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Intro to Respiratory Therapy > Test 4 Study Guide > Flashcards

Test 4 Study Guide Flashcards

1
Q

Goals of Humidity Therapy

A

To provide adequate heat and humidity.
* To treat hypothermia.
* To prevent reactive airway response to cold air.
* To aid removal of thick secretions

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2
Q

For premature and newborn infants, a ____ ______ environment should be
maintained.

A

Neutral Thermal

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3
Q

the point at which inspired gas
reaches body temperature and humidity

A

isothermic saturation boundary (ISB)

5 cm below the carina
* 44 mg/L at 37˚C

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4
Q

Breathing ____ _____ moves the ISB deeper into the respiratory tract.

A

Dry gas

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5
Q

During exhalation, heat is transferred from exhaled gas to the ____ and ____
mucosa by convection

A

Trachea and Nasal

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6
Q

____ is a poor conductor of heat, the mouth is less efficient than the nose at
heating inspired air.

A

Air

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7
Q

Humidiers that add water or heat or both to the inspired gas.

A

Active Humidifier

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8
Q

Types of active humidifiers:

A
  • Cool passover humidifier
  • Heated passover humidifier
  • Bubble humidifier
  • Jet nebulizer
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9
Q

Can be used with intubated patients.
* Flows 10 to 120 L/min.
* Risk of bacterial transmission from
humidifier reservoir to patient .

A

Heated Bubble Humidifier

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10
Q

Types of active humidifiers:

A
  • Cool passover humidifier
  • Heated passover humidifier
  • Bubble humidifier
  • Jet nebulizer
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11
Q

Can be used with intubated patients.
* Flows 10 to 120 L/min.
* Risk of bacterial transmission from
humidifier reservoir to patient .

A

Heated Bubble Humidifier

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12
Q

Humidifier used that captures exhaled heat and moisture and transfers part of heat and humidity back to patient with each breath.

A
  • Passive humidifiers
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13
Q

Types of passive humidifiers

A

Heat moisture exchangers (HME)/artificial nose

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14
Q

What to consider when choosing humidifier therapy

A
  1. Source, temperature, humidity the patient is breathing.
  2. Point of entry of airway
  3. rate of inspiratory flow or minute volume
  4. normal or diseased lungs?
  5. increased, thick secretions or a humidity deficit?
  6. Are special needs imposed by dead space or the patient’s size, age, ability to
    tolerate administration, or sensitivity to changes in the work of breathing?
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15
Q

Used to administer pentamidine for Antifungal or Pneumocystis jiroveci (carinii).

A

Respirgard nebulizer

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16
Q

Primary indications for aerosol therapy (humidification)

A
  • Tracheostomy.
  • Upper airway inflammation;
  • Cool mist for local vasoconstriction.
  • Prevent occlusions of airway stents.
  • Induce sputum for diagnostic purposes.
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17
Q

a simple open-ended tube or bag that provides space for the pMDI
plume to expand by allowing the propellant to evaporate.

A

Spacer

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18
Q

allows the plume from the pMDI to expand and incorporates a one-way valve that permits the aerosol to be drawn from the
chamber during inhalation only.

A

Valved holding chamber

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19
Q

Purpose of spacers and valve holding chambers

A

Reduce oropharyngeal deposition of drugs.
* Ameliorate the bad taste of some medications.
* Eliminate the cold Freon effect.
* Reduce the need for hand-breath coordination; (valved holding chamber)

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20
Q

Hazards associated with HME use

A

Impaction of pulmonary secretions.
* Higher resistive work of breathing.
* Mucus plugging.
* Hypercapnia.
* Hypothermia.

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21
Q

What is an HME?

A

Heat Moisture Exchanger

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22
Q

Free floating bacteria

A

planktonic

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23
Q

Bacteria that are capable of forming complex and stable aggregate communities

A

Bacterial mats and Biofilms.

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24
Q

What can biofilms attach to?

A

Biofilms attach to any surface, liquid or solid.

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25
Q

Biofilms are ____ times more resistant to antibiotics than free-floating bacteria.

A

100 x

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26
Q

2 ways that toxins are formed

A

Endotoxins and Exotoxins

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27
Q

Integral part of cell walls of gramnegative bacteria.
* Released with cellular lysis or death.
* Moderately toxic.
* Heat tolerant.

