In the event a PT is unable to make medical decisions for himself, a health care agent would be assigned according to aDurable Power of Attorney for Health Care
A PT > Chronic Hypercapnia in ED complaining of increased shortness of breath and pleuritic on inspiration. PT placed on 40% Venturi mask + Chest Xray. RT is preparing the PT for transport the PT is somnolent and cool to touch. RT shouldReduce the Oxygen Percentage
A PT with allergic asthma would most likely show an increase inEOSINOPHILS
Several tests are conducted on a PT qualifying for a Pulmonary Rehabilitation program. His activities of daily living scale is a 6 and dyspnea grade is a 5. The physician should be informed that the PT.Qualifies for rehab with assistance
A 17-year-old male PT has recently learned he has a life threatening illness. The RT attempts to instruct the PT to perform medicated nebulizer therapy but the PT does not seem to grasp the concept. His ability to learn is most likely compromised byDesire to learn
Which of the following be considered signs of congestive heart failure?Pitting Edema Venous Distention
Metabolic acidosis can be associated withHYPERKALEMIA
During the radiographic assessment, the RT observes increased hyperlucency on one side vascular markings are not visible and the PT trachea and mediastinum have moved away from the affected side. The medical resident asks the RT to interpret the findings.Pneumothrax
A PT is in the ICU after undergoing myocardial catheterization and valve replacement surgery. A pulmonary artery catheter has been inserted and the RT is asked to assess proper catheter placement.Where should the catheter appear on a chest radiograph?In the right lower lung field
Pulmonary embolism is evident on a ventilation/perfusion scan byAbnormal blood flow
While chest physiotherapy is performed the PT begins to expectorate bright red blood. the RT should immediatelyPlace the PT in reverse Trendelenburg position
During bedside assessment of a PT, the ECG shows a waveform with completely irregular rhythm with no discernable rate count. The RT should quickly assess the PT forA PULSE
Digitalis toxicity will result in what changes on a 12 lead ECG tracing?Inverted T waves
Bradycardia Heart rate < 60
The best way to assess the level of methemoglobin present during nitric oxide therapy is toMeasure a blood sample via co-oximetry
Which of the following is considered a common complication of transcutaneous monitoring resulting electrode temperature?Erythema
A PT cardiac index is determined to be 1.8 L/min/m2. This would also indicate that theCv02 is reduced
What is NORMAL RANGE for a PTs HEART RATE?60-100/min
What term would be used to describe a HEART RATE of 120/min? What would this indicate?Tachycardia >100 Indicates Hypoxemia, Anxiety, Stress
What term would be used to describe a pulse of 47/min? What would this indicate?Bradycardia <60 Indicates Heart Failure, Shock, Code/Emergency
What does paradoxical pulse/pulsus paradoxus indicate?Pulse/Blood Pressure Varies with Respiration. May indicate Severe Air Trapping (Status Asthmaticus or Cardiac Tamponade)
Causes of tracheal deviation Pulled to ABNORMAL side TOWARD PATHOLOGYPulmonary Atelectasis, Pulmonary Fibrosis, Pneumonectomy, Diaphragmatic Paralysis
Causes of tracheal deviation Pulled to NORMAL side TOWARD PATHOLOGYMassive Pleural Effusion, Tension Pneumothorax, Neck or Thyroid Tumors, Large Mediastinal Mass
What is tactile fremitus?Vibrations that are felt by the hand on the chest wall
What is meant by tenderness?PT Skin may be tender around sutures, Chest Tubes, Bruises, Fractured Bones and Burns; Avoid Areas of Tenderness if possible
What is meant by crepitus and what condition is it associated with?Bubbles of Air Under the Skin that can be Palpated and Indicates the Presence of Subcutaneous Emphysema
Describe the normal appearance of each of the following structures on a chest x-ray HEMIDIAPHRAGMSAre Rounded (Dome-Shaped)
Describe the normal appearance of each of the following structures on a chest x-ray TRACHEAis Midline, Bilateral Radiolucency, with Sharp Costophrenic Angles
Describe the normal appearance of each of the following structures on a chest x-ray CLAVICLESHead of ClAVICLES Should Be Level
List THREE possible causes for LOSS OF AIRWAY PATENCYForeign Body Obstruction, Edema as Seen with Croup, Epiglottitis or Allergic Reactions, Tracheal Spasms, Internal or External Compression, Trauma Leading to Air leak
What condition causes OBLITERATION of the COSTOPHRENIC ANGLES?Angle made by the outer curve of the diaphragm and chest wall. These angles are Obliterated by Pleural Effusions
