Respiratory Care Technology Final Exam Review:


Question Answer
In chronic hypercapnia, what can happen if a patient is placed on high FIO2?
Oxygen-induced hypoventilation – know about it!
Air compressor systems must be capable of maintaining 50 psig at a flow of ____ LPM. 100 L/min
To increase aerosol output from an ultrasonic nebulizer, you would increase __________. amplitude, the greater the signal amplitude, the greater is the nebulizer output
After a treatment the SVN should be rinsed with sterile water and air dried. True
American Academy of Pediatrics says to keep newborn PaO2 below ______ mmHg. 80 mmHg
If infant PaO2 is greater than 80 mmHg for a prolonged period, what can happen? can cause Retinopathy of prematurity
Inhaled aerosol particles that are less than 1 [lc µ]m wind up where? Lungs or Parenchyma
What are the low-flow oxygen delivery systems – list them. nasal O2 cannula, nasal O2 catheter, transtracheal catheter.
How do you determine the remaining contents of a liquid-filled CO2 cylinder? weighing the cylinder
Particle distribution produced by a typical MDI is ___ to ___ [lc µ]m MMAD? 3 to 6
One cubic foot of liquid oxygen equals approximately ________ cubic feet of gaseous oxygen. 860
Best way to administer oxygen therapy to a 2 year old is ______ _____. MDI, holding chamber, and mask
If a patient receiving nasal oxygen complains of nasal dryness and irritation, you should….
Sputum should be inspected for ____, ____, ____, and _____. Color, Volume, Odor ,Consistency
Calculate the total flow of an air entrainment device with a particular source gas flow.
How do you clean a cylinder valve outlet of foreign material. Quickly open, then close, the valve
Usual method of monitoring the remaining contents in a gas-filled cylinder. Read the pressure gauge.
Simplest way to increase the humidity output of a humidifier is ……….. by heating it
To produce the highest density aerosol from a USN, set the amplitude and flow how? amplitude- High , Flow-Low
Best MMAD for deposition of aerosol into the lower airways ___ to ___ micrometers. 2 to 5 micrometers
Air embolism a potential complication in what procedures? cardiovascular prodcedure, lung biopsy, hemodialysis, and central line placement
An HME is performing well when ________ appears in the attached flex tube. Mositure
When removing a flow meter from the wall outlet there is suddenly a massive gas leak. What should you do immediately? attach back to wall
Advantages of a small volume nebulizer versus a MDI. List them. Inexpensive ,Light,compact,resistant to moisture, Quick delivery of drugs ,Precise and consistent doses ,Available with most anti asthmatic drugs
MDI medications likely to cause opportunistic yeast infections. List them. Corticosteroids
Indications for hyperbaric oxygen administration – List them.
0.28 is the cylinder factor used to compute the duration of flow for 22 cu/ft O2 or air E cylinder. Also know the other cylinder factors.
Primary objective of cool aerosol therapy in the treatment of inflammation is to soothe inflamed tissues and reduce edema. Examples of such inflammation include what?
Eye condition occurring in some low-birth weight infants receiving supplemental oxygen is ____________ of ____________. Retinopathy of prematurity
Humidifier which “traps” the patient’s body heat and expired water vapor is the ___. Heat-moisture exchanger
Key property of helium which makes it useful as a therapeutic gas is its low _______. low density
Advantages of pulse demand delivery devices. List them.
If you use a Bourdon gauge against high outflow resistance, what will the flowmeter show?
Retinopathy of prematurity may result in _______________.
Continuous nebulization of the bronchodilators – when might you consider?
Which device would most likely cause over hydration when used on a continuous basis?
Principle used by the ultrasonic nebulizer to produce aerosol droplets is what?
If patient’s inspiratory flow collapses the reservoir bag on a non-rebreather mask, you should do what?
A (+) sign next to the test date on a cylinder means what?
Active HME can deliver ___% relative humidity at BTPS?
To determine whether a pressure-reducing valve uses multiple stages for pressure reduction, check the number of ______ _______ ______.
Key difference between disposable partial rebreathing and nonrebreathing O2 masks.
3AA stamped into an oxygen cylinder’s shoulder means what?
Gas used to treat pulmonary hypertension is ________ oxide. NO
Amount of water vapor that the respiratory tract must add to incoming gas to achieve BTPS is termed __________ deficit.