A

Endotoxins

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28
Q

Excreted by gram-positive bacteria or
gram-negative bacteria.
* Secreted or released following lysis.
* Highly toxic, fatal in large quantities.
* Inactivated at high temperatures.

A

Exotoxins

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29
Q

How does bacteria cause disease?

A
  1. Toxin formation
  2. Direct damage
  3. Inflammatory response
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30
Q

Deplete host tissue nutrients.
Produce substances that cause tissue damage and spread bacteria.

A

Direct damage

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31
Q

2 substances that cause tissue damage and spread bacteria

A

Collagenase and hyaluronidase (Strep-pyogenes);

Panton-Valentine leucocidin toxin (MRSA);

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32
Q

What does Strep-pyogenes do to cause tissue damage and spread bacteria?

A

Digest intracellular matrix.

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33
Q

What does MRSA do to cause tissue damage and spread bacteria?

A

Tissue necrosis, abscess formation, high mortality.

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34
Q

Signs of inflammatory response to a bacteria

A

Fever
 Hypotension
 Muscle aches
 Malaise/loss of appetite
 Confusion
 Temporary liver and heart dysfunction

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35
Q

Bacteria that requires oxygen for survival.

A

Aerobe

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36
Q

Examples of aerobe bacteria

A

 Pseudomonas aeruginosa (water, soil, leaves and plants

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37
Q

Bacteria that requires the absence of oxygen

A

Anaerobe

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38
Q

Examples of anaerobe bacteria

A

Clostridium (GI tract, soil).

39
Q

Bacteria that has limited oxygen tolerance

A

facultative anaerobe

40
Q

Examples of facultative anaerobe bacteria

A

Escherichia coli (GI tract, animals).

41
Q

Detects the presence of an immune response to mycobacteria by eliciting a
delayed-type hypersensitive response.

A

PPD or tuberculin skin
test

42
Q

Positive TB test = induration of ___ to __ mm in diameter.

A

5 to 15 mm

43
Q

Represents positive exposure in past, not necessarily active infection.
Once converted most patients are positive indefinitely.

A

Positive PPD/TB test

44
Q

A PPD/TB test manifests within ____ hours

A

72

45
Q

Patients that fail to demonstrate immune response even after exposure to TB

A

Anergic

46
Q

With the exception of prions, ____ are the smallest and simplest class
of pathogens.

A

Viruses

47
Q

Viruses are ____ X smaller than bacteria

A

100 times

48
Q

Size range of viruses

A

0.02 to 0.3 microns.

49
Q

_____ are infectious agents that are unable to grow or reproduce
outside a host cell.

A

Viruses

50
Q

Viruses produce clinical disease when:

A
  1. Host cell ruptures and death.
  2. Host cell dysfunctions (including fusion with other cells)
  3. Malignant transformation (cancer)
  4. Stimulating the body’s cellular host defenses against infection
51
Q

systemic symptoms associated with viral infection

A

Loss of appetite, fever, malaise, increased mucus production.

52
Q

a plant or animal that lives with or on another, deriving benefit from the
association but having a detrimental effect on the host.

A

Parasite

53
Q

Parasite that lives inside host

A
  • Endoparasites:
54
Q

Parasites that live on the hosts surface.

A
  • Ectoparasites
55
Q

A sputum collection technique designed to bypass the upper airway, with its potential contaminants.

A

Transtracheal aspiration (TTA)

56
Q

A Transtracheal aspiration (TTA) is Obtained with a sterile needle directly
inserted into the trachea through the
_____ membrane.

A

cricothyroid

57
Q

Examples of direct contact viruses

A

Influenza, HIV, Ebola

58
Q

Examples of indirect contact viruses

A

Staph, Hep B and C, HIV, Pseudomonas Aeruginosa

59
Q

Examples of droplet viruses

A

Rhinovirus, SARS, Rubella

60
Q

3 types of contact transmission

A
  1. Direct
  2. Indirect
  3. Droplets
61
Q

3 types of noncontact transmission

A
  1. Airborne
  2. Vehicle
  3. Vector-borne
62
Q

Examples of airborne viruses

A

Legionellosis, TB, and varicella

63
Q

Examples of vehicle viruses

A

Cholera (waterborne), Salmonella and hep (foodborne)

64
Q

Examples of vector-borne viruses

A

Rickettsia and Lyme disease (ticks), Malaria (mosquitos)

65
Q

Common opportunistic infection during first decade of AIDS.
* Causes PCP pneumonia.