In what pathology is the diaphragm flattened?Flattened with COPD, Left or Right Hemidiaphragms may shift downward with a pneumothorax; appearing Flattened on one side
Describe each of the following positions used for chest x-rays LATERAL POSITIONProjection from either the right or left side, Adds a third dimension to structures viewed on AP or PA films
Describe each of the following positions used for chest x-rays LATERAL DECUBITUSPT Lying on the Affected Side, Valuable for Detecting Small Pleural Effusions
Where should the tip of the endotracheal tube be positioned when viewed on a chest roentgenogram?Should be Positioned below the Vocal Cords and no Closer Than 2cm or 1 in above the Carina. Approximately at the same level of the aortic Knob or Aortic Arch
What is the quickest way to determine adequate Ventation following endotracheal intubation?Observation and Auscultation
Describe where each of the following should be located when positioned properly CHEST TUBEShould be Located in the Pleural Space Surrounding the Lung
Describe where each of the following should be located when positioned properly NASOGASTRIC and FEEDING TUBEShould be Positioned in the Stomach 2-5cm below the Diaphragm
Describe where each of the following should be located when positioned properly PULMONARY ARTERY CATHETERShould Appear in the Right Lower Lung Field
Describe where each of the following should be located when positioned properly PACEMAKERShould be Normally Positioned in the Right Ventricle
Describe where each of the following should be located when positioned properly CENTRAL VENOUS CATHETERAre Placed in the Right or Left Subclavian or Jugular Vein and Should Rest in the Vena Cava or Right Atrium of the Heart
What diagnostic test is appropriate for determining an upper airway obstruction in a child?A Lateral Neck X-Ray (croup and epiglottis)
Briefly, describe each of the following condition CROUPA Viral Disorder Common in Infants and Young Children, X-ray will reveal Tracheal Narrowing with Subglottic Swelling in a Classic Pattern called; Steeple Sign, Picket Fence Sign, Pencil Point Sign
Briefly, describe each of the following condition EPIGLOTTISA Potentially Life-Threating Inflammation of the Supraglottic Airway caused by a Bacterial Infection, Lateral Neck X-ray Shows Supraglottic Narrowing with an Enlarged and Flattened Epiglottis and Swollen Aryepiglottic Folds
Describe the normal appearance of each of the following structures on a chest x-ray RIGHT HEMIDIAPHRAGMSSlightly Higher than the Left, is at the level of the Sixth Anterior Rib
Describe a CT ScanAn X-ray through a specific plane of the body part to be examined. Images as narrow slices of the organ or body part
With What Pathologies Would a CT be indicated?Useful in detecting the presence of a Mediastinal Mass, Pleural and Parenchymal Masses and Pulmonary Nodules and Lesions not Visualized on a Chest X-Ray
What is Special type of CT Scan indicated to diagnose a Pulmonary Embolus?A spiral CT scan with contrast dye may be used
What is the advantage of using MRI over a conventional X-ray?Magnetic Resonance Imaging is used to obtain Two-Dimensional Views of an organ or structure without the use of radiation
What type of Ventilators are used with MRI and why?Fluidic(non-electric, gas powered)Ventilators are used for PT requiring Mechanical Ventilation because the magnetic fields would disrupt electronic devices
Describe how this test is performed Pulmonary Ventilation/Perfusion Scans (V/Q Scan)Radioisotope(xenon gas) is inhaled and the location of the gas is recorded producing a photographic pattern of distribution throughout the lungs
What is indicated by normal Ventilation with Abnormal PerfusionPulmonary Emboli
What are three indications for a barium test?abnormalities in the Hypopharynx, Esophagus or Stomach
What is the main indication for a bronchoscopy?to clear the airways
What does a CBC(Complete blood count)measure?Complete blood count measurement of all major ingredients of the blood
RBC(Red Blood Cells)DescriptionContain hemoglobin necessary for oxygen transport
RBC(Red Blood Cells) Normal Value/Range4-6 mil/mm3
RBC(Red Blood Cells) Significance of Low ValuesAnemia= occurs with blood loss, hemorrhage
RBC(Red Blood Cells) Significance of High ValuesPolcythemia= occurs with chronic tissue hypoxemia (i.e. COPD)
Hb(Hemoglobin)DescriptionCarries oxygen (1.34 ml per gram Hb)
Hb(Hemoglobin) Normal Value/Range12-16 gm/100 mL blood(g/dl)
Hb(Hemoglobin) Significance of Low ValuesAnemia
Hb(Hemoglobin)Significance of High ValuesPolcythemia
Hct(Hematocrit) DescriptionSpin the whole blood and measure the % of RBC in the original blood volume.