Structural requirements for the central piping systems that are used in hospitals are set by ____.
Humidity output of a simple unheated humidifier is always( less than or greater than) saturated air at ambient temperature. Choos
What happens when a Bourdon gauge encounters back-pressure resistance?
What percentage of an aerosol drug delivery device’s output deposits in the lungs? 10%-20%
Which SVN design features affect performance?
If a patient is being mechanically ventilated using a heat-moisture exchanger (HME). The patient starts to develop thick secretions, you should…….
Servocontrolled heated humidifiers monitor heater ____________.
At an FIO2 of 1, what is the approximate half-life of blood carboxyhemoglobin?
SPAG is used for ___ infection. an anitviral agent ribavirin(Virazole) to be administered by aerosol to an infant with bronchiolitis
When monitoring a patient receiving O2 therapy, you should assess what?
Compressed gas cylinders are manufactured from which metal?
When using a chamber-style adapter for MDI to deliver a bronchodilator to a patient receiving mechanical ventilation, coordinate firing with (beginning or end) ___________ of inspiration. Coordinate firing the MDI with the beginning of the ventilator inspiration
Oxygen administration is monitored carefully with COPD patients, because they many have ________ drive. Too much oxygen for a COPD patient can cause a depression in ventilation by “knocking out” their hypoxic drive
Is Thorpe tube or Bourdon gauge best for Oxygen administration during patient transport? Bourdon gauge
If you double the length of an oxygen tube by adding connecting tubing, what happens to resistance to flow? the resistance to flow increase
Problems common to mist tents – especially study heat retention and CO2 buildup if there is insufficient flow! providing high gas flow
For MDI bronchodilators, what time period should elapse between each puff of a two puff treatment? Allow 30 to 60 seconds
Tachycardia is the primary indication of hypoxemia, but also know the other signs. Tachypnea, Tachycardia, Cyanosis
Cooling and condensation – process of manufacturing medical air to remove the water content. usually is produced by filtering and compressing atmospheric air
Food and Drug Administration (FDA) purity standard for Oxygen – what percentage? 99%
Main safety concerns in the application of hyperbaric oxygenation – know these! sudden decompression, co2 accunulation
Duration of flow from an H cylinder of oxygen – be able to calculate when full, when half full, etc…….. at different flowrates.
Bubble humidifiers running at high flow can produce ___________.
In aerosol therapy, if the patient breathes and aerosol mist disappears, what action could the therapist take?
2015+ on the shoulder of a gas cylinder – what does that mean? can be filled to approximately 2200 psi
ASSS System for threaded high-pressure connections – know about this system.
Air for medical use must be free of _________, ___________, and ____________. Particle-free, Oil-free, Dry
Medical gases which will support combustion – list them. O2, N2O, compressed air
Aerosol particles in the 5- to 10-[lc µ]m range deposit where? Upper airways
Indications for the use of humidity therapy – what are the primary ones?
Air entrainment masks are based on the _____________ principle. venturi
Advantages of passover humidifiers – know them!


Question Answer
What are the causes associated with resorption and passive atelectasis? Passive atelectasis = Persistent breathing at small tidal volumes Resorption atelectasis = Mucus plugging present in the airways that block ventilation REF: 904
True or False: Patients at high risk for developing atelectasis can be those who are heavily sedated, those with neuromuscular disorders, or those with abdominal or thoracic pain. True REF: 904
True or False: Clinical findings that indicate the development of atelectasis normally include inspiratory and expiratory wheezing. False REF: 905
True or False: Increasing the transpulmonary pressure gradient is responsible for increasing lung volume during lung expansion therapy. True REF: 905
____________________ is the most physiologic form of lung expansion therapy. Incentive spirometry REF: 905
An alert and cooperative 30-year-old man with no prior history of lung disease underwent knee repair surgery. His x-ray film currently is clear. Which of the following approaches to preventing atelectasis would you recommend for this patient? A. incentive spirometry A, REF: 905
True or False: The most likely cause of a postoperative patient using incentive spirometry and complaining of dizziness and numbness around the mouth after therapy sessions is gastric insufflation False REF: 906
How are incentive spirometry devices generally categorized? As flow-oriented or volume-oriented devices REF: 908
