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Respiratory Therapy student 210-230 > RT210: Introduction to & Applied Respiratory Theraputics ( study guide ) > Flashcards

RT210: Introduction to & Applied Respiratory Theraputics ( study guide ) Flashcards

1
Q

SMI- Sustained maximal inhalation ( Incentive spirometry ) INDICATION

A

Improve atelectasis
Prevent atelectasis
Mobilize secretion

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2
Q

INCENTIVE SPIROMETRY CONTRAINDICATIONS

A

patient unable to cooperate
patient unable to follow instruction
patient unconscious
patient unable to take deep breath

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3
Q

INCENTIVE SPIROMETRY HAZARDS

A

ineffective unless preformed correctly
hyperventilation
barotrauma
discomfort secondary to pain
fatigue

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4
Q

INCENTIVE SPIROMETRY PROCEDURE

A

slow deep inspiration
inspiratory hold
relaxed exhalation
volume of gas move should be IC
coaching
frequency

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5
Q

INCENTIVE SPIROMETRY PATIENT EVALUATION

A

patient must be ALERT
COOPERATIVE
Physically able to increase IC greater than Vt
Should be 3 times predicted Vt

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6
Q

IPPB- PRIMARY INDICATIONS

A

If patient has inadequate VC to facilitate a cough
VC less than 3 times predicted VT
VC less than 15ml/kg of ideal body weight

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7
Q

IPPB-SECONDARY INDICATIONS

A

Deliver medication
improve I:E ratio
improve cough and mobilize secretions
alter V/Q
improve or prevent atelectasis
decrease CO2 temporarily

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8
Q

CONTRAINDICATIONS OF IPPB

A

untreated closed pneumothorax
( below are considerations )
hemodynamic instability
TB, can increase air trapping
Widespread blebs or bulla
may cause or worsen hemoptysis
may cause pneumothorax
tachypnea
decreased cardiac output

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9
Q

IPPB HAZARDS

A

barotrauma, increase ICP
nosocomial infection
hypocarbia, hyperventilation
tachypnea, decrease CO
gastric distention, Cause or worsen hemoptysis
impedance of venous return
air trapping, O2 induced hypoventilation

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10
Q

IPPB PHYSIOLOGIC EFFECTS

A

increase intrapulmonary pressure
decrease venous return, decrease CO
mechanical bronchodilation, alter I:E ratio
alter V/Q, mobilization of secretion
increase PaO2 and decrease PaCO2
decrease WOB

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11
Q

CLASSIFICATION OF BIRD MARK 7

A

positive pressure ventilator, pneumatically powered, pneumatically driven, single circuited

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12
Q

CLASSIFICATION BIRD MARK 7

A

Modes ( assist, assist control, control ) pressure cycled, flow limited, flow pattern, pressure pattern

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13
Q

CLASSIFICATION BIRD MARK 7

A

internal resistance, principle of operation
SPECIFICATION; flow is variable and adjustable, venturi/venturi gate, air mix controller, nebulizer, pressure, sensitivity, expiratory timer, circuit

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14
Q

HUMIDITY

A

water in a gaseous state, water vapor, molecular water in gas, potential humidity, saturated, Absolute Humidity, Relative Humidity

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15
Q

HUMIDIFICATION INDICATIONS ( primary )

A

humidifying dry medical gases
overcoming humidity deficit created when the upper airway is bypassed

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16
Q

HUMIDIFICATION INDICATIONS ( secondary )

A

treating bronchospasm caused by cold air, thick copious or bloody secretions, with expired tidal volume less than 70% of the delivered tidal volume, receiving in-line drugs etc….

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17
Q

HAZARDS AND COMPLICATIONS OF HUMIDIFICATIONS

A

potential electrical shock, potential for burns to caregivers, underhydration and mucous impaction

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18
Q

SIGNS AND SYMPTOMS OF INADEQUATE HUMIDIFICATION

A

atelectasis, dry nonproductive cough, increase airway resistance, increased work of breathing, patient complaint of substernal pain and airway dryness, thick dehydrated secretions

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19
Q

PRINCIPLES GOVERNING HUMIDIFIER FUNCTIONS

A

Temperature, surface area, contact time, thermal mass

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20
Q

BLAND AEROSOL THERAPY INDICATIONS

A

treat upper airway edema, overcome heat and humidity deficits in patients with tracheal airways, help obtain sputum specimens

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21
Q

AEROSOL

A

water particles suspended in air, particulate water in a gas, mist, fog

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22
Q

AEROSOL HAZARDS

A

adverse effect of aerosol drug therapy, infection, airway reactivity, Systemic effects of bland aerosols, Drug concentration changes during nebulization

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23
Q

FACTORS AFFECTING AEROSOL

A

Deposition
Inertia
Gravity
Diffusion

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24
Q

POSTURAL DRAINAGE INDICATIONS

A

mobilize accumulate secretions due to ( COPD, Dehydration, Acute pulmonary disease )
Prophylactically( history of pulmonary problems )

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25
Q

POSTURAL DRAINAGE CONTRAINDICATION

A

empysema, flail chest, wounds, spinal injuries, pneumothorax, head injuries, unstable cardiac status, COPD, obesity, pregnancy, recent meals or tube feeding, PE

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26
Q

HAZARDS CPT

A

hypoxemia, increase ICP, acute hypotension, pulmonary hemorrage, pain or injury to muscle, vomiting and aspiration, dysrhythmias

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27
Q

Right Upper Lobe

A

apical
anterior
posterior

28
Q

Right Middle Lobe

A

medial
lateral

29
Q

Right Lower Lobe

A

superior
anterior basal
lateral basal
posterior basal

30
Q

Left Upper Lobe

A

anterior
apical - posterior
superior lingula
inferior lingula

31
Q

Left Lower Lobe

A

superior
anterior medial
lateral basal
posterior basal

32
Q

PERCUSSION INDICATIONS

A

When difficult to mobilize secretions, when postural drainage alone may not be effective

