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respiratory therapy > lab final > Flashcards

lab final Flashcards

1
Q

What are the indications for SVN use

A

neonates and older
1. person unable to follow instructions
2. poor inspiratory capacity
3. incapable of inspiratory hold
4. rapid or unstable respiratory pattern
5. need to nebulize non stand drug solutions

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2
Q

Indications for DPI use

A

3-4 years or older
1. inadequate coordination for MDI use
2. need for more portable alternative to SVN
3. subjects capable of high inspiratory flow rates >60
4. need for accurate dose monitoring
5. drug available in DPI formulation

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3
Q

Indications for MDI

A

7 years or older
1. ability to follow instructions
2. ability to mechanically coordinate actuation and breathing
3. adequate inspiratory capacity >900 ml
4. capable of inspiratory hold
5. stable, calm respiratory pattern

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4
Q

how do spacers/ holding chambers work?

A

Increases the distance between the MDI and the pts mouth, allowing aging of particles. incorporates a one way valve to prevent drug loss in pts with poor hand-breath coordination.

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5
Q

What are regulators also called?

A

Pressure-reducing valves

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6
Q

What do regulators do?

A

They are used in gas supply systems and mechanical ventilators to maintain constant pressure. They are also used on cylinders to reduce gas pressure from 2200 psi to a working pressure of 50 psi

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7
Q

what is a single stage pressure reducing valve

A

High pressure chamber that is supplied with a safety relief valve preset to 200 psig

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8
Q

what is a multiple stage pressure reducing valve

A

the first stage is to reduce pressure to 200-700 psig
the second stage reduces pressure to 50 psig

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9
Q

Describe ASSS

A

The American standard safety system is used with large cylinders, and utilizes differing thread pitches, and internal and external threading to prevent accidental misconnections (wrench)

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10
Q

Describe PISS

A

Pin index safety system is used with small compressed tank systems, it utilizes a yoke collar with varying pi placements to prevent accidental misconnections

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11
Q

Describe DISS

A

diameter index safety system connections consist of an externally threaded body and a mated nipple with a nut that may be hand tightened, it used to prevent accidental interchange of low pressure <200
op- 50 max pressure- 200

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12
Q

What is a bourdon gauge

A

A bourdon gauge measures flow based off of pressure, it has a fixed orifice and is typically used during transport.

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13
Q

What are the three goals of oxygen therapy?

A
  1. treat hypoxemia
  2. decrease work of breathing
  3. decrease myocardial workload
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14
Q

What is a nasal cannula?

A

It is a low flow oxygen device that deliver flows 24-44% from 1-6 LPM there is a 4% increase per liter. more than 6lpm does not increase fio2 delivered to the patient. A humidifier need to be used at 4 or more lpm

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15
Q

What is a simple mask

A

low flow oxygen device that delivered 35-55% oxygen from 6-10 LPM. There is a 5% increase per liter. A humidifier can be used at any liter. Cannot do less than 6 lpm due to build up of exhaled CO2 in the mask

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16
Q

what is a nonrebreathing mask

A

low flow oxygen device that delivers 75-100% oxygen at flows of 8-15 lpm. Flow rates to the mask must be sufficient enough to keep reservoir bag 1/2-1/3 full at all times. This device is only used short term and should never be used with a humidifier

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17
Q

What are the 7 factors that increase FiO2 delivered to patients

A
  1. Higher O2 input
  2. mouth-closed breathing
  3. lower inspiratory flow
  4. lower tidal volume
  5. slow rate of breathing
  6. small minute volume
  7. long inspiratory time
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18
Q

What are the 7 factors that decreases total FiO2 delivered to patients

A
  1. lower O2 input
  2. mouth-open breathing
  3. higher inspiratory flow
  4. higher tidal volumes
  5. fast rate of breathing
  6. large minute volume
  7. short inspiratory time
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19
Q

What are the five indications for using an incentive spirometer?

