Large Volume Jet Nebulizer Flashcards
Why should you analyze inspired O2 percentage near the patient?
Because both water in the aerosol tubing and back pressure decrease the entrained air and raise the O2 percentage
What could happen if water is present in the large-bore tubing or if the tubing is pinched?
Less room air will be entrained and the delivered oxygen percentage will be higher than ordered
Since water temperature increases as the water level drops, what should you do near the patient for safety purposes?
Monitor the gas temperature
Heating the water or aerosol ______ the patients humidity deficit and usually is done if the secretions are thick.
reduces
What is happening when the flow is high enough that aerosol mist can be seen flowing out of the side ports during an inspiration?
Little or no room air is being inspired and the aerosol mask is now a high-flow device
It is best to analyze the O2 percentage ______ the mask to be sure of what the patient is inhaling.
inside
What will result when warmed, humidified gas cools on its way to the patient?
Condensation in water draining to the lowest part of the large bore tubing
When is an incubator needed?
In the care of a sick newborn who needs an enclosed space for an isolated, controlled environment.
Controls below the infant are used to adjust the ______, ______, and possibly ______ ______ within the incubator,
temperature
humidity
oxygen percentage
A ______ ______ may be positioned over an incubator to keep the infant in a neutral thermal environment.
radiant warmer
What four things has an incubator been used for the infant?
1) manage infants temperature
2) manage surrounding humidity
3) isolate infant from outside environment
4) control infants inspired O2
The internal temperature of the incubator usually is kept between ______ and ______ to keep the infant in a neutral thermal environment (NTE).
36 and 36.5 degrees Celsius
Difference between aerosol/mist tents and O2 tents
No supplemental O2 is used because the patient does not need it.
Aerosol tents are sometimes used to treat an ______ ______ with an upper respiratory tract problem such as ______.
active child
laryngotracheobronchitis (LTB, or pediatric croup)
What can be done to reduce airway edema in a child who has laryngotracheobronchitis?
Cool aerosol
Never use so much aerosol that the child cannot be seen inside the tent
What is common of the SVN?
Bacterial contamination (Should be changed everyday)
Ultrasonic nebulizers function by transforming standard household ______ into ultrasonic ______ ______.
current
sound waves
Ultrasonic nebulizers incorporate an ______ ______ that varies the intensity of ultrasonic waves, allowing varying aerosol outputs.
amplitude control
Ultrasonic nebulizers are used principally to deliver ______ ______ for sputum induction.
bland aerosols
Jet nebulizers: ___% of aerosol particles produced fall in the therapeutic range of ___ to ___ um.
55%
1-5 um
Ultrasonic nebulizers: ___% of aerosol particles produced fall in the therapeutic range of ___ to ___um.
97%
1-5um
Heating options include ______, ______, ______, or ______.
hot plate
wraparound
yolk (collar)
immersion
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.
40 L/min
80 L/min
The ratio of O2 to airflow determines the ______and ______ to the patient. Does not entrain room air; both gases are medically pure.
O2 concentration and total flow
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.
baffles
disk
Airway appliances used to deliver bland aerosol therapy include: ______, ______, ______, and ______.
aerosol mask
face tent
T-tube
tracheostomy mask
In all cases, ______ (22-mm ID) is used to minimize flow resistance and prevent occlusion by ______.
large-bore tubing
condensate
The ______ and ______ are used with patients who have intact upper airways.
aerosol mask and face tent
______ and ______ are used for patients who have been intubated with an endotracheal tube or who have a tracheostomy in place.
T-tubes and tracheostomy masks
______ mask modified with two 6 in. sections of 22-mm ID aerosol tubing. Each 6 in. section has a ___mL internal volume.
Aerosol
50mL
What is a potentially serious problem for patients treated with heated jet nebulizers and USN’s?
Over-hydration
Bland aerosol effectively eliminates ______ through the lungs and thus should be equated to a daily water gain (approx. 200 mL/day for avg. adult)
insensible water loss
Another complication associated with over-hydration is the potential for _______ to swell after high-density aerosol therapy.
inspissated pulmonary secretions
Aerosol is defined as a ______ of water in ______ form (or mist) in gas.
suspension
particulate
Nebulizers are often referred to as ______.
Aerosol generators
The ______ is commonly used to deliver aerosol to an oxygen tent.
hydrosphere
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.
1.35 Mc (1 Mc = 1 million Hz)
The ______ contains tap water to help absorb mechanical heat and to act as a transfer medium for the sound waves to the mediation cup.
couplant chamber
The ______ determines the volume of the aerosol output.
amplitude control
Hazards of ultrasonic therapy:
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
What can increase the percentage of O2 being delivered to a patient?
water in aerosol tubing
What can happen when water is in the tubing?
obstruct gas flow, resulting in back pressure in the nebulizer
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.
less
increase
decreases