True or False: Flow-oriented devices have proved less effective than volumetric systems. False REF: 908
In teaching a patient to perform the sustained maximal inspiration maneuver during incentive spirometry, what would you say? A. “Exhale normally, then inhale as deeply as you can, then hold your breath for 5 to 10 seconds.” A, REF: 909
True or False: Diaphragmatic breathing at slow to moderate flows is the correct instruction technique used for teaching incentive spirometry True REF: 909
How long should a patient be told to sustain a breath during the performance of a sustained maximal inspiration during incentive spirometry? 5 to 10 seconds REF: 909
Which of the following conditions is most likely to predispose a patient to atelectasis? C. Gall bladder surgery. C, Page: 904
Physical signs of atelectasis include: I. Decreased or bronchial/tubular breath sounds II. Tachypnea III. Normal breath sounds IV. Tachycardia when hypoxemia is present D. I, II and IV only I. Decreased or bronchial/tubular breath sounds II. Tachypnea IV. Tachycardia when hypoxemia is present D, Page: 905
An increase in the __________________pressure gradient is responsible for the way lung expansion therapy works. transpulmonary Page: 905
True or False: Intermittent positive-pressure breathing is associated with a passive exhalation. A. true A, REF: 909
Which of the following patient groups should be considered for lung expansion therapy using intermittent positive-pressure breathing (IPPB)? A. I and II I. patients with clinically diagnosed atelectasis who are not responsive to other therapies II. patients at high risk for atelectasis who cannot cooperate with other methods A, REF: 911
True or False: IPPB should be the single treatment modality used for resorption atelectasis. False,REF: 911
Which of the following is NOT a potential contraindication for intermittent positive-pressure breathing? A. neuromuscular disorders A,REF: 912
True or False: Respiratory alkalosis is probably the most common complication associated with intermittent positive-pressure breathing (IPPB)? True, REF: 912
Intermittent positive-pressure breathing (IPPB) can be associated with which of the following hazards? D,REF: 912 D. I, II, III, and IV I. hyperventilation II. air-trapping, auto-PEEP III. increased airway resistance IV. nosocomial infection
Potential outcomes of IPB Therapy should include: I. Improved VC II. Improved oxygenation III. Improved breath sounds IV. Decreased secretion clearance and reduced cough mechanism C,REF: 913 C. I, II, and III I. Improved VC II. Improved oxygenation III. Improved breath sounds
Which of the following are potential desirable outcomes of (IPPB) therapy? I. improved oxygenation II. increased cough and secretion clearance III. improved breath sounds IV. reduced dyspnea (subjective response) D,REF: 913 D. I, II, III, and IV I. improved oxygenation II. increased cough and secretion clearance III. improved breath sounds IV. reduced dyspnea (subjective response)
What should the practitioner explain before starting an (IPPB) on a new patient? I. what the IPPB treatment will do II. why the physician ordered the treatment III. what the expected results are IV. how the IPPB treatment will feel D,REF: 913 D. I, II, III, and IV I. what the IPPB treatment will do II. why the physician ordered the treatment III. what the expected results are IV. how the IPPB treatment will feel
True or False: The semi-fowler’s position is ideal for the patient receiving an intermittent positive-pressure breathing treatment. True REF: 914
Which of the following adjuncts would you attempt first in order to eliminate leaks in an alert patient receiving an intermittent positive-pressure breathing treatment? D. nose clip
Which of the following parameters are you changing when you adjust the sensitivity control on an intermittent positive-pressure breathing device, B,REF: 914 B. effort required to cycle the device “on” (begin inspiration)
True or False: The following are appropriate initial settings for an IPPB treatment given to a new patient: Sensitivity –1 to –2 cm H2O Pressure 10 to 15 cm H2O Moderate flow True,REF: 914
Which of the following are appropriate volume goals for intermittent positive-pressure breathing (IPPB) therapy? I. 10 to 15 ml/kg ideal body weight II. at least 30% of the inspiratory capacity (IC) B,REF: 914 B. I and II I. 10 to 15 ml/kg ideal body weight II. at least 30% of the inspiratory capacity (IC)
True or False: All of the following factors are responsible for making an IPPB device cycle off prematurely? I. airflow obstructed II. kinked tubing III. occluded mouthpiece IV. active resistance to inhalation True, REF: 915
