therapeutic procedures Flashcards
tic
1
Q
ideal breathing is what?
A
slow and deep inspiration, inspiration pause, then slow passive exhalation
2
Q
proper breathing position for CHF patient
A
fowlers
3
Q
proper breathing position for ARDS
A
prone
4
Q
proper breathing position for obsese pt
A
lateral fowlers
5
Q
“good lung down” is the position for what?
A
unilateral lung disease
6
Q
a technique that aims to improve function of resp muscles through specific exercise
A
inspiratory muscle training
7
Q
a technique to treat and prevent atelectasis
A
IS
8
Q
how often is IS performed?
A
10 times per hour if pt is awake
9
Q
a treatment modality to treat or prevent atelectasis for pt who is unable to take deep breaths
A
IPPB
10
Q
prevents or decreases pulmonary edema in COPD pt
A
IPPB
11
Q
most common IPPB machine used that is pneumatically powered and pressure cycled
A
Bird mark 7
12
Q
with IPPB you would increase what to increase the volume?
A
pressure
*pressure and volume are directly related
13
Q
with IPPB if you decrease the flow what will happen with the volume?
A
increase the volume
*volume and flow are inversely related
14
Q
with IPPB if you decrease the flow the i time ____?
A
i time increases
15
Q
with IPPB if you increase the flow the i time will ___
A
i time will decrease
16
Q
if their is a leak in the IPPB machine what will happen to the cycle off?
A
it will not cycle off
17
Q
if theirs a leak in the IPPB around the mouthpiece how can you improve it??
A
use a bennet seal
18
Q
if you increase the pressure will this give you a smaller or bigger VT?
A
bigger
19
Q
if a patient needs a faster breath on IPPB what should you do to the flow?
A
increase the flow
20
Q
improves and supports oxygenation at lower fio2
A
CPAP
21
Q
CPAP is used when the patients Co2 level is normal but hypoxemia is presented. if cpap doesnt improve hypoxemia what should you do?
A
mechanical ventilation
22
Q
bronchial hygiene is used with what 2 types of patients?
A
cystic fibrosis and bronchiastasis
23
Q
the purpose of this is to mechanically dislodge secretions often combined with postural drainage
A
chest percussion
24
Q
contradiction of chest percussions
A
pneumothorax
25
move the secretions into the large airways
vibrations
26
method to remove secretions involving a deep breath followed by a forced exhalation
coughing techniques
27
type of coughing technique that opens glottis
hough cough
28
type of coughing technique that prevents increased ICP
hough cough
29
common in post op patients to press a pillow over incision area to enhance a better cough
splinting
30
type of cough that the RT applies pressure to the its abdomen during exhalation
quad cough
31
face down position
prone
32
on your back position
supine
33
best position for hypoxic dyspean and post op pt
fowlers
34
position for pt with low BP
trendelenburg
35
position for obese pt
lateral fowlers
36
best position to prevent aspiration
lateral flat
37
if a patient aspirates what do you do before placing them in the opposite position for postural drainage
suction before moving patient to another position
38
type of drainage that utilizes controlled expiratory airflow to mobilize secretions
autogenic drainage
39
external percussive device or "the vest" is used for what types of patients that can't tolerate any other forms of bronchial hygiene
cystic fibrosis
40
type of percussive ventilation that allows aerosol to help past the obstruction into distal airways
intrapulmonary percussive ventilation (IPV)
41
type of humidity used to compensate for a humidity deficit and prevent mucosal crusting
humidity therapy
42
if a proper humidity of ____ is not obtained then secretions will become very thick and more difficult to manage
44mg/ L or 47mmhg
43
type of humidifier used for only low flow devices
bubble humidifier
44
to check a bubble humidifier for proper functioning you should pinch the tubing and hear what?
whistling sound
45
if a bubble humidifier is whistling without tubing being pinched this indicates what?
flow is set too high
46
type of system that can heat and humidify oxygen up to 40L/min and provides 100% body humidity
membrane cartridge system
47
HME is located between ___ and the patient
y piece
48
type of humidifier that can deliver 100% body humidity
heated wick
49
HME may become obstructed, which will cause an increase in peak pressure. If this occurs then you should replace it with what?
heated wick humidifier
50
type of circuit used in tandem with a humidification system to minimize amount of condensation in the circuit
heated wire circuit
51
type of neb to deliver small dosages of meds
SVN
52
how do you instruct pt to use a SVN
have them breathe normally followed by a 1-3 second hold
53
meds given in a SVN
short acting, anticholingeric, corticosteroid, mucolytic, antibiotic
54
used to deliver bland aerosols to the upper airways
LVN
55
if their is condensation in tubing connected to LVN this will cause what to increase?
