RCP midterm Flashcards
The development of the ____ _______ significantly advanced the field of respiratory care.
mechanical ventilator
Who are the organizations involved in respiratory care and their roles?
NBRC & CoARC
Year when the first mechanical ventilator developed?
1928 by Julias Drinker & Louis Agassiz Shaw
What condition was treated with the iron lung?
Polio
Include the landmarks in Respiratory Care.
1940 - techs hauled o2 cylinders
1950 - positive pressure breathing devices applied
1960 - formal education programs for inhalation therapists
1974 - designation of “Respiratory Therapist” becomes standard
What is the primary purpose of American Association for Respiratory Care (AARC)?
To advance the professional practice of respiratory care
Precursor to Modern Ventilators is the _______ ________.
iron lung
What is the primary role of a Respiratory Therapist?
To assess, treat, and care for patients with breathing disorders
What are components for professional behavior in respiratory care?
clinical competence, ethical practice, effective communication, and commitment to lifelong learning
Who provides guidelines and standards in respiratory practice?
rcb
The minimum educational requirement for respiratory therapist is?
Associate’s degree
What is the required Certification to work in California?
RRT certification
Define the purpose of Continuing Education for respiratory therapist.
To maintain competence and stay updated with advancements
Define ethical principles: Include autonomy, beneficence, and nonmaleficence, justice, veracity
Autonomy: respect for patient choices;
Beneficence: act in the patient’s best interest; Nonmaleficence: do no harm
Justice : to ensure fairness
Veracity : binds the healthcare provider and patient to be accurate & truthful
Which responsibilities do respiratory therapists hold with regards to education?
To educate patients and families about respiratory care
How do clinical practice guidelines help the respiratory department staff?
They provide evidence-based recommendations for patient care
Define TJC.
The Joint Commission - nonprofit that accredits & certifies healthcare
Define ambulation and its benefits.
The act of walking; benefits include improved circulation and respiratory function
All electrical equipment should be connected to ________ outlets with three wire cords.
grounded/red
Know the fire hazards acronym plans RACE and PASS.
RACE: Rescue, Alarm, Contain, Extinguish; PASS: Pull, Aim, Squeeze, Sweep
For a fire to start three conditions must exist: ____________, ___________, ___________.
Heat, Fuel, Oxygen
Oxygen is ______ __________ but support ______________.
not flammable; combustion
Know hazards with MRI and RT equipment.
Metal objects, pacemakers, and certain implants
What is an RT department’s function?
combination of diagnostic, therapeutic, emergency and preventive care
What is the responsibility of a department manager?
To oversee departmental operations and staff
Respiratory Care Protocols ensure _________________________________.
consistent and safe patient care practices
What are common responsibilities for respiratory therapist in the clinical setting?
Administering therapies, conducting assessments, and monitoring patient status
What discipline is usually in charge of managing sleep disorders?
RT
What is the responsibility of a medical director?
To provide clinical oversight and ensure quality of care
Define CoARC.
Commission on Accreditation for Respiratory Care
-credentialing in respiratory
What do policies and procedures provide?
Guidelines for consistent practice and compliance
What are the usual tools and equipment used in respiratory care?
Ventilators, nebulizers, and oxygen delivery devices
What is the goal in all treatments provided for patients?
To improve respiratory function and patient outcomes
Normal Respiratory Rate:
12-20 breaths per minute
Take note of normal breath sounds.
Vesicular, bronchial, and bronchovesicular
Define platypnea, trepopnea.
Platypnea: shortness of breath when upright; Trepopnea: shortness of breath when lying down on one side
Barrel Chest:
abnormal increase in anteroposterior diameter; often seen in emphysema
What is capillary refill, time, and significance of slow response?
Time taken for color to return after pressure; >2 seconds indicates poor perfusion
What are common signs of respiratory distress in infants?
Nasal flaring, grunting, retractions
Define values for normal, mild, moderate and severe in pulse oximetry reading.
Normal : 95-100%
Mild: 91-94%
Moderate: 86-90%
Severe: <85%
Define jaundice, erythema, pallor, cyanosis.
Jaundice: yellowing of skin due to excess bilirubin in the blood
Erythema: redness caused by increased blood flow
Pallor: paleness due to decreased blood flow or oxygen in the blood
Cyanosis: bluish discoloration of the lips or skin caused by poor circulation or inadequante oxygen
How does palpating the trachea help during assessment?
To assess for deviation or abnormal positioning
Define pleuritic chest pain vs nonpleuritic chest pain.
Pleuritic: sharp pain with breathing caused by pneumonia and pulmonary embolism
Nonpleuritic: dull, constant pain in center of chest. By angina, gastreosophagul reflex, esophageal spasm, chest wall pain & gallbladder
Define vocal/tactile fremitus conditions that cause an increase or decrease.
Increased: pneumonia; Decreased: pleural effusion
Define percussion note for emphysema and pneumonia.
Emphysema: hyperresonant; Pneumonia: dull
Abnormal Lung Sounds: Rhonchi, crackles, wheeze and stridor.
Rhonchi: low-pitched; Crackles: high-pitched; Wheeze: musical; Stridor: high-pitched
Define the following terms Hyperpnea, hypopnea, apnea, eupnea.
