Large Volume Jet Nebulizer

Question 1

Why should you analyze inspired O2 percentage near the patient?

Answer 1

Because both water in the aerosol tubing and back pressure decrease the entrained air and raise the O2 percentage

Question 2

What could happen if water is present in the large-bore tubing or if the tubing is pinched?

Answer 2

Less room air will be entrained and the delivered oxygen percentage will be higher than ordered

Question 3

Since water temperature increases as the water level drops, what should you do near the patient for safety purposes?

Answer 3

Monitor the gas temperature

Question 4

Heating the water or aerosol ______ the patients humidity deficit and usually is done if the secretions are thick.

Answer 4

reduces

Question 5

What is happening when the flow is high enough that aerosol mist can be seen flowing out of the side ports during an inspiration?

Answer 5

Little or no room air is being inspired and the aerosol mask is now a high-flow device

Question 6

It is best to analyze the O2 percentage ______ the mask to be sure of what the patient is inhaling.

Answer 6

inside

Question 7

What will result when warmed, humidified gas cools on its way to the patient?

Answer 7

Condensation in water draining to the lowest part of the large bore tubing

Question 8

When is an incubator needed?

Answer 8

In the care of a sick newborn who needs an enclosed space for an isolated, controlled environment.

Question 9

Controls below the infant are used to adjust the ______, ______, and possibly ______ ______ within the incubator,

Answer 9

temperature
humidity
oxygen percentage

Question 10

A ______ ______ may be positioned over an incubator to keep the infant in a neutral thermal environment.

Answer 10

radiant warmer

Question 11

What four things has an incubator been used for the infant?

Answer 11

1) manage infants temperature
2) manage surrounding humidity
3) isolate infant from outside environment
4) control infants inspired O2

Question 12

The internal temperature of the incubator usually is kept between ______ and ______ to keep the infant in a neutral thermal environment (NTE).

Answer 12

36 and 36.5 degrees Celsius

Question 13

Difference between aerosol/mist tents and O2 tents

Answer 13

No supplemental O2 is used because the patient does not need it.

Question 14

Aerosol tents are sometimes used to treat an ______ ______ with an upper respiratory tract problem such as ______.

Answer 14

active child

laryngotracheobronchitis (LTB, or pediatric croup)

Question 15

What can be done to reduce airway edema in a child who has laryngotracheobronchitis?

Answer 15

Cool aerosol

Never use so much aerosol that the child cannot be seen inside the tent

Question 16

What is common of the SVN?

Answer 16

Bacterial contamination 
(Should be changed everyday)

Question 17

Ultrasonic nebulizers function by transforming standard household ______ into ultrasonic ______ ______.

Answer 17

current

sound waves

Question 18

Ultrasonic nebulizers incorporate an ______ ______ that varies the intensity of ultrasonic waves, allowing varying aerosol outputs.

Answer 18

amplitude control

Question 19

Ultrasonic nebulizers are used principally to deliver ______ ______ for sputum induction.

Answer 19

bland aerosols

Question 20

Jet nebulizers: ___% of aerosol particles produced fall in the therapeutic range of ___ to ___ um.

Answer 20

55%

1-5 um

Question 21

Ultrasonic nebulizers: ___% of aerosol particles produced fall in the therapeutic range of ___ to ___um.

Answer 21

97%

1-5um

Question 22

Heating options include ______, ______, ______, or ______.

Answer 22

hot plate
wraparound
yolk (collar)
immersion

Question 23

The primary gas is delivered to the jet, which delivers limited flows up to ___L/min; the secondary gas port allows additional flow up to ___L/min.

Answer 23

40 L/min

80 L/min

Question 24

The ratio of O2 to airflow determines the ______and ______ to the patient. Does not entrain room air; both gases are medically pure.

Answer 24

O2 concentration and total flow

Question 25

Babbington nebulizer includes ______, attached to the ______, producing an aerosol. This mechanism is used in many commercially available, large-volume room humidifiers intended for home use.

Answer 25

baffles

disk

Question 26

Airway appliances used to deliver bland aerosol therapy include: ______, ______, ______, and ______.

Answer 26

aerosol mask
face tent
T-tube
tracheostomy mask

Question 27

In all cases, ______ (22-mm ID) is used to minimize flow resistance and prevent occlusion by ______.

Answer 27

large-bore tubing

condensate

Question 28

The ______ and ______ are used with patients who have intact upper airways.

Answer 28

aerosol mask and face tent

Question 29

______ and ______ are used for patients who have been intubated with an endotracheal tube or who have a tracheostomy in place.

Answer 29

T-tubes and tracheostomy masks

Question 30

______ mask modified with two 6 in. sections of 22-mm ID aerosol tubing. Each 6 in. section has a ___mL internal volume.

Answer 30

Aerosol

50mL

Question 31

What is a potentially serious problem for patients treated with heated jet nebulizers and USN’s?

Answer 31

Over-hydration

Question 32

Bland aerosol effectively eliminates ______ through the lungs and thus should be equated to a daily water gain (approx. 200 mL/day for avg. adult)

Answer 32

insensible water loss

Question 33

Another complication associated with over-hydration is the potential for _______ to swell after high-density aerosol therapy.

Answer 33

inspissated pulmonary secretions

Question 34

Aerosol is defined as a ______ of water in ______ form (or mist) in gas.

Answer 34

suspension

particulate

Question 35

Nebulizers are often referred to as ______.

Answer 35

Aerosol generators

Question 36

The ______ is commonly used to deliver aerosol to an oxygen tent.

Answer 36

hydrosphere

Question 37

The frequency (which determines the particle size) of the electric energy supplied to the transducer is approx. ___Mc. Particle size cannot be adjusted by the user.

Answer 37

1.35 Mc (1 Mc = 1 million Hz)

Question 38

The ______ contains tap water to help absorb mechanical heat and to act as a transfer medium for the sound waves to the mediation cup.

Answer 38

couplant chamber

Question 39

The ______ determines the volume of the aerosol output.

Answer 39

amplitude control

Question 40

Hazards of ultrasonic therapy:

Answer 40

1) Over-hydration
2) Bronchospasm
3) Sudden mobilization of secretions
4) Electrical hazard
5) water collection in the tubing
6) Swelling of secretions from the absorption of saline, which may obstruct airway
7) Changes in drug dosage, caused by drug reconcentration because of the solvent in the medication cup, leading to an increasingly stronger dose as treatment continues

Question 41

What can increase the percentage of O2 being delivered to a patient?

Answer 41

water in aerosol tubing

Question 42

What can happen when water is in the tubing?

Answer 42

obstruct gas flow, resulting in back pressure in the nebulizer

Question 43

As pressure increases in the nebulizer, ______ air is entrained in the entrainment port; therefore delivered FiO2 ______, total flow to the patient ______, and less aerosol is delivered.

Answer 43

less
increase
decreases