Hct(Hematocrit) Normal Value/Range40-50%
Hct(Hematocrit) Significance of Low ValuesAnemia
Hct(Hematocrit) Significance of High ValuesPolcythemia
WBC(White Blood Cells) Descriptionare used by the body to fight infections
WBC(White Blood Cells) Normal Value/Range5,000-10,000 per mm3
WBC(White Blood Cells) Significance of Low Values(leukopenia)= Viral Infection
WBC(White Blood Cells) Significance of High Values(leukocytosis) = Bacterial Infection
What are neutrophils?Major WBC(White Blood Cells)
Describe the difference between Bands and Segs: BANDSImmature cells: normally 4% of WBC; Increased with Bacterial Infections
Describe the difference between Bands and Segs: SEGSmature cells: normally 60% of WBC; Decreased with Bacterial Infections
What Pathology would show an increase in eosinophils?asthma; 2% of WBC; Increased with ALLERGIC Reactions (Produce Yellow Sputum)
What are electrolytes and what is their function?Elements required by the body for normal metabolism, Closely associated with fluid levels and kidney function
Describe the signs and symptoms of an electrolyte imbalance?Muscle weakness, soreness, Nausea Mental changes(Lethargy, Dizziness, Drowsiness)
Description of Na+ SodiumMajor: Extracellular Cation Controlled by kidneys
Normal Value/Range of Na+ Sodium135-145 mEq/L range
Significance of Low Values of Na+ SodiumHyponatremia Fluid loss from diuretics, vomiting, diarrhea, fluidgain from CHF, IV therapy
Significance of High Values of Na+ SodiumHYPERnatremia Dehydration
Description of K+(Potassium)Major: Intracellular Cation. Important for acid-base balance.
Normal Value/Range of K+ (Potassium)3.5-4.5 mEq/L range
Significance of Low Values of K+(Potassium)Hypokalemia-(Metabolic Alkalosis) excessive exertion, renal loss, vomiting, Flattened T waves
Significance of High Values of K+(Potassium)HYPERkalemia-(Metabolic ACIDOSIS)Kidney failure, spiked T wave
Dscription of Cl- (Chloride)Major: Extracellular Anion.