Select the mechanisms below that probably contribute to the beneficial effects of continuous positive airway pressure (CPAP) in treating atelectasis? D,REF: 916 D. I, II, III, and IV I. recruitment of collapsed alveoli II. decreased work of breathing III. improved distribution of ventilation IV. increased efficiency of secretion removal
Which of the following are contraindications for continuous positive airway pressure (CPAP) therapy? I. hemodynamic instability II. hypoventilation III. facial trauma IV. low intracranial pressures C,REF: 916 C. I, II, and III I. hemodynamic instability II. hypoventilation III. facial trauma
True or False: Potential complications associated with CPAP therapy usually include all of the following: barotrauma, hypoventilation, gastric distention, and hypercapnia True,REF: 916
List the essential components of a CPAP flow system? I. blended source of pressurized gas II. nonrebreathing circuit with reservoir bag III. low-pressure or disconnect alarm IV. expiratory threshold resistor
True or False: During administration of a continuous positive airway pressure flow mask to a patient the most common problem is system leaks or leaks around the mask. True REF: 917
What initial flow setting would you use when setting up a CPAP mask system for a patient with atelectasis? 2 to 3 times the patient’s minute ventilation REF: 917
Which of the following hyperinflation techniques relies on the patient’s ventilatorymuscles to achieve hyperinflation goals? D. II and IV II. incentive spirometry IV. positive expiratory pressure (PEP) therapy
True or False: Irritation, inspiration, compression, and expulsion are all part of the normal cough reflex. True,REF: 922
True or False: A patent airway, functional mucociliary escalator, and effective cough are all necessary for normal airway clearance. True, REF: 922
True or False: Anesthesia can provoke a cough? False REF: 922-923
Partial airway obstruction can result in all of the following except: C,REF: 923 C. increased oxygenation
Match the phase of a cough on the “right” with the mechanism responsible for impairing the cough on the “left”. Answers may be used once, more than once or not at all. ____1. Abdominal muscle weakness 1. C & D C. Compression D. Expulsion
Match the phase of a cough on the “right” with the mechanism responsible for impairing the cough on the “left”. Answers may be used once, more than once or not at all. ____2. Anesthesia A. Irritation
Match the phase of a cough on the “right” with the mechanism responsible for impairing the cough on the “left”. Answers may be used once, more than once or not at all. 3. Tracheostomy tube 3. C C. Compression
Match the phase of a cough on the “right” with the mechanism responsible for impairing the cough on the “left”. Answers may be used once, more than once or not at all. ____4. Pain 4. B B. Inspiration
Match the phase of a cough on the “right” with the mechanism responsible for impairing the cough on the “left”. Answers may be used once, more than once or not at all. ____5. Emphysema 5. D D. Expulsion
All of the following drug categories can impair mucociliary clearance in intubated patients except: A. general anesthetics B. bronchodilators C. opiates D. narcotics B,REF: 923 B. bronchodilators
Conditions that can affect airway patency and cause abnormal clearance of secretions include which of the following? I. foreign bodies II. tumors III. inflammation IV. bronchospasm D,REF: 924 D. I, II, III, and IV I. foreign bodies II. tumors III. inflammation IV. bronchospasm
Which of the following conditions alter normal mucociliary clearance? I. bronchodilation II. cystic fibrosis (CF) III. ciliary dyskinesia D,REF: 924 D. II and III II. cystic fibrosis (CF) III. ciliary dyskinesia
True or False: The primary goal of bronchial hygiene therapy is to help mobilize and remove retained secretions. True,REF: 924
Which of the following conditions are associated with chronic production of large volumes of sputum? I. bronchiectasis II. pulmonary fibrosis III. cystic fibrosis IV. chronic bronchitis A,REF: 925 A. I, III, and IV I. bronchiectasis III. cystic fibrosis IV. chronic bronchitis
Chest physical therapy can be expected to improve airway clearance when a patient’s sputum production exceeds _____________ml/day D, REF: 925 D. 25 to 30
True or False: When assessing the potential need for postoperative bronchial hygiene for a patient, considering the number of prior surgeries is very relevant. False,REF: 925
Key considerations in initial and ongoing patient assessment for chest physical therapy include which of the following? I. posture and muscle tone II. breathing pattern and ability to cough III. sputum production IV. cardiovascular stability C. I, II, III, and IV REF: 925 I. posture and muscle tone II. breathing pattern and ability to cough III. sputum production IV. cardiovascular stability
