Special Procedures and General Patient Care

Question 1

Inhaled Nitric Oxide Indications

Answer 1

Primary pulmonary hypertension
Refractory hypoxemia related to increased PAP
Increased PVR
Right heart failure/Cor pulmonale

Question 2

Dosage of iNO

Answer 2

20-40 ppm

Shouldn’t exceed 80 ppm

Question 3

iNO Side Effects

Answer 3

Methemoglobin increase
NO2 levels increase, toxic at > 10 ppm
Rebound pulmonary hypertension - occurs when iNO discontinued too rapidly

Question 4

Thoracentesis

Answer 4

Pleural Effusions

Question 5

Transudate Fluid indicates

Answer 5

CHF

Question 6

Sleep Apnea

Answer 6

Patient goes apneic during sleep for 10 secs or more

Question 7

Central Sleep Apnea

Answer 7

Apnea due to loss of ventilation effort

Question 8

Obstructive Sleep Apnea

Answer 8

apnea due to blockage of the upper airway

Question 9

Apnea Hypopnea Index (AHI)

Answer 9

of apneas and hypopnea / hrs of sleep

Mild: 5-15
Moderate: 16-30
Severe: >30

Question 10

Chest Tube Placement for Pneumothorax

Answer 10

2nd ICS in the midclavicular line

Question 11

Chest Tube Placement for Pleural Effusion

Answer 11

5th-7th ICS in the midaxillary line

Question 12

Water Seal Bottle during Pneumothorax

Answer 12

Patient breathing spontaneously: bubbling during expiration

Patient on vent: bubbling during inspiration

Continuous bubbling = leak

Question 13

Cardioversion

Answer 13

Administering a low voltage current to the heart in an attempt to convert a cardia dysrhythmia to normal sinus rhythm

Electric shock delivered on the R wave

Question 14

Respiratory Quotient

Answer 14

VCO2 / VO2
Normal 0.8

> 1.1 = overfeeding
< 0.7 = underfeeding

Question 15

Nicotine Addiction Treatment

Answer 15

Varenicline (Chantix)

Question 16

Ethylene Oxide Sterilization

Answer 16

Sterilizes equipment by alkylation of emzymes

Bird Mark VII, flowmeters, etc

Question 17

Alkaline Glutaraldehyde

Answer 17

Disinfection or sterilization process

Reusable plastics - mouthpieces, tubing, nebulizers, humidifiers

Sterilizing flexible fiberoptic bronchoscopes

Question 18

Bleach

Answer 18

Disinfection process, most appropriate for surface disinfection, used to clean blood spills

Question 19

Pulse-Dose O2 Delivery Systems

Answer 19

Device sense the start of inspiration and deliver O2 only during inspiration