RTH 190 > Final > Flashcards

Final Flashcards

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1
Q

What are the indications for chest pt?

A
  • evidence or suggestion of retained secretions in the presence of an artificial airway
  • inability or reluctance of patient to change body position
  • evidence or suggestion of difficulty with secretion clearance
  • difficulty clearing secretions, with expectorated sputum production greater than 25-30 ml/day
  • diagnosis of diseases such as CF, bronchiectasis, or cavitating lung disease
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2
Q

What are the hazards of chest pt?

A
  • hypoxemia
  • increased ICP
  • bronchospasm
  • vomiting/aspiration
  • acute hypotension during procedure
  • pulmonary hemorrhage
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3
Q

What position would you place the patient in for percussion of the anterior segment of the upper lobes?

A

bed flat. patient supine with pillow under knees for comfort

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4
Q

What position would you place the patient in for percussion of the superior and inferior segments of the lingula?

A

foot of bed 20 degree angle as tolerated. patient partially on right side (1/4 turn) with pillow behind back and shoulders

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5
Q

What position would you place the patient in for percussion of the anterior basal segment of the lower lobes?

A

foot of bed 30 degree angle. patient on right side (1/2 turn)

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6
Q

What position would you place the patient in for percussion of the lateral basal segment of the lower lobe?

A

foot of bed 30 degree angle. patient partially on right side (3/4 turn)

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7
Q

What position would you place the patient in for percussion of the superior segment of the lower lobes?

A

bed flat. patient prone

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8
Q

What position would you place the patient in for percussion of the posterior basal segment of the lower lobes?

A

foot of bed 30 degree angle

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9
Q

What position would you place the patient in for percussion of the lateral and medial segments of the right lower lobe?

A

foot of bed 20 degrees. patient on left side (1/4 turn) with pillow under back and shoulders

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10
Q

How many compressions to how many breaths do you do?

A

30:2

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11
Q

When bagging, how often do you give a person a breath?

A

1 breath every 5 seconds

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12
Q

What are the critical responsibilities of airway maintenance?

A
  • securing the tube and maintaining its proper placement
  • providing for patient communication
  • ensuring adequate humidification
  • minimizing possibility of infection
  • aiding in secretion clearance
  • providing appropriate cuff care
  • troubleshooting airway related problems
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13
Q

What are the indications for IPPB?

A
  • atelectasis
  • increased WOB
  • hypoventilation
  • increased RAW
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14
Q

What are the hazards of IPPB?

A
  • increased RAW
  • airtrapping
  • bronchospasm
  • pneumothorax
  • hyperventilation
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15
Q

What are the physiologic effects of IPPB?

A
  • increase MAP
  • increase VT
  • decrease WOB
  • secretion control
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16
Q

What should you look at when troubleshooting for IPPB?

A
  • sensitivity
  • pressure
  • flow
  • air flow mix
  • circuit
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17
Q

What is an uncompensated flowmeter?

A

it won’t change when it’s moved or occluded

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18
Q

What is a compensated flowmeter?

A

the ball will drop when it is occluded

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19
Q

What is an example of an uncompensated flowmeter?

A

bourdon gage

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20
Q

What is an example of a compensated flowmeter?

A

thorpe tube

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21
Q

What is relative humidity?

A

the amount of water vapor in a gas when not fully saturated

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22
Q

What is the equation for calculating relative humidity?

A

[(content or absolute humidity) / saturated capacity] x 100

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23
Q

What is absolute humidity?

A

the amount of water extracted from air

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24
Q

What is the equation for calculating absolute humidity?

A

relative humidity x capacity

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25
What is body humidity?
the ratio of its actual water vapor content to the water vapor content in saturated gas at body temp (37C)
26
What is the equation for calculating body