33
Q

PERCUSSION CONTRAINDICATIONS

A

empysema, flail chest, wounds, frank hemoptysis, anticoagulant therapy, pain or patient intolerance, TB, metastasized cancer

34
Q

VIBRATIONS(used with percussion or alone) INDICATIONS

A

after each segment with percussion to move secretions in large airways, alone when percussion is not tolerated

35
Q

INDICATIONS FOR OXYGEN THERAPY

A

treat hypoxemia, decrease the work of breathing, decrease myocardial work

36
Q

HAZARDS OF OXYGEN THERAPY

A

oxygen toxicity, absorption atelectasis, oxygen induced hypoventilation, Retrolental Fibroplasia-RLF-ROP-retinopathy of prematurity

37
Q

INDICATIONS FOR LOW FLOW DEVICES

A

Patients Vt 300-700ml, Respiratory rate lower than 25 BPM, Consistent regular ventilator patterns

38
Q

FACTORS INFLUENCING FIO2

A

patients venilatory pattern, flow of gas, reservoir

39
Q

FIO2 IS

A

unpredictable
immeasurable
may vary from minute to minute

40
Q

LOW FLOW DEVICES

A

nasal cannula, nasal catheter, simple O2 mask, partial rebreather mask, non rebreather mask

41
Q

HIGH FLOW SYSTEMS

A

meets all patients demands for gas delivered, total system output must be at least 3 times patients minute volume, consistent predictable measurable FIO2

42
Q

USE OF ANALYZERS

A

to analyze high flow systems, patients may not receive FIO2 analyzed if flow is not adequate, used in measuring mechanical ventilation

43
Q

CALIBRATION

A

Greater than 60% - Calibrate last to 100%
Less than 60% - Calibrate last to 21%
Should be calibrated once per shift

44
Q

CALIBRATION Possible sources of error:

A

Weak batteries
Torn, wet, or leaky membranes
Positive pressure (PEEP or IPPB)
Altitude

45
Q

Avogadro’s Law

A

1 gram of any substance has 6.02 x 1023 known as a mole
1 mole of a gas at STP = 22.4 Liters

46
Q

PRESSURE

A

PB = Barometric Pressure
760 mmhg
14.7 PSI
1034 cmH2O

47
Q

Water vapor (or humidity) exerts pressure

A

PH2O at 100% humidity at body temperature = 47 mmhg

48
Q

Dalton’s Law

A

Individual partial pressures = Total
Pb = PN2 + PO2 + P trace gases

49
Q

Concentrations of Gases in the Air

A

Oxygen 20.95%
Nitrogen 78.08%
Argon 0.93%
Carbon Dioxide 0.03%
Trace Gases 0.01%

50
Q

Ideal Gas Law

A

If mass is constant then

      P1V1 = P2 V2
        T1         T2
51
Q

Boyle’s Law

A

If temperature and mass are constant, volume and pressure are inversely proportional.

P1V1 = P2 V2

52
Q

Charles’ Law

A

If pressure and mass are constant, temperature and volume are directly proportional.

V1 = V2
T1 T2

53
Q

Gay-Lussac’s Law

A

If volume and mass remain constant, pressure and temperature are directly proportional.

P1 = P2
T1 T2

54
Q

Tank duration

A

Tank Pressure x tank Factor/Liter Flow= min
Tank Factors:
E Cylinder = 0.28
G Cylinder = 2.41
H Cylinder = 3.14
EX: E cylinder has 2200 PSI and your pt. is on 5L NC. How long will this cylinder last.
Always round down
To determine hour divide min/60

55
Q

Cylinder testing

A

every 5- 10 years
water displacement measured to check for expansion with 5/3 maximum pressure

56
Q

Henry and Graham Law

A

Henry Law
(0.003 x PaO2)
Graham Law
(1.34 x Hgb x SaO2)
Total O2 Content
CaO2 = (0.003xPaO2) + ( 1.34 x Hgb x SaO2)

57
Q

Oxygen Carried Two Ways

A

Dissolved
Combined with hemoglobin

58
Q

Hypoxemia

A

Deficiency of oxygen in the arterial blood.

Causes of Hypoxemia:

Decreased alveolar oxygen tension:

Alveolar air equation, Intrapulmonary shunting

59
Q

Responses to Hypoxemia

A

Increased ventilation

Increased cardiac output

60
Q

Hypoxia

A

Decreased oxygen to the tissues.

61
Q

Hypoxia TYPES

A

Hypoxemic Hypoxia or Ambient Hypoxia
Anemic Hypoxia or Hemic
Stagnant Hypoxia or Circulatory Hypoxia
Histotoxic Hypoxia

62
Q

CO2 IS TRANSPORTED IN THE BLOOD BY

A

dissolved gas, (2) bicarbonate, and (3) carbaminohemoglobin bound to hemoglobin

63
Q

Ventilation

A

air movement in and out of the lungs to allow external respiration to occur.

64
Q

Respiration

A

gas exchange across a permeable cellular membrane

65
Q

External respiration

A

gas exchange between alveolar gas (AIR) and capillaries (BLOOD)

66
Q

Internal respiration

A

gas exchange between capillaries and the tissues.

67
Q

Normal Ventilation Pressures

A

Inspiration
Intrapleural= (-9 cmH2O)
Intrapulmonary= (-3 cmH2O)

Expiration-
Intrapleural= (-5cmH2O)
Intrapulmonary= (+3 cmH2O)

Respiratory Therapy student 210-230 (2 decks)

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