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Pediatric Respiratory Care > Kettering NPS Test: The Rematch > Flashcards

Kettering NPS Test: The Rematch Flashcards

1
Q

What is the normal red blood cell count?
What is the normal hemoglobin count?
What is the normal hematocrit count?

A

4.1-5.7
15 +/-3
47 +/-10

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2
Q

What is the normal white blood cell count?

A

6,800 - 14,300 mm3

Can be as high as 30,000 in first few days of life

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3
Q

If pre-ductal PaO2 is more than 15 torr greater than post ductal PaO2, this indicates the presence of a (Right to left or left to right) shunt.

A

Right to left

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4
Q

An oxygen challenge (hyperoxia) test differentiates between ___ or ___ / ___.

A

Paranchymal lung disease or PPHN / congenital heart defect.

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5
Q

What are the indications for chest transillumination?

A

Asymetrical chest movement with resp distress
Decreased lung sounds
Decreased heart sounds
Trachea or mediastinum shifting away.

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6
Q

Optimum placement of an uncuffed ET tube is with the tip between __ and __.
Cuffed ET tubes: __ above carina.

A 
T2 and T4.
2 cm (1 inch) above carina.
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7
Q

When the feeding tube is coiled up in the mediastinum, suspect ___.

A

Esophageal Atresia.

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8
Q

OI (Oxygen Index) greater than ___ is associated with high mortality rate, consider ECMO.

A

40

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9
Q

A P/F ratio is __ divided by __.
Less than 300: ___
Less than 200: ___

A

PaO2/FiO2
ALI
ARDS

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10
Q

Capillary blood samples are used to measure __ and __, but not __.

A

Measures pH and PCO2

Not PO2.

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11
Q 
Normal ABG's for a newborn:
pH: \_\_
PCO2: \_\_
PO2: \_\_
HCO3: \_\_
BE: \_\_
A 
ph: 7.25-7.35
PCO2: 40-50
PO2: 50-70
HCO3: 17-23
BE: -10 - +2
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12
Q

Chest movement is seen for (central or obstructive) apnea. Chest movement is NOT seen for (central or obstructive) apnea.

A

+ chest movement in obstructive apnea.

- chest movement in central apnea.

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13
Q

What does AHI stand for? What does it mean?

A moderate AHI is __ to __.

A

Apnea-Hypopnea Index. It is an index of severity that combines apneas with hypopneas.
Moderate AHI: 6-10

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14
Q

An increased CaO2-CvO2 indicates (increased or decreased) Qt or (increased or decreased) O2 extraction.

A decreased CaO2-CvO2 indicates (increased or decreased) Qt or (increased or decreased) O2 extraction.

A

Increased values = decreased Qt or increased O2 extraction.

Decreased values = increased Qt or decreased O2 extraction.

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15
Q

What is normal cardiac index?

A

2.5-5

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16
Q

CvO2 values will (increase or decrease) when cardiac output decreases.

A

Decrease

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17
Q

On an ET tube, if high cuff pressures are needed to seal the airway, you should change to a (smaller or larger) tube.

A

Change to a larger tube.

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18
Q

On an ET tube if ventilating pressures are greater than 30 without an air leak, change to a (smaller or larger) tube.

A

Change to a smaller tube.

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19
Q

What is the suction pressure for neonates?

What is the suction pressure for children?

A

60-80 for neonates

80-100 for children

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20
Q

A patient with unilateral pneumonia may have a V/Q mismatch when lying on the ___ side because blood flow is affected by gravity.

A

Affected

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21
Q

What airway clearance device should you use on a cystic fibrosis patient? (Besides the oscillating vest)

A

PEP device.

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22
Q

Use this airway clearance device for patients with neurologic problems or muscular weakness.

A

Cough Assist Device (In-Exsufflator)

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23
Q

Use this airway clearance device for patients with cerebral atrophy and poor cognitive skills who cannot use PEP or flutter valve.

A

Intrapulmonary Percussive Ventilation (IPV)

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24
Q

How much humidity?

A

30-34

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25
Q

What does a whistling sound in the bubble humidifier mean?

A

Obstruction in the tubing or cannula

26
Q

When you place a Passy-Muir device on a patient, make sure the cuff is ___. Consider changing to a ____ tube.

A

Deflated.

Fenestrated

27
Q

The skin around a transcutaneous electrode should be heated to ___.

A

43-44 degrees centigrade.

28
Q

How is calibration for a transcutaneous monitor done?

A

Done on room air and with a zeroing solution.