True or False: Lack of sputum production, development of a fever, labored breathing, and increased inspiratory and expiratory crackles are all clinical signs that indicate a patient is having a problem with retained secretions? True,REF: 925
True or False: Incentive spirometry is considered bronchial hygiene therapy: False,REF: 925
Postural drainage therapy uses the application of __________ to achieve specific clinical objectives in respiratory care B,REF: 925 B. gravity
Which of the following is NOT a hazard or complication of postural drainage therapy? D,REF: 926 D. pulmonary barotraumas
Primary objectives for turning include all of the following except to: A,REF: 928 A. prevent postural hypotension
Which if the following is the only absolute contraindication to turning? D. when the patient has unstable spinal cord injuries REF: 928
In which of the following patients would you consider modifying any head-down positions used for postural drainage? I, II, III, and IV REF: 929 I. a patient with unstable blood pressure II. a patient with a cerebrovascular disorder III. a patient with systemic hypertension IV. a patient with orthopnea
True or False: Vital signs, bedside PFTs, and auscultation are all mandatory components of the pre-assessment for postural drainage? False, REF: 929
What postural drainage position would you recommend if a patient’s chest radiograph shows infiltrates in the posterior basal segments of the lower lobes? Head down (foot of bed elevated 18 inches), patient prone with a pillow under abdomen REF: 930 Figure 40-3.
What postural drainage position would you recommend for a patient with an infiltrate in the right middle lobe. Head down (foot of bed elevated 12 inches), patient half-rotated to left, right lung up REF: 930 See Figure 40-3
Question Answer
Cylinders of Liquid gases are filled accordingly to what specification? Filling Density
Under what conditions will the gauge pressure of a cylinder of N20 accurately represents its contents? II Only. When the ambient temperature exceeds the critical temperature.
According to the National Institute of standards and technology of the US department of commerce, a gas cylinder that is color coded brown and green should remain: 02-He mixture
Which of the following is true about an uncompensated Thorpe tube? Flow lower than actual if downstream pressure increases.
When used to control the flow of medical gases to a patient, how is a flow restrictor classified? Fixed orifice, constant-pressure flowmetering device.
If you had to power a ventilator from a large cylinder of compressed gas, which of the following devices would be required? Reducing valve.
After attaching a yoke connector to an E cylinder and opening the cylinder valve, you notice a leak at the gas outlet. Which of the following are possible causes of this leak? I and II. I- The has outlet brushing is missing or damaged. II- the yoke hand screw is not tight enough.
You are called by a nurse home to help set up O2for a patient, delivered through a jet nebulizer unfortunately all that is available is an old uncompensated Thorpe tube flowmeter. When set to 8L/min, the nebulizer creates an additional 30 psig of.. downstream pressure. About what flow of 02 will the patient now recieve? 12L/min
Which of the following statements is false about PISS standards? They apply to low-pressure
Dept of transportation (DOT) regulations require compressed gas cylinders to be hydrostatically tested for leaks and expansion every how often? 5 to 10 years
What key property of He makes it useful as a therapeutic gas? Low density
What is the PISS index hole posititon for 02? 2 and 5
Which of the following is false about Bourdon gauge? It will register zero flow when the outlet is completely blocked.
Compressed gas cylinders are manufactured form of which of the following? Seamless steel
When used to control the flow of medical gases to a patient, how is a Thorpe tube classified? Variable orifice, constant pressure flowmetering device.
Question Answer
The effect of breathing 5% co2 on a healthy subject ? Increase depth and rate of breathing
In it’s gaseous state oxygen is? Odorless, tasteless, colorless, and supports combustion
Which of the following indicates a flow that is activated by a downstream resistance to flow?
Pertaining to the preset reducing valve which of the following would be true? The valve at H , L may pop off, this is a single stage preset regulator, B reads cylinder or tank pressure(bourdon gauge)
Which method below is most common for Bulk commercial production of oxygen? Fractional distillation
Which of the following devices/systems do NOT use a compressor as part of its principal of operation? Piped 100% oxygen
Which of the following devices/stems USE a compressor as part of its principal of operation?