Normal Value/Range of Cl- (Chloride)Normal: 80-100 mEq/L range
Significance of Low Values of Cl- (Chloride)Hypochloremia: (Metabolic alkalosis)
Significance of High Values of Cl- (Chloride)HYPERchloremia: (Metabolic ACIDOSIS )
Describe Radiology Term RADIOLUCENTDark Pattern Air
Radiology Term RADIOLUCENT DiagnosisNormal for Lungs
Describe Radiology Term RADIODENSEWhite Pattern, Solid, Fluid
Radiology Term RADIODENSE DiagnosisNormal for Bones, Organs
Describe Radiology Term InfiltrateAny Ill-Defined Radiodensity
Radiology Term Infiltrate DiagnosisAtelectasis
Describe Radiology Term CONSOLIDATIONSolid White Area
Radiology Term CONSOLIDATION DiagnosisPneumonia / Pleural Effusion
Describe Radiology Term HYPERLUCENYExtra Pulmonary Air
Radiology Term HYPERLUCENY DiagnosisCOPD, Asthma Attack, Pneumothorax
Describe Radiology Term VASCULAR MARKINGSLymphatics, Vessels, Lung Tissue
Radiology Term VASCULAR MARKINGS DiagnosisIncreased with CHF Absent with Pneumothorax
Describe Radiology Term DIFFUSESpread Throughout
Radiology Term DIFFUSE DiagnosisAtelectasis/Pneumonia
Describe Radiology Term OPAQUEFluid, Solid
Radiology Term OPAQUE DiagnosisConsolidation
Describe Radiology Term BILATERALOn Both Side
Describe Radiology Term UNILATERALOn One Side
Describe Diagnostic Term FLUFFY INFILTRATESDiffuse Whiteness
Diagnostic Term FLUFFY INFILTRATES DiagnosisPulmonary Edema
Describe Diagnostic Term BUTTERFLY/BATWING PATTERNInfiltrate in Shape of Butterfly
Diagnostic Term BUTTERFLY/BATWING PATTERN DiagnosisPulmonary Edema
Describe Diagnostic Term PATCHY INFILTRATESScattered Densities
Diagnostic Term PATCHY INFILTRATES DiagnosisAtelectasis
Describe Diagnostic Term PLATELIKE INFILTRATESThin-Layered Densities
Diagnostic Term PLATELIKE INFILTRATES DiagnosisAtelectasis
Describe Diagnostic Term HONEYCOMB PATTERNReticulonodular
Describe Diagnostic Term AIR BRONCHOGRAMrefers to the phenomenon of air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey – white).
Diagnostic Term AIR BRONCHOGRAM DiagnosisPneumonia
Diagnostic Term PERIPHERAL WEDGE-SHAPED INFILTRATE DiagnosisPulmonary Embolus
Diagnostic Term Diagnosis BASILAR INFILTRATES with MENISCUSPleural Effusion
Shows White on x-raySolid
Shows BLACK on x-rayUNSOLID
Peripheral Edema Assesment by Inspection DefinePrsence of Excessive Fluid in the tissue Known as Pitting Edema Occurs Primarily in Arms and Ankles
Peripheral Edema Pathology DefineCaused by Congestive Heart Failure (CHF) and Renal Failure
Ascites Assesment by Inspection DefineAccumulation of Fluid in the Abdomen
Ascites Pathology DefineGenerally Caused by liver Failure
Clubbing Assesment by Inspection DefineThe condition is present when angle of the nail bed and skin increases
Clubbing Pathology DefineCaused by Chronic Hypoxemia. Presence of this is suggestive of Pulmonary disease
Venous Distention by Inspection Defineincreased venous distention
Venous Distention Pathology DefineOccurs with Congestive Heart Failure Seen with PT with Obstructive Lung Disease. Seen during exhalation because of the obstructive component
Capillary Refill by Inspection DefineIndication of peripheral circulation
Capillary Refill Pathology DefineBlanching the hand and watch the blood return Commonly done for the Modified Allen’s Test before drawing arterial blood gases.
Diaphoresis by Inspection DefineA state of Profuse/heavy sweating
Diaphoresis Pathology DefineHeart failure, Fever, Infection Anxiety, Nervousness Tuberculosis (night sweats)
Ashen/pallor Skin color DefineAbnormal Decrease in Color
Ashen/Pallor Skin Color IndicateDue to anemia or acute Blood loss
Erythema Skin Color Defineredness of skin
Erythema Skin Color IndicatesMay be due to capillary congestion, Inflammation or Infection
Cyanosis Skin Color DefineBlue or Blue-Gray (Dusky) Discoloration of Skin and Mucous Membranes.