Fio2
56
designed to specifically to administer RIbavirin (virazole) to treat RSV
SPAG
57
recommended for its with thick secretions because it has the highest output range of all the nebulizers without heat
ultrasonic nebulizer
58
an electrically powered nebulize which produces the smallest aerosol so pt will actually receive more of the medication compared to an SVN
vibrating mesh nebulizer
59
if a nebulizer system has water condensation in the tubing what will increase?
inspired oxygen percentage
60
what causes the condensation in tubing to increase the inspired oxygen percentage?
the back pressure of the jet and air entrainment ports prevent room air from being drained from the system
61
type of inhaler primarily used to treat asthma and COPD
MDI
62
steps of administering a MDI
1) take cap off and shake
2) prime inhaler by spraying one puff into the room
3) have pt breathe out completely
4) hold MDI 1-2 inches away from mouth
5) start slow inhalation with deep breath
6) hold 10 seconds the exhale normal
**wait 1 minute to take next dose if you're taking a quick relief med
63
meds given through an MDI1
1) short acting (albuterol, levalburterol)
2) long acting (salmeterol, fomerotol)
3) anticholingeric (ipatropium bromide, tiotropium bromide)
4) corticosteroid (fluticason, budesonide)
5) mast cell stabilizer (cromlyn sodium, nedocromil sodium)
64
if at the patient is having hand eye coordination issues when administering an MDI, what should they use?
spacer or holding chamber
65
similar to an MDI except much easier to use and medicine is in powder form
DPI
66
steps to administering a DPI
1) have pt exhale completely
2) place inhaler to your lips and inhale RAPIDLY
3) exhale normally
**do not exhale back into inhaler
67
meds given through DPI
long acting & steroids
68
for really thick secretions always use what neb?
ultrasonic neb
69
if a pt starts hyperventilation during an SVN treatment and pt becomes dizzy lightheaded or tingling in the fingers what should you instruct patient to do?
have them take breath more slowly rather than more deeply
70
proper fio2 range for COPD, therapeutic, and Emergency situations
COPD=24-28%
therapeutic=30-60%
Emergency= always 100%
71
oxygen device where only a portion of the total inspired volume is delivered
low flow oxygen devices
72
types of low flow oxygen devices
nasal cannula, simple mask, partial rebreather
73
how much fio2 does a nasal cannula provide and at what Liter flows?
24-45% at 1-6L
74
how much fio2 does a simple mask deliver and at what liter flows?
40-55% at 6-10L
75
how much fio2 does a partial rebreather mask deliver and at what liter flows?
60-65% at 6-10L
76
To estimate Fio2, increase by how many % for every L
4%
77
this mask has no one way valve
partial rebreather
78
provides pt with the entire inspired volume
high flow devices
79
how much fio2 does a nonrebreather deliver?
21-100%
80
oxygen device used to emergencies to deliver 100% oxygen
non-rebreather
**has 3 valves
81
if the reservoir bag collapses during inspiration what do you do to correct the issue?
increase the flow
82
oxygen device that delivers precise fio2 and is the ideal choice for the patient with irregular VT, rate, or pattern
venturi mask or air entrainment mask
83
how much fio2 is delivers with a t-piece or briggs adaptor
21-100% depending on the aerosol source
84
the purpose of this is to maintain the desired fio2
reservoir bag
85
if the reservoir bag is removed what will happen to the fio2?
it will decrease due to the entrained room air
86
if aerosol decreases what do you do?
increase the flow
87
what 3 makes deliver 21-100% fio2 depending on the aerosol source and nebulizer output
aerosal mask, trach collar, face tent
88
a clear plastic device that fits over the head of an infant or small child for administration of oxygen and humidity
oxyhood
89
what are the flow ranges for an oxyhood
7-14L
*to prevent co2 buildup and maintain the proper fio2 without feeling the patients neck around the hood
90
provides controlled temps, humidity, and oxygen levels for a premature baby
incubator or isolette
91
these are ideal for unstable newborns who require constant care. they provide neutrothermal environments but will not decrease the insensible water loss that occurs due to evaporation in premature infants
radiant warmer
92
helps attach the flowmeter to the cylinder.
regulator
93
an instrument used to measure for of oxygen
flowmeter
94
calculate the duration of the cylinder
gauge pressure x factor / liter flow
ex) 2200 x 0.3 / 5
95
used to control the mixing of oxygen and air in order to get a specific fio2
blender
96
is able to provide a compressed gas source without using a cylinder
compressor
97
always choose what type of flowmeter?
back pressure compensated flowmeter
***DO NOT PICK THIS DURING TRANSPORTS***
98
what types of flowmeter are used during transports?
burden gauge
99
for sputum to be cultured it must come from where?
lower respiratory tract
*can not be saliva*