29
Q

After giving surfactant, you need to reduce ___ and ___. Also, reduce the ___ and ___ if indicated.

A

PIP and PEEP.

Pressure limit and rate.

30
Q

While giving NO therapy, monitor ___ levels by ___.

A

Methemoglobin levels, co-oximetry

31
Q

What drug is given to treat methmoglobinemia?

A

Methylene Blue. (Given IV)

32
Q

The INOvent delivery system blends ___ into inspired air to maintain ___ and ___.

A 
Nitric Oxide (NO)
FiO2 and NO
33
Q

How often do you calibrate the INOvent? (Low range and high range calibrations)

A

Low range: every 24 hours

High range: once per month

34
Q

When using the INOvent with a HFOV, install a ___ between the ___ and the ___.

A 
One-way valve
injector module and humidifier
35
Q

Hypoxia indications for ECMO:
___ hours of hypoxia
Oxygenation index ___.
With FiO2 100%, PaO2 of ___ on ventilation with PIP ___ or Paw ___.

A

4 hours
Greater than 40
50 or less, PIP 35, or Paw 20 or higher

36
Q

Acidosis indications for ECMO:
pH less than ___ despite treatment with ___ and ___.
Also, ___.

A

7.20 despite bicarb and hyperventilation.

Also, rising lactic acid levels.

37
Q

Name four pathologies that may indicate ECMO treatment is necessary.

A

Barotrauma
CDH
Cardiac Dysfunction
Severe PPHN

38
Q

A water seal suction drainage system (chest tube) has three compartments. The first one is known as the ___ compartment. The second one is the ___. The third one is the ___.

A
  1. Collection compartment.
  2. Water seal compartment.
  3. Suction control compartment.
39
Q

Which chest tube compartment bubbles continuously?

A

Suction control compartment

40
Q

Which chest tube compartment bubbles intermittently?

A

Water seal bottle

41
Q

If continuous bubbling is noted in the ___ compartment of a chest drainage system, this indicates ___ and it must be reported immediately.

A

Water seal

Air leak in system or patient.

42
Q

You’re doing a bronchoscopy for therapeutic reasons. Use a (rigid or flexible) bronchoscope.

A

Rigid

43
Q

You’re doing a bronchoscopy for diagnostic reasons. Use a (rigid or flexible) bronchoscope.

A

Flexible

44
Q

What is the initial HFJV rate?

A

7 Hz with background IMV of 2

45
Q

To increase ventilation on HFJV, what should you do? (Two things)

A

Increase drive pressure to increase Tv
or
Increase I time to increase Tv

46
Q

To increase Pmean on the HFJV, what should you do?

A

Increase PEEP
or
Increase drive pressure to increase Tv

47
Q

What is the initial Tv for HFJV?

A

90% of CV peak pressure.

48
Q

If the PIP is going up, look at the ___. If it is still the same then the ___ is increasing. If not, then ___ is decreasing.

A

Pplat.
Raw
Compliance

49
Q

How do you calculate RAW?

A

PIP - Pplat

50
Q

How do you calculate Corrected Tidal Volume?

A

Set Tv - Compressible Volume

51
Q

How do you calculate compressible volume?

A

(PIP - PEEP) x tubing compliance factor

52
Q

If a patient is 26 weeks gestation, keep ___ below 26.

A

PIP

53
Q

For full-term, healthy lungs, keep PIP below ___.

For sick lungs, premature, or RDS, PIP should be ___.

A

Low 20’s.

High 20’s. Use gestational age.

54
Q

At high altitudes, you should ___ the oxygen analyzer.

A

Recalibrate

55
Q

How often should you calibrate a capnograph?

A

Every 8 hours.

56
Q

Low PetCO2 readings following intubation indicate the tube is in the ___.

A

Espohagus.

57
Q

The accuracy of SpO2 readings are affected by light transmission and ___.

A

Perfusion

58
Q

To calculate the amount of gas flow while giving heliox, multiply the observed O2 flow by the heliox factor.
What is the Heliox factor for 80% He & 20% O2?
What is the Heliox factor for 70% He & 30% O2?
What is the Heliox factor for 60%He & 40%O2?

A
  1. 8
  2. 6
  3. 4
59
Q

On the HFJV, what does it mean if the servo pressure is going down?

A

Either less compliance or more resistance.

60
Q

On the HFJV, what does it mean if the servo pressure is going up?

A

Either more compliance or less resistance.

61
Q

What is the calculation for Oxygen Index?

A

FiO2 x Mean Airway Press / PaO2

Pediatric Respiratory Care (6 decks)

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