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RTH 190 > Final > Flashcards

Final Flashcards

1
Q

What are the indications for chest pt?

A
  • evidence or suggestion of retained secretions in the presence of an artificial airway
  • inability or reluctance of patient to change body position
  • evidence or suggestion of difficulty with secretion clearance
  • difficulty clearing secretions, with expectorated sputum production greater than 25-30 ml/day
  • diagnosis of diseases such as CF, bronchiectasis, or cavitating lung disease
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2
Q

What are the hazards of chest pt?

A
  • hypoxemia
  • increased ICP
  • bronchospasm
  • vomiting/aspiration
  • acute hypotension during procedure
  • pulmonary hemorrhage
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3
Q

What position would you place the patient in for percussion of the anterior segment of the upper lobes?

A

bed flat. patient supine with pillow under knees for comfort

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4
Q

What position would you place the patient in for percussion of the superior and inferior segments of the lingula?

A

foot of bed 20 degree angle as tolerated. patient partially on right side (1/4 turn) with pillow behind back and shoulders

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5
Q

What position would you place the patient in for percussion of the anterior basal segment of the lower lobes?

A

foot of bed 30 degree angle. patient on right side (1/2 turn)

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6
Q

What position would you place the patient in for percussion of the lateral basal segment of the lower lobe?

A

foot of bed 30 degree angle. patient partially on right side (3/4 turn)

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7
Q

What position would you place the patient in for percussion of the superior segment of the lower lobes?

A

bed flat. patient prone

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8
Q

What position would you place the patient in for percussion of the posterior basal segment of the lower lobes?

A

foot of bed 30 degree angle

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9
Q

What position would you place the patient in for percussion of the lateral and medial segments of the right lower lobe?

A

foot of bed 20 degrees. patient on left side (1/4 turn) with pillow under back and shoulders

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10
Q

How many compressions to how many breaths do you do?

A

30:2

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11
Q

When bagging, how often do you give a person a breath?

A

1 breath every 5 seconds

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12
Q

What are the critical responsibilities of airway maintenance?

A
  • securing the tube and maintaining its proper placement
  • providing for patient communication
  • ensuring adequate humidification
  • minimizing possibility of infection
  • aiding in secretion clearance
  • providing appropriate cuff care
  • troubleshooting airway related problems
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13
Q

What are the indications for IPPB?

A
  • atelectasis
  • increased WOB
  • hypoventilation
  • increased RAW
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14
Q

What are the hazards of IPPB?

A
  • increased RAW
  • airtrapping
  • bronchospasm
  • pneumothorax
  • hyperventilation
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15
Q

What are the physiologic effects of IPPB?

A
  • increase MAP
  • increase VT
  • decrease WOB
  • secretion control
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16
Q

What should you look at when troubleshooting for IPPB?

A
  • sensitivity
  • pressure
  • flow
  • air flow mix
  • circuit
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17
Q

What is an uncompensated flowmeter?

A

it won’t change when it’s moved or occluded

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18
Q

What is a compensated flowmeter?

A

the ball will drop when it is occluded

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19
Q

What is an example of an uncompensated flowmeter?

A

bourdon gage

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20
Q

What is an example of a compensated flowmeter?

A

thorpe tube

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21
Q

What is relative humidity?

A

the amount of water vapor in a gas when not fully saturated

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22
Q

What is the equation for calculating relative humidity?

A

[(content or absolute humidity) / saturated capacity] x 100

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23
Q

What is absolute humidity?

A

the amount of water extracted from air

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24
Q

What is the equation for calculating absolute humidity?

A

relative humidity x capacity

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25
Q

What is body humidity?

A

the ratio of its actual water vapor content to the water vapor content in saturated gas at body temp (37C)

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26
Q

What is the equation for calculating body humidity?

A

(absolute humidity / 44mg/L) x 100

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27
Q

What is a humidity deficit?

A

the amount of water vapor the body must add to the inspired gas to achieve saturation at body temp (37C)

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28
Q

What does the interview part of patient assessment aid in?

A
  • establishes patient rapport between the clinician and the patient
  • obtains essential diagnostic information
  • helps monitor changes in the patient’s symptoms and response to therapy
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29
Q

Where is the introduction of the interview done?

A

social space (4-12 feet from patient)

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30
Q

Where does the interview begin?

A

personal space (2-4 feet from patient)

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31
Q

What do you look for during the physical assessment?

A
  • general appearance
  • LOC
  • vital signs (RR, BP, HR, BS)
  • body temp
  • cyanosis
  • dyspnea
  • edema
  • hemoptysis
  • cough and sputum production
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32
Q

What is eupnea?

A

normal, relaxed breathing

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33
Q

What is hypernea?

A

increased depth of breathing

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34
Q

What is orthopnea?

A

shortness of breath when lying flat

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35
Q

What is platypnea?

A

shortness of breath when sitting up

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36
Q

What is dyspnea?

A

shortness of breath

37
Q

What is paradoxical nocturnal dyspnea?

A

severe shortness of breath and coughing that generally occurs at night

38
Q

What is biot’s breathing?

A

abnormal pattern of breathing that includes quick, shallow inspirations followed by regular or irregular patterns of apnea

39
Q

What is cheyne stokes breathing?

A

deep, fast breathing followed by irregular periods of apnea

40
Q

What is kussmal’s breathing?

A

deep and labored breathing, and is a form of hyperventilation and occurs with metabolic acidosis

41
Q

What is PISS?

A

pins that prevent misconnection

42
Q

What is DISS?

A

screw type safety system found on flowmeters and gas outlets

43
Q

What are the indications of IS?