A

Pneumocystis jiroveci (carinii)

66
Q

Common in patients with weakened immune systems, such as AIDS patients.
 Transplant patients.
 Medium to high dose corticosteroids.
 Severe malnutrition (children and elderly).

A

Pneumocystis jiroveci (carinii)

67
Q

These procedures decrease the spread of infection.

A

Infection control

68
Q

Strategies for infection control

A

Protective equipment
* Safety training
* Immunization of healthcare providers:

69
Q

Immunizations for healthcare providers

A

Hepatitis A and B.
* Immunity against varicella, rubella, and measles.
* Annual influenza vaccinations.
* Employees should not report to work if they have a potentially infectious condition.

70
Q

____ _____ remains the most important infection control measure.

A

Hand hygiene

71
Q

Appropriate hand hygiene

A

Washing with soap and water for 20 seconds.
* The use of alcohol-based gels, foams, or rubs.

72
Q

used to prevent the
transmission of infectious agents that are spread by
direct contact.

A

Contact precautions

73
Q

Patient is placed in single patient room to protect the patient and patient environment. Providers wear gloves and gowns.

A

Contact precautions

74
Q

Infections are transmitted during patient care primarily through:

A

human contact or inanimate surfaces.

75
Q

For transmission of infectious agents three conditions are necessary:

A

A source of infection.
* A susceptible host with a portal of entry receptive to the agent.
* A mode of transmission for the agent.

76
Q

Levels of equipment processing

A
  1. Critical
  2. Semi-critical
  3. Non-critical
77
Q

Must be sterile.
* No viable (living) organisms.
* Chest tubes

A

Critical processing

78
Q

Must be disinfected.
* Few organisms remaining, with spores and
non-lipid viruses possibly remaining viable.
* Ventilator expiratory cassette.

A

Semi-critical processing

79
Q

Must be clean
* Grossly appreciable organic matter (dirt)
removed.
* Touches only intact skin;
* Pulse oximeter
* Stethoscope
* Blood pressure cuf

A

Non-critical processing

80
Q

Is the complete destruction of all microorganisms, including spores.
Sterilization prevents the transmission of diseases.

A

Sterilization

81
Q

2 types of sterilization

A

Physical and Chemical

82
Q

Sterilization involving Steam (autoclaving) and Radiation

A

Physical sterilization

83
Q

Sterilization involving Ethylene oxide
* Hydrogen peroxide gas
plasma
* Peracetic acid sterilization

A

Chemical sterilization

84
Q

A quantity of sterile saline is drawn through the lumen of the equipment to
be tested, after which the saline is cultured.

A

Aspiration

85
Q
  • Irregular surfaces that are not easily rolled onto an agar plate may be rubbed
    with a sterile swab coated with culture medium.
  • The swab may then be used to inoculate a agar plate.
A

Swabbing

86
Q

2 Equipment Surveillance Methods

A

Aspiration and swabbing

87
Q

Occurs when microorganisms are
transmitted via contaminated:
* Food
* Water
* Medications
* Equipment

A

Vehicle transmission

88
Q

used to prevent the
transmission of infectious agents over a long
distance when suspended in the air.

A

Airborne precautions

89
Q

Precautions where patient must be placed in single patient negative-pressure
room.

A

Airborne precautions

90
Q

Examples of pathogens causing airborne precautions

A

Tuberculosis
* Ebola
* Measles
* Smallpox

91
Q

Spherical gram-positive coccus.
* Turns gold on blood agar.

A

Staphylococcus aureus

92
Q

Virus that is Methicillin antibiotic (MRSA) resistant
(Patnon-Valentine Leukocidin toxin).

A

Staphylococcus aureus

93
Q

Causes of staphylococcus aureus

A

Clot formation
 Minor skin infections
 Pneumonia
 Meningitis
 Toxic shock syndrome
 Severe necrotizing pneumonia in children

Intro to Respiratory Therapy (5 decks)

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