen delivered by a nasal cannula depends on which of the following factors?
I. the flowrate from the oxygen flowmeter
II. the patient’s minute ventilation (rate & depth) (VE)
III. the patient’s hemoglobin level
IV. the patient’s heart rate
l and Il
I. the flowrate from the oxygen flowmeter
II. the patient’s minute ventilation (rate & depth) (VE)
When delivering an 80-20% helium-oxygen mixture using an oxygen flowmeter at 14 I/m, the total flow going to the patient is:
25.2 L/m
If one were to heat a gas from 21 C to 36 C the ability of the gas to hold moisture would:
Increase
A nursing home patient admits to MICU due to pneumonia and dehydration. If therapeutic gases are delivered dry for a period of time, what
consequences will this have on the patient’s airway?
impair mucocilliary clearance
is the most important factor influencing aerosol deposition from an MDI?
breath hold
A 40% aerosol runs at 13 L/m. What is the total flow output?
52 L/min
Dr. Ritz has ordered instruction on the use of dry powder inhaler (DPI). You would emphasize to the patient that:
DPI is dependent on high inspiratory flow.
You are to give a patient a bronchodilator with a small volume nebulizer. Aerosol deposition in the lower respiratory tract will be enhanced by:
I. normal tidal volume breathing
II. aerosol droplets are in the 2- 5 micron range
III. high inspiratory flowrate
IV. respiratory rate > 20 bpm
I and II
I. normal tidal volume breathing
II. aerosol droplets are in the 2- 5 micron range
A patient with an endotracheal tube requires an Fi02 of 0.45. Which of the following oxygen-administration devices would be most appropriate?
T-piece
A COPD patient is receiving a bronchodilator agent via a small volume nebulizer. The respiratory therapist notes that the
patient’s heart rate has increased from 98 beats per minute to 110 beats/minute during the treatment. What should the therapist do at this time?
continue the treatment and monitor the patient
Use of a DPI for the administration of a bronchodilator should NOT be used in which of the following patient groups?
I. Infants and children less than 4 years old
ll. Patients suffering an acute bronchospastic episode
Ill. Patients requiring maintenance therapy
I and II
I. Infants and children less than 4 years old
ll. Patients suffering an acute bronchospastic episode
During the initial treatment, a PEP device is set to deliver a pressure of 15 cmH20 on exhalation. The patient complains of dyspnea and can only maintain exhalation for a short period. Which of the following should the respiratory therapist
recommend?
Decrease the PEP level to 10 cmH20
While in the position for postural drainage of the posterior basal segments of both lungs,
a patient complains of a headache and dizziness when coughing. The patient has a history of cerebral vascular accidents. Which of the following
actions is the most appropriate at this time?
Place the patient in a semi-Fowler position and reassess before continuing
Chest assessment indicates that retained secretions have caused atelectasis of the right middle lobe in a 45-year old non
smoking patient. The patient has received postural drainage therapy and directed cough technique, but both have been ineffective. What should now be recommended to help remove secretions and reverse atelectasis?
Hydrate the patient and use positive expiratory pressure
The patient in the diagram below is positioned so that which lobes are being drained?
Trendelenburg and prone with pillow under hips
I. right lower lobe
II. left lower lobe
III. left upper lobe
IV. right upper lobe
I and II
I. right lower lobe
II. left lower lobe
You are summoned to evaluate a 45-year old female, who is two days post abdominal surgery and is conscious, oriented and dyspneic. Her vital signs reveal a HR of 115 b/m, Respiratory rate of 30 bpm, and Temperature of 37 C. The patient has been performing flow-oriented incentive spirometry for the last two days at a frequency of TID and 10 sustained deep breaths each treatment. Auscultation of the patient’s lungs reveal diminished breath sounds in both bases accompanied by a few late inspiratory crackles. Which of the following modifications to therapy would you recommend for this patient?
Increase the frequency of the incentive spirometry treatments to Q 1 hour
A 24 year old female has sustained a broken arm and fractured ribs in a windsurfing accident. She has been instructed to use an incentive spirometer by taking slow, deep sustained breaths for approximately 10 breaths every hour. Two days later, the patient reports that she has been able to reach the incentive goal pointer set at the 600 cc mark with every inspiratory effort, although it causes pain at the rib-fracture site. What should the therapist recommend?
I. a rest period of 5 to 10 seconds between inspirations
II. that pain medication be given to the patient every hour incentive spirometry is performed
III. that the patient perform a rapid inspiration but continue to breath-hold at end inspiration
IV. that the incentive goal pointer be advanced to a higher inspiratory volume
I and IV
I. a rest period of 5 to 10 seconds between inspirations
IV. that the incentive goal pointer be advanced to a higher inspiratory volume