In the field or respiratory care, pressurized gas systems are most often read in which of the following units of measure? Pounds per square inch gauge
The value of this gauge is based solely on its low density? Helium-oxygen
Disadvantages of using compressed oxygen cylinders in the home include the following except? Gas wastage when not in use
What are the disadvantages when using compressed oxygen cylinders in the home? High pressure hazard, Limited volume of oxygen, Bulkiness of cylinders, Need for frequent deliveries
Disadvantages of home LIQUID oxygen systems Include? Oxygen is lost when not used, The low temperature of LOX can be a hazard, Liquid oxygen must be delivered when needed
A student has 2 H cylinders, one full at 2200psi and 1 empty at room temp he joins them together in a manifold opens both and reads the new pressure what will the pressure be? 1100
Heliums therapy most valuable therapeutic property is? Decrease the work of breathing in airways obstruction
Which of the following are true concerning oxygen concentrators? As flow rates increase delivered concentrations decrease
In the field of respiratory care barometric pressure is most often read in? Torr
Which of the following statements are true concerning liquid filled cylinders? Unlike gas cylinders the pressure bears little relationship to the Amount of liquid remaining in the system & only when the liquid is gone will the pressure fall in proportion to the reduction of volume
Which of the following is used for anasthetic agent? N2O=Nitrous oxide
Which of the following are used in selectively low concentrations to dilate pulmonary blood vessels? NO=Nitric Oxide
Oxygen Supports combustion, is colorless, odorless, tasteless, in green cylinder
Helium Is non-flammable, in a brown cylinder
Nitrogen Non-flammable, in black cylinder
Carbon dioxide Non-flammable, in gray cylinder
Nitrous Oxide In blue cylinder
In which of the following conditions would you initially seek to provide the highest fio2? Cyanide poisining, Severe shock or truama
A 27year old relieved from theER department is on a nasal cannula at 3L per min. What fio2 is this patient receiving? 32%
Which of the following are true about the simple oxygen mask? It has no valving system or reservoir bag, requires a minimum input flow of 5L min, functions as a variable performance system
A patient is on a simple nasal cannula at flow of 12L per minute the goal is to receive 70% oxygen, which of the following would you recommend? The O2 to be given through a reservoir mask at 10L min
You must deliver the highest possible fiO2 to a 67 yr old man with pulmonary edema breathing at a rate of 35 per min, which of the following O2 delivery systems would be most appropriate ? Non-Rebreathing mask at 12-15L per minute
What is the minimum flow setting for a a simple mask applied to an adult? 5L per minute
Which of the following would indicate a need for oxygen therapy for an adult or child? SaO2 less than 90% and a PaO2 less than 60mmhg
Which of the following typically occurs first when monitoring the earliest physiological response to breathing 100% oxygen? Substernal chest pain
Delivery systems that provide only a portion of a patients inspired gas are referred to as? Low flow oxygen systems
FiO2 of .40 by oxyhood and blender for an infant RT anaylizing notes the fiO2 is .30 and the flow meter is set at 10L per minute. Nebulizer entrainment port is set at 50% and blender is set at fiO2 .40 the therapist should? Set the nebulizer entrainment to 100%
RT is administering a mixture of helium and oxygen through a non- Rebreathing mask to a 40yr old during an acute asmathitic episode, SPO2 is at 92 % RT observes the reservoir bag on the mask nearly collapses on each breath, what is int response? Increase the flow of gas mixture into the mask
Which of the following is true about air entrainment mask? The smaller the jet orifice the more air will be entrained, The restricted orifice or jet is used to entrain air, the greater the jet velocity of 02 the more air is entrained
Describe the characteristics of a Thorpe tube flow meter Preset inlet pressure with adjustable outlet orifice
Characteristics of a bourdon gauge flow meter Adjustable inlet pressure with fixed outlet orifice
Characteristics of a flow restrictors to a downstream resistance to flow
Identify safety connections of the American standard safety system Threaded connection and it’s used on greater than 200psig, larger than E
Diameter index safety system Establish to prevent accidental interchange of low pressure (less than 200psig) medical gas connectors
U connect an incubated patient to a air entrainment neb sys. Via t-tube set at 60% w/input flow of 15l/min, toward the middle of expiration you observe that midst stops exiting from open end of t-tube. What does this indicate? Patient is not receiving 60% o2
Physician orders 70% He and 30% oz mixture to reduce the work of breathing in a patient having an acute asthmatic attack. Which of the following delivery systems would be most appropriate? Nonrebreathing mask
Equipment processing would be the min you would recommend for a reusable device that only contracted a patients intact skin Low level disinfection
The application of steamed under pressure for sterilization is termed Autoclaving
Biots breathing Very irregular and interspersed with long periods of apnea
A patient develops an infection after exposure to contaminated food. This is an example of what root transmission? Vehicle