Cyanosis Skin Color IndicatesCaused by hypoxia from increased amount of reduced hemoglobin (5g of reduced hemoglobin)
Jaundice Skin Color DefineIncrease in Bilirubin in Blood and Tissue
Jaundice Skin Color IndicatesThis appears mostly in face and trunk
Kyphosis Chest Configuration DefineConvex Curvature of the Spine (lean Forward)
Scoliosis Chest Configuration DefineLateral Curvature of the spine (Lean side to side)
Barrel Chest Configuration DefineA result of air trapping in the lungs for a long period of time Generally due to chronic Obstructive Pulmonary Disease Increase A-P Diameter
Describe Symmetrical Chest MovementOccurs when both sides of the chest moves at the same time
List five underlying Pathologies that can contribute to a PT displaying Asymmetrical (unequal)movementChronic Lung Disease, Atelectasis Pneumothorax, Flail Chest- Paradoxical Intubated patient with endotracheal tube in one lung
Eupnea Breathing Patterns and Conditions Associated with itNormal Respiratory Rate, Depth and Rhythm Normal Respiratory rate for an adult is 12-20 breaths/min
Tachypnea Breathing Patterns and Conditions Associated with itIncreased Respiratory Rate (over 20 breaths per minute) Causes: Hypoxia, Fever, Pain, CNS problem
Apnea Breathing Patterns and Conditions Associated with itCessation of breathing
Patterns and Conditions Associated with it are dangerous to the patient
What are the normal muscles of ventilation?Diaphragm External intercostal Exhalation is normally Passive
What are the accessory muscles are used to increase ventilation?Internal Intercostal, sternocleidomastoid (elevated sternum)scalene muscles, Pectoralis Major, Abdominal Muscles (Oblique, rectus abdominus,) Hypertrophy (increase in Muscle size)
What causes Hypertrophy of the accessory muscles?(increase in Muscle size) of accessory muscles occurs with COPD
Wasting away of muscles is also referred to asAtrophy is loss of muscle tone and occurs in Paralysis
List the signs of respiratory distress in infantsFlaring of the nostrils during inspiration
PT presents to the out PT clinic with a fever and cough producing a small amount of sputum. The Respiratory therapist should evaluate the PT for presence ofAn Infection
Describe the following Terms Reasonantnormal air filled lung. This gives a HOLLOW sound
Describe the following Terms Flatheard over the sternum, muscle or areas of atelectasis
Describe the following Terms Dullheard over fluid-filled organs such as the heart or liver. Pleural effusion or pneumonia
Describe the following Terms Tympanicis a loud, drum-like sound, heard over the lungs indicates increased in volume. heard over the air-filled stomach.
Describe the following Terms Hyperresonantfound in areas of the lung where PNEUMOTHORAX or EMPHYSEMA is PRESENT
What is the difference between veslcular and adventitious breath sounds?VESLCULAR breath sounds = Normal Breath Sounds Adventitious breath sounds = Abnormal Breath Sounds
What is egophony and what would it indicateThe patient is instructed to say “E” and it sounds like “A”. Indicate Consolidation of the lung tissue as with a pneumonia-like condition
Give a brief description of each of the following breath sounds and the recommended treatmentKnow them all
Give a brief description of each of the following breath sounds COARSE RALES(Ronchi) Large Airway Secretions
Give a description of each of the following breath sounds recommended treatment COARSE RALESPatient needs suctioning
Give a brief description of each of the following breath sounds MEDIUM RALESMEDIUM Airway Secretions
Give a description of each of the following breath sounds recommended treatment MEDIUM RALESPT needs chest physical therapy
Give a brief description of each of the following breath sounds WheezeDue to Bronchospasm,
Give a description of each of the following breath sounds recommended treatment WheezePT needs a bronchodilator Unilateral wheeze indicative of a foreign body obstruction
Give a brief description of each of the following breath sounds STRIDORDue to upper airway obstruction Supraglottic Swelling (Epiglottitis) Subglottic Swelling (Croup, Post Extubation) Foreign Body Aspiration (Solids or Fluids)
Give a description of each of the following breath sounds recommended treatment STRIDORTopical Decongestant (racemic epinephrine) for swelling/edema-Suctioning and/or Bronchoscopy for secretions and foreign body aspiration Intubation for Severe swelling and epiglottitis
Give a brief description of each of the following breath sounds PLEURAL FRICTION RUBA coarse grating or crunching sound, Caused by inflamed surface of the visceral and parietal pleura rubbing together,
Give a description of each of the following breath sounds recommended treatment P
Describe the Following Heart Sounds and when they would occur in the Cardiac Cycle First Sound (S1)is created by the normal closure of the mitral and tricuspid valves at the beginning of ventricular contraction
Describe what the following abnormal heart sounds may indicate? Second Sound (S2)is normal and occurs when systole ends. The ventricles relax and the pulmonic and aortic valves close
Describe what the following abnormal heart sounds may indicate? (S3)is abnormal and may suggest congestive heart failure.