A
  • presence of conditions predisposing to the development of pulmonary atelectasis (upper abdominal surgery, thoracic surgery, surgery in COPD patients)
  • presence of pulmonary atelectasis
  • presence of restrictive lung defect associated with quadriplegia or dysfunctional diaphragm
44
Q

What are the hazards of IS?

A
  • hyperventilation
  • fatigue
  • barotrauma
  • hypoxia
  • exacerbation of bronchospasm
  • discomfort secondary to inadequate pain control
45
Q

What are the physiologic effects of IS?

A
  • absence or improvement in signs of atelectasis
  • increased VC and peak expiratory flows
  • increased FVC
  • restoration of preoperative FRC or VC
46
Q

What are some low flow devices?

A
  • nasal cannula
  • simple mask
  • partial and non rebreathers
47
Q

What is a nasal cannula?

A
  • FiO2 24-40%
  • up to 6L/min
  • over 4L/min must use a humidifier
48
Q

What is a simple mask?

A
  • FiO2 35-50%

- 5-10L/min

49
Q

What is a partial rebreather?

A
  • FiO2 40-70%

- minimum of 10L/min

50
Q

What is a non-rebreather?

A
  • FiO2 60-80%
  • minimum of 10L/min
  • bag must be full during inspiration to prevent from collapsing
51
Q

What liter flow is run for a SVN?

A

6-8L/min

52
Q

What is normal flow?

A

30L/min

53
Q

What do low flow devices provide?

A

only a portion of a patient’s inspiratory flow

54
Q

What do high flow devices provide?

A

equal to or exceeds the patients inspiratory flow and FiO2 is stable/fixed

55
Q

The bigger the jet nozzle, the ____ the FiO2

A

higher

56
Q

What is the cylinder factor for an E cylinder?

A

0.28

57
Q

What is the cylinder factor for a H/K cylinder?

A

3.14

58
Q

How do you calculate the air to oxygen ratio?

A

(100-x) / (x-21)

59
Q

How do you calculate total flow?

A

(air + o2) x flow

60
Q

How do you calculate the duration of flow?

A

(pressure x cylinder fact) / flow

61
Q

What is the formula for finding PAO2?

A

(Pb-47)xFiO2 - (PACO2x1.25)

62
Q

What is the formula for the a/A ratio?

A

PaO2 / PAO2 (normal >60%)

63
Q

What does O2 therapy do?

A
  • decrease WOB, shortness of breath
  • decreases HR and RR
  • increase SpO2 and PaO2
64
Q

What sound indicates a leak or that the tubing is obstructed?

A

whistling

65
Q

What does condensation or kinking in the tubing do to flow and FiO2?

A
  • decreases flow
  • increases FiO2
  • increases RAW
66
Q

What is the alkalosis equation?

A

7.40+(40-CO2)*.01

67
Q

What is the acidosis equation?

A

7.40-(CO2-40)*.006

68
Q

If trending in opposite directions, what kind of problem is it?

A

metabolic

69
Q

If trending in same direction, what kind of problem is it?

A

respiratory

70
Q

When the pH, CO2 and HCO3 are all abnormal, what is it?

A

partially compensated

71
Q

When the pH is abnormal and everything else is normal, what is it?

A

uncompensated

72
Q

When only the pH is normal, what is it?

A

fully compensated

73
Q

When the pH is calculated to be worse than expected, what does it mean?

A

combined metabolic and respiratory

74
Q

What are the indications for USN?

A
  • presence of upper airway edema
  • subglottic edema
  • postextubation edema
  • postoperative management of upper airway
  • presence of bypassed airway
  • need for sputum specimen or mobilization of secretions
75
Q

What are the hazards of USN?

A
  • wheezing or bronchospasm
  • infection
  • patient discomfort
  • edema of the airway wall
  • overhydration
  • bronchoconstriction
76
Q

What are the physiologic effects of USN?

A
  • improved vital signs
  • improved O2 saturation
  • decreased WOB
  • decreased dyspnea
77
Q

What are the clinical findings of mild asthma (stage 1)?

A
  • PaO2 normal
  • PaCO2 decreased
  • pH increased
78
Q

What are the clinical findings of moderate asthma (stage 2)?

A
  • PaO2 decreased
  • PaCO2 decreased
  • pH increased
79
Q

What are the clinical findings of severe asthma (stage 3)?

A
  • PaO2 decreased
  • PaCO2 normal
  • pH normal
80
Q

What are the clinical findings of very severe asthma (stage 4)?

A
  • PaO2 decreased
  • PaCO2 normal
  • pH decreased
81
Q

What are the clinical findings of COPD stage 1?

A
  • FEV1/FVC <70%

- FEV1 80% predicted

82
Q

What are the clinical findings of COPD stage 2?

A
  • FEV1/FVC <70%

- FEV1 50-79% predicted

83
Q

What are the clinical findings of COPD stage 3?

A
  • FEV1/FVC <70%

- FEV1 30-49% predicted

84
Q

What are the clinical findings of COPD stage 4?

A

-FEV1/FVC <30% predicted

85
Q

What are the clinical findings of emphysema?

A
  • FEV1 decreased
  • FEV1/FVC decreased
  • lung volumes increased
  • residual volumes increased
86
Q

What is cleaning?

A

removing of all foreign material (e.g., soil, organic material) from objects

87
Q

What is disinfection?

A

a process that destroys vegetative forms of all pathogenic organisms on an inanimate object except bacterial spores

88
Q

What is sterilization?

A

a process that destroys all microorganisms on the surface of an article or in a fluid. forms of sterilization include steam (autoclaving), flash and low temperature

RTH 190 (2 decks)

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