The diaphragm contracts during Inspiration/ inhalation
Orthopenea Difficult breathing in reclining position
Normal respiratory rate 12-20 breaths per min
Reasons for an adjustable regulator Reduce gas pressure, reduce gas flow, allow for an indication of quantity of the gas in the cylinder
True concerning bulk o2 storage Liquid o2 systems provide large quantities of o2 at relatively low pressures under 250 psi and cost
The gauge pressure on a full E cylinder, 100% co2 containing liquid and gas is 500psig, the gas has been flowing at 6L/M for a period of time, student notes tat press. Has dropped from 500psi to 300psi. What can be said concerning the contents of cyl. Cylinder is of empty liquid
heliums therapy most valuable therapeutic property is The ability to decrease the work of breathing in airway obstructions
What are some key patient considerations in selecting o2 therapy equipment Severity and cause of hypoxemia, Age group, and type of airway
First thing: Always treat hypoxia or possibility of hypoxemia, always administer o2 therapy
Physician orders 02 for a patient with chronic hypercapnea/hypoxemia pao2=47 mm hg. What is most appropriate action? Admin 02 to achieve a pao2 of 60-80 mm hg
Copd patient placed on FiO2 of .6 becomes lethargic and less responsive why? o2 induced hypoventilation
2yr old child receiving o2 by an aerosol tent maintaining a consistent fio2 inside the canopy. What do u do? Increase o2 flow
What following factors of flow increase fiO2 delivered by a low flow O2 system Small Vt and minute ventilation
A physician orders 2L/min of O2 through a simple mask to a 65yr old with chronic hypercapnea. What would be the correct action at this time?
List the possible hazards of O2 therapy Absorption atelectasis, pul. o2 toxicity, O2 induced hypoventilation
A disease may be transmitted from one patients to another by a health care doctor. This mode of disease spread is termed cross-contaminated
Hospital acquired infections nosocomial infections
Asepsis absence of disease producing micro-organisms
Micro-organisms transmission may occur by contact transmission; airborne transmission; and vehicle transmission
Minimized dangers of radiation minimize exposure time and ensure proper distance
Following conditions must be met for fire to occur presence of oxygen; temperature high enough for combustion; and presence of flammable material
Describe surveillance with regard to infection control contain the source; interrupt transmission; reduce susceptibility of the host; and/or number of susceptible host
Types of processing resp care equipment sterilization; cleaning; disinfection;
Clean the removal of all foreign material from an object. contact with intact skin.
disinfection the inactive most pathogenic organisms EXCLUDING spores. includes pasteurization and chemical disinfection
Low-level disinfection when devices that touch the only intact skin or do not contact patient;non critical
high level disinfection devices that directly or indirectly contact mucous membranes;semi-critical. indoscopes; oral and nasal trachea, humidifiers, mouth pieces
sterilization devices introduced into the bloodstream or other parts of the body;critical
Sterilization complete destruction of all forms of microbial life; dry heat; boiling; auto-claving, radiation; ethylene oxide
what equipment processing do you use to clean up a blood spill? 1:10 ratio dilution of bleach
When should a resp care practitioner should wear a gown? when gown can be soiled and highly contagious disease
the most frequent route for transmission of nosocomial infection? contact
infection-control precautions should be applied to ALL patients? wash hands after touching blood, wash hands after removing gloves, clean gloves, extreme caution when handling “sharps”
Virulence the power of a microorganism to produce disease; the strength
List the factors associated with an increased risk of a patient acquiring a nosocomial infection. ground-neg colonization, surgical patients, elderly, odese, COPD and smokers
Describe why infection control is important in respiratory care. to prevent transmissions of infections in health care enviroments
State the three major routes for transmission of human sources of pathogens in the health care environment. contact, respiration droplets, and airborne droplets,common vehicle, vector
Describe strategies to control the spread of infection in the hospital. individual health care personnel behavior, institutional climate, work environment
Define vital signs. measurements of the bodys most basic functions
transmission via contaminated food or water is food poison
vector transmission from an animal or insect
True about fires in oxygen enriched atmospheres? they burn more intensely; more difficult to put out, and burn quicker
hospital grade plugs with be? 3 pronged with a green dot
droplet transmission requires private room for the patient, use a filtered mask for working within 3 feet, use of gloves, and use of gown if soiled clothing is likely
if you observe someone getting continuous shock you should turn off the power source or knock them away with non conductive object
voltage the power potential behind electrical energy
pathogen microorganism capable of producing disease in humans
airborne transmissions precautions include HEPPA mask, use of gloves, hand washing before entering and after leaving,
List six factors that influence the pulse rate.