Describe what the following abnormal heart sounds may indicate? Fourth Sound (S4)is an indicative of a cardiac abnormality such as myocardial infarction or cardiomegaly
Describe what the following abnormal heart sounds may indicate? Murmurare sound caused by turbulent blood flow. May be caused by heart valve defects or congenital heart abnormalities and should be investigated
Describe what the following abnormal heart sounds may indicate? Bruitsare the sounds made in
What effect would Cardiac Stress have on Blood Pressure?Hypoxemia
What effect Hypoperfusion have on blood pressure?decreased blood flow through an organ, as in hypovolemic shock; if prolonged, it may result in permanent cellular dysfunction and death
Give a brief description of each of the following breath sounds FINE RALES(moist crepitant rales) alveoli, Fluid PT has CHF/Pulmonary edema
Give a description of each of the following breath sounds recommended treatment FINE RALESPT needs IPPB, Heart drugs, Diuretics and Oxygen
what are four life functions?ventilation, oxygenation, circulation, perfusion
what is the most common problem when dealing with life function?oxygenation
how do you find smoking history?pack years= # of packs per day X # of years smoked
what is the normal urine output?40 ML/hr or about 1 Liter/ day
what is sensible water loss?urine, vomiting
what is insensible water loss?lungs and skin
if intake exceeds output this can cause what?Weight gain, electrolyte imbalance, increased hemodynamic pressures, and decrease lung compliance
what can a decrease is cvp (<2 mm hg) indicate?hypovolemia
what can an increase in cvp (>6 mm hg) indicate?hypervolemia
what is peripheral edema?presence of excessive fluid in the tissue primarily in the ankles and arms
what causes peripheral edema?CHF and Renal failure
what is ascites and what causes it?accumulation of fluid in the abdomen generally caused by liver failure
what causes venous distention?CHF, and obstructive lung disease
What can cause diaphoresis?heart failure, fever, anxiety, TB
what are the normal muscles of ventilation?diaphragm,external intercostals,
What are accessory muscles of ventilation?intercostal, scalene, sternocleidomastoid, pectoralis, abdominal muscles, such as oblique
what is hypertrophy and what disease does this occur in?increase in muscles size. which you would see in your COPD pts
signs of respiratory distressretraction, accessory muscle use, nasal flaring grunting
normal heart rate60-100
what is tachycardia and what does it indicate?>100 indicates hypoxemia, anxiety, stress
what is bradycardia and what does it indicate?<60 indicates heart failure, shock code emergency
what is paradoxical pulse/ pulsus paradoxus and what can it indicate?pulse/ blood pressure varies with respiration. may indicate severe air trapping such as in status asthmaticus or cardiac tamponade
what causes the trachea to be deviated toward the pathology?pulmonary atelectasis, pulmonary fibrosis, pneumonectomy, or diaphragmatic paralysis
what cause the trachea to be deviated away from the pathology?massive pleural effusion, tension pneumothorax, neck or thyroid tumors, or large mediastinal mass
what is the normal blood pressure?120/80
what can cause hypertension?cardiac stress such as hypoxemia
what can cause hypotension?poor perfusion such as in hypovolemia and CHF
What are the four critical life functions?ventilation = moving air in and out of lung Oxygenation = getting oxygen into blood Circulation = moving blood through the body Perfusion = getting blood , oxygen into tissue
Which of these Life functions is the first priority?ventilation = moving air in and out of lung establish open airway and breath
What assessments would determine how well a patient is ventilating?respiratory rate, tidal volume, chest movement, breath sounds, PaCO2
How would the therapist determine if a patient has a problem with Oxygenation?Heart rate, color, sensorium, PaO2
What information would help the therapist determine if a patients Circulation is Adequate?Puls/heart rate and strength, cardiac output
