Test 4 Study Guide Flashcards
Goals of Humidity Therapy
To provide adequate heat and humidity.
* To treat hypothermia.
* To prevent reactive airway response to cold air.
* To aid removal of thick secretions
For premature and newborn infants, a ____ ______ environment should be
maintained.
Neutral Thermal
the point at which inspired gas
reaches body temperature and humidity
isothermic saturation boundary (ISB)
5 cm below the carina
* 44 mg/L at 37˚C
Breathing ____ _____ moves the ISB deeper into the respiratory tract.
Dry gas
During exhalation, heat is transferred from exhaled gas to the ____ and ____
mucosa by convection
Trachea and Nasal
____ is a poor conductor of heat, the mouth is less efficient than the nose at
heating inspired air.
Air
Humidiers that add water or heat or both to the inspired gas.
Active Humidifier
Types of active humidifiers:
- Cool passover humidifier
- Heated passover humidifier
- Bubble humidifier
- Jet nebulizer
Can be used with intubated patients.
* Flows 10 to 120 L/min.
* Risk of bacterial transmission from
humidifier reservoir to patient .
Heated Bubble Humidifier
Types of active humidifiers:
- Cool passover humidifier
- Heated passover humidifier
- Bubble humidifier
- Jet nebulizer
Can be used with intubated patients.
* Flows 10 to 120 L/min.
* Risk of bacterial transmission from
humidifier reservoir to patient .
Heated Bubble Humidifier
Humidifier used that captures exhaled heat and moisture and transfers part of heat and humidity back to patient with each breath.
- Passive humidifiers
Types of passive humidifiers
Heat moisture exchangers (HME)/artificial nose
What to consider when choosing humidifier therapy
- Source, temperature, humidity the patient is breathing.
- Point of entry of airway
- rate of inspiratory flow or minute volume
- normal or diseased lungs?
- increased, thick secretions or a humidity deficit?
- 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?
Used to administer pentamidine for Antifungal or Pneumocystis jiroveci (carinii).
Respirgard nebulizer
Primary indications for aerosol therapy (humidification)
- Tracheostomy.
- Upper airway inflammation;
- Cool mist for local vasoconstriction.
- Prevent occlusions of airway stents.
- Induce sputum for diagnostic purposes.
a simple open-ended tube or bag that provides space for the pMDI
plume to expand by allowing the propellant to evaporate.
Spacer
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.
Valved holding chamber
Purpose of spacers and valve holding chambers
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)
Hazards associated with HME use
Impaction of pulmonary secretions.
* Higher resistive work of breathing.
* Mucus plugging.
* Hypercapnia.
* Hypothermia.
What is an HME?
Heat Moisture Exchanger
Free floating bacteria
planktonic
Bacteria that are capable of forming complex and stable aggregate communities
Bacterial mats and Biofilms.
What can biofilms attach to?
Biofilms attach to any surface, liquid or solid.