List four factors that increase blood pressure
List four factors that can reduce blood pressure.
spontaneously breathing but comatose bc of CO inhalation. PaO2=87 mmHg and a PaCO2= 36 mmHg on room air. what action would you recommend? administer as high FiO2 as possible
An intubated patient with an inspired flowrate of 40 l/min is connected via a TTube to a Jet Neb set at 70% O2 with and input flow of 12 l/min. is this high or a low flow system? low flow bc inspiratory demands are not met
An O2 delievery devices takes seperate pressurized air and O2 sources as input, then mixes these gases through a precision valve. what does this describe? oxygen blender
characteristics of a simple mask no valving system or reservoir bag, requires a minimal input of 5 l/m
physician orders 2 l/min of simple mask to a 65 year old with chronic hypercapnia. what would be the correct action at this time recommend that the mask be changed to cannula @ 2 l/min
you must deliver the highest possible FiO2 to a 67 year old man with pulmonary edema breathing at a rate of 35 per min which of the o2 delivery system non rebreather
what is the key functional differnce btwn disposable, partial rebreathing,AND NON rebreathing 02 mask non rebreather had a one way valve btwn the mask and bag
which of the following are common features seen in patients suffering from 02 toxicity extensive physiological shunting, decreasing P(A-a)02, and pachy infiltrates on xrays
2 assure a stable Fi02 under varying patients demands, what must an 02 delivery system provide all the gas needed by the patient during inspiration
a patient receiving 02 through a non rebreather mask for 8L/min the bag collapses completely before the end of inpiration. what should you do? increase liter flow
Physician orders 32% 02 for an intubated post-op patient, which delivery suystme would be the best and most practical approach to provide 02 therapy? air entrainment neb set at 30% with t-tube and reservoir
physician asks for your advice best delivery system for hypercapnic patient needing lond term continuous low Fio2 in the home setting. which of the following would you recommend? low flow nasal cannula
the cooperative and alert post operative patient taking food orally requires a small increment in Fi02 to be provided continuusly. Which of the following devices would best achieve this? nasal cannula
specific clinical obj. of 02 therapy include which of the followin… decrease symptoms caused by chronic hypoxemia, decrease workload it imposes on heart and lungs, correct arterial hypoxemia
gas powered air entrainment nebs: True fixed performance devices at high fi02s, air to 02 ratio alter by entrainment port size, 02 or aerosol can be delivered via t-tube trache mask or aerosol mask
an air 02 blender is used to provide an fi02 of .4 by oxyhood, the blender alarm and the low 02 alarm are triggered, why? low 02 pressure
which of the following values indicate the need for an increase for the 02 percentage delivered? 02 sat., spo2 of 85% on a 35% air entrainment mask
which patients receive highest Fi02 from a nasal cannula set at 1L/min? 6 day old female infant, that is 22 in. tall and 10 pounds
which of the following patients would receive the highest fi02 from a nasal cannula set at 3 liters per minute the patient who is breathing 10 breaths per min with a avg. Vt of 500ml
which of the following devices is NOT set up with a large vol neb? partial rebreathing mask
primary factors determining the risk of 02 detrimental affect of the lungs and the CNS? PO2 and length of exposure
low flow 02 delivery systems: nasal 02 cannula, nasal 02 catheter, and transtracheal catheter
physiological effects of inhaled NO include? improved blood flow to ventilated alveoli, decrease pul. vas. resistance, reduce intrapulmonary shunting
palpation method to obtain Bp obtains the systolic BP
depth and rate increases then decreases followed by a period of apnea cheyne stokes
Kussmals breathing breathing quickly and deeply
major muscle of inspiration diaphragm
normal pulse rate 60-100
which of the following are reasons for an adjustable 02 regulator? reduced gas pressure, reduced gas flow, allows for an indication of the quantity of the gas in the cylinder