What changes would indicate that a patient may not have adequate Perfusion?Blood pressure,sensorium,temperature,urine output,hemodynamics
Explain the difference between “Signs and Symptoms” and list example of each.Signs = Objective information, those things you can see or measure EX. (color, pulse, edema, blood pressure) Symptoms = Subjective information, those things a patient must tell you EX. (Dyspnea,pain,nausea,muscle weakness)
What are in the Admission Notes, when you look at in a Patient Chart?Admittimg diagnosis, History of present illness, Cheif complaint, Past Medical History. you want to look at everything
List the 8 items that are important to examine when reviewing a patients chart?Admission Notes, Signs and Symptoms, Occupation or employment History, Allergies or Allergic Reactions, Prior surgery(illness or injury), Vital Signs, Physical Examie of Chest, Smoking History, Advance Directives
Define Advance DirectivesSet of instructions documenting what treatment a PT would want if he was unable to make medical decisions
Types of Advance DirectivesDo Not Resuscitate Living will Durable Power of Attorney for Health Care
A properly written order for respiratory care should include what four factorsType of Treatment Frequency Medication dosage and dilution Physician Notes
The Respiratory Therapist has just finished administering an aerosol treatment with albuterol to a child with asthma. How should the treatment be charted?Respiratory = record date,time,reactions,
What is the normal value for urine output?Normal Urine Output 40 mL/hr (approximately 1 Liter/day)
What finding might indicate that the patients fluid intake has exceeded his urine output?Weight Gain Electrolyte Imbalance Increased Hemodynamic Pressures Decreased Lung Compliance
Changes in what reading can indicate Hypovolemia?Deacreased CVP (< 2 mmHg) can indicate Hypovolemia
Changes in what reading can indicate Hypervolemia?Increased CVP (>6 mmHg) can indicate Hypervolemia
Patient interview/History Term Semicomatose DefineResponds to only pain stimuli
Patient interview/History Term Lethargy/Somnolence: DefineSleepy
Patient interview/History Term Obtunded DefineDrowsy state may have a decreased cough or gag
When assessing a patients orientation to time, place and person, what are some of the factors that could affect the patient’s ability to cooperate?Language difficulties Influence of Medications Hearing Loss Fear, Apprehension, Depression
Define “Activities of Daily Living” (ADL)Activities of daily Living are the basic tasks of everyday living
List the Six criteria that “Activities of Daily Living” (ADL)are based upon.Bathing with sponge, Bath or shower Eating – Dressing Toliet Use – Transferring Urine and bowel continence
Describe what a “Katz ADL” score of 1 indicates.A score of 2 or less indicates severe impairment and the patient requires assistance when performing any activity
Measuring Subjective Symptoms Define OrthopneaDifficulty breathing except in the upright position (heart problem, CHF)
Measuring Subjective Symptoms Define General MalaiseRun down feeling, Nausea, Weakness, Fatigue, Headache (Electrolyte Imbalance)
Measuring Subjective Symptoms Define DyspneaA Feeling of Shortness of Breath or Difficulty in Breathing
Measuring Subjective Symptoms Define Dysphagia(Difficulty Swallowing) and Hoarseness are also common Symptoms
What should the therapist consider while conducting a patient interview?Ask open- ended question, not yes or no question Communicate using simple language (KISS Method) Utilize pictures, Diagrams, Begin to Identify the patient’s major problem
Define Patient Learning NeedsPatient education is the process of influencing patient behavior and producing the changes in Knowledge, Attitudes, and Skills necessary to maintain or improve health.
What criteria is a patients ability to learn based upon?Cultural and Religious values Emotional Barriers, Language Barriers Desire and Motivation to learn Age and Education Level Physical and Cognitive Limitations