Hyperpnea: increased depth; Hypopnea: decreased depth; Apnea: cessation; Eupnea: normal breathing
Define the following terms: bradypnea, tachypnea, tachycardia, bradycardia, hypotension, hypertension.
Bradypnea: slow breathing; Tachypnea: fast breathing; Tachycardia: fast heart rate; Bradycardia: slow heart rate; Hypotension: low blood pressure; Hypertension: high blood pressure
Define orthopnea:
Difficulty breathing when lying flat
What is whispered pectoriloquy and the indication if positive?
Increased clarity of whispered sounds; indicates lung consolidation
Normal Breath Sound over the Trachea:
Bronchial breath sounds
Define clubbing of fingers and cause.
Enlargement of the fingertips; caused by chronic hypoxia
Normal Oral Body Temperature:
98.6°F (37°C)
Normal Adult Heart Rate:
60-100 beats per minute
Normal Oxygen Saturation:
95-100%
Know color and characteristics of sputum, indications and conditions (all).
Clear: normal; Yellow/green: infection; Rusty: pneumonia; Pink frothy: pulmonary edema
What is the preferred site for ABG Sampling?
Radial artery
Name noninvasive methods used for monitoring gas exchange.
Pulse oximetry, capnography
What are the names of oxygen analyzers?
Galvanic fuel cell, paramagnetic, electrochemical
Know the procedure for a Modified Allens Test and its purpose.
Assess collateral circulation in the hand
What is capillary blood gas used for?
To assess acid-base status and oxygenation
Common oxygen analyzer malfunctions. (3)
- Calibration errors
- Sensor failure
- Environmental interference
Know contraindications for arterial puncture.
Infection at the site, coagulopathy, severe peripheral vascular disease
Effect of Air in ABG Sample.
Causes inaccurate results due to dilution of blood gases
What are transcutaneous monitoring sites for infants and children?
Chest, abdomen, and thigh
What is measured with pulse oximetry and how?
Oxygen saturation using light absorption in hemoglobin
Term used for graphical display of CO2 levels.
Capnogram
Define the advantages of point-of-care testing.
Immediate results and faster clinical decision-making
Know hemoglobin types in oximetry.
Oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin, methemoglobin
Know complication and risk with indwelling catheters.
Infection, thrombosis, and catheter occlusion
Know supplies and procedure for arterial blood gas.
Syringe, needles, antiseptic, and ice
Include common sites for arterial puncture.
- Radial artery
- Femoral artery
- Brachial artery
Name the PaCO2 Measurement Electrode.
Severinghaus electrode
A false positive can be caused by what condition during pulse oximetry?
Nail polish or artificial nails
Know normal mixed venous O2 saturation (SvO2).
60-80%
Purpose of Quality Control in ABG Analysis.
To ensure accuracy and reliability of test results
Know the two methods used for capnometry during mechanical ventilation.
- Mainstream
- Sidestream
Indications for Blood Gas Sampling.
Respiratory failure, metabolic disorders, and monitoring therapy
What are common pre-analytic errors in ABG measurements?
Air contamination, improper sample handling, temperature variations
What is a random error in quality control:
An error that occurs without a predictable pattern
How does transcutaneous monitoring work?
Measures CO2 and O2 levels through the skin
What are terms used for chest wall deformities?
Pectus excavatum, pectus carinatum
Term describing difficulty breathing and scale used.
Dyspnea; often assessed with the Borg scale
A low blood oxygen levels is referred to as?
Hypoxemia
Define the term oriented x 4.
Awareness of person, place, time, and situation
High-pitched sound is caused by upper airway abnormalities.
Stridor
What is peripheral cyanosis and its causes?
Bluish discoloration of extremities; caused by poor circulation
Know the following terms hemoptysis and hematemesis.
Hemoptysis: coughing up blood; Hematemesis: vomiting blood
A term described as discontinuous lung sounds caused by secretions or fluid.
Crackles
Lung sound in chronic bronchitis due to inflammation.
Rhonchi
Define tripoding:
Sitting posture leaning forward to ease breathing
Noninvasive CO2 Monitoring terms, capnography, capnometry and capnogram.
Capnography: monitoring CO2 levels; Capnometry: measurement of CO2; Capnogram: graphical representation
Breath sound over trachea, major bronchi and peripheral areas of the lungs.
- Trachea: bronchial
- Major bronchi: bronchovesicular
- Peripheral areas: vesicular
Know terms used to describe deformation of the spine.
Kyphosis, lordosis, scoliosis
Define DNR, DNI and AND.
- DNR: Do Not Resuscitate
- DNI: Do Not Intubate
- AND: Allow Natural Death
Define JVD, retractions, nasal flaring, pursed lip breathing and what population of patient this is seen in.
- JVD: Jugular Venous Distension
- Retractions: inward movement of chest wall
- Nasal flaring: widening of nostrils during breathing
- Pursed lip breathing: technique to improve airflow; often seen in COPD patients
Know formula for Pack-years and how to calculate.
Full pack x 20 years, half pack x 20 years, and a pack and a half x 20 years