A
  1. prevention and reversal of atelectasis
  2. facilitate cough reflex
  3. mobilize secretions
  4. surgery
  5. improve inspiratory muscle performance
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20
Q

What are the 6 potential outcomes of using an incentive spirometer?

A
  1. absence or improvement in signs of atelectasis
  2. improved PaO2
  3. presence or improvement in previously absent or diminished breath sounds
  4. increased vital capacity and peak expiratory flows
  5. attainment of prep flow and volume levels
  6. improved inspiratory muscle performance
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21
Q

What is the most common pressure that most hospitals equipment operates

A

50 psig

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22
Q

what color gas is oxygen

A

green

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23
Q

what color gas is carbon dioxide

A

gray

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24
Q

what color gas is nitrous oxide

A

blue

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25
Q

what color gas is cyclopropane

A

orange

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26
Q

what color gas is helium

A

brown

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27
Q

what color gas is nitrogen

A

black

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28
Q

what color gas is air

A

yellow

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29
Q

what color gas is helium/oxygen

A

brown and green

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30
Q

what color gas is carbon dioxide/oxygen

A

gray and green

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31
Q

what color gas is nitric oxide

A

teal and black

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32
Q

what is hypoxemia

A

relative deficiency of oxygen in the blood

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33
Q

what is hypoxia

A

oxygen deficiency at the tissue level

34
Q

what is hypoxemia hypoxia

A

oxygen deficit at the tissues due to increase altitude, suffocation, drug overdose, neurological injury that results in hypoventilation, and lung disease.

35
Q

what is stagnant (circulatory) hypoxia

A

oxygen deficit at the tissues due to shock and cardiac arrest

36
Q

what is anemic hypoxia

A

oxygen deficit at the tissue due to anemia, blood loss, and carbon monoxide poisoning

37
Q

what is histotoxic hypoxia

A

oxygen deficit at the tissues due to cyanide poisoning

38
Q

What is a variable performance oxygen delivery device

A

It is a Low flow oxygen device, that gas flow of the apparatus is insufficient to meet all of an individuals inspiratory requirements. Room air is entrained to augment gas flow from the device

39
Q

what is a fixed performance oxygen delivery device

A

High flow oxygen device, gas flow of the apparatus is sufficient to meet all of an individual inspiratory requirements. room air is not entrained

40
Q

what are the four hazards of oxygen therapy

A
  1. oxygen toxicity
  2. retinopathy of prematurity
  3. oxygen-induced hypoventilation (COPD patients)
  4. Absorption atelectasis ( mucus plugging)
41
Q

what does a large entrainment port do

A

it takes in more room air, and decreases total FiO2 delivered

42
Q

what do small air entrainment ports do

A

it takes in less room air, increasing the total FiO2 delivered

43
Q

what does a small jet orifice do

A

it lowers oxygen flows delivered through the device

44
Q

what does a large jet orifice do

A

it raises oxygen flows through the device

45
Q

what is the difference between asepsis and sterile

A

sterile is the complete absence of all forms of microorganisms while asepsis is the absence of disease producing microorganisms

46
Q

where does aerosol deposition occur for >15 microns

A

completely removed above the larynx with mouth breathing

47
Q

where does aerosol deposition occur for 10-15 microns.

A

completely removed above the larynx with nose breathing

48
Q

where does aerosol deposition occur for 5-10 microns

A

enter the lower respiratory tract with mouth breathing

49
Q

where does aerosol deposition occur for 1-5 microns

A

they deposit in the lung periphery

50
Q

what is the optimal particle size

A

2-5 microns

51
Q

what are the effects of low humidity on the airways

A
  1. long exposure to dry gases will cause heat/water loss changes to the epithelial layer
  2. ciliary activity is impaired when the BH% falls below 70%
  3. ciliary activity ceases when the BH% falls below 30%
52
Q

what is the action of a baffle in a nebulizer

A

the number of baffles allow larger particles to impact (while small particles remain in suspension)

53
Q

what are the 7 signs of humidity deficit

A
  1. dry, hacking, nonproductive cough
  2. inspissated secretions
  3. earache
    4.sore throat
    5.substernal pain
  4. dryness of skin
  5. unstable control of bodily fluids
54
Q

why are the standard precautions used

A

to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals

55
Q

what are the three factors that effect humidity output

A
  1. temperature
  2. surface area
  3. contact time
56
Q

what are the three factors that influence particle size produced by jet nebulizer

A
  1. change in gas flow (increase=decrease in particle size)
  2. jet size= (increase= decrease in particle size)\
  3. number of baffles (the more the smaller the particles
57
Q

what is the appropriate gas flow rate for powering a SVN

A

6-10 lpm

58
Q

what are the 8 potential complications of aerosol therapy

A
  1. infection
  2. bronchial obstruction
  3. atelectasis (mucus plugging)
  4. overhydration
  5. electrolyte changes
  6. dyspnea
  7. drug concentration effect
  8. airway reactivity
59
Q

korotkoff sounds

A

phase 1: systolic pressure
phase 5: silence marks the diastolic pressure

60
Q

what is a heat/moisture exchanger also called

A

hygroscopic condensor humidifier

61
Q

what is the specifics about a heat/moisture exchanger

A

passive humidifier that uses paper, wool, foam, treated with hygroscopic salt to increase thermal conductivity (increases temperature and RH%)

62
Q

what is E cylinders safety and escape factor

A

escape- 0.28
safety- 500 psi

63
Q

what is H-cylinders safety and escape factor

A

escape- 3.14
safety- 200 psi

64
Q

what is the formula to calculate time remaining in a cylinder

A

(cylinder psig-safety factor) x escape factor divided by liters

65
Q

indications for aerosol therapy (5)

A
  1. delivery of medications
  2. humidification of airways
  3. mobilize tracheobronchial secretions
  4. upper airway edema
  5. sputum induction
66
Q

what are the three clinical situations in which humidity might be required

A
  1. administration of medical gases
  2. any artificial airway that bypasses the normal anatomical route for humidification
  3. treatment of thick secretions
67
Q

what happens when an air entrainment device has an occlusion

A

the occlusion causes downstream resistance that builds up backpressure in the system. This will decrease the amount of air entrained and result in an increase in FiO2 delivered but will decrease the total flow delivered to the patient

68
Q

what are the 3 functions of a spacer/holding chamber

A
  1. increase time and provide a holding volume to allow aging of aerosol particles
  2. reduction of oropharyngeal drug loss
  3. provision of a reservoir holding chamber to remove the need for coordination of actuation and inhalation by the user
69
Q

what do you change to help a patient overcome work of breathing

A

you change the flow rates

70
Q

what do you change to improve a patients oxygenation

A

you change the FiO2

71
Q

if a patient is not capable of using a incentive spirometer what should you have them do

A

you have them do deep breath, cough exercises

72
Q

if there is a picture of big single bubbles what device is this

A

a simple bubble humidifier

73
Q

if there is a picture of lots of bubble what will this be

A

a diffuser

74
Q

what does a salter or high flow nasal cannula typically run at

A

15 lpm

75
Q

if patient cannot use a svn on there own what should you do

A

have them use Blow by for passive treatment, the aerosol will go through there nose

76
Q

heat and moisture exchangers should only be used

A

short term

77
Q

HEM

A

more saturation with water will cause resistance to increase, and coughing can occlude the device

78
Q

everyone who comes into the hospital should get a blood gas done

A

false

79
Q

what are the oxygen percentages for the Venturi mask

A

24-50%

80
Q

what will a bourdon gauge show if the device is occluded

A

the bourdon gauge will not change but the patient will receive lower FiO2s

81
Q

what is the equation for MAP

A

MAP= systolic + (diastolic x 2) divided by 3

respiratory therapy (2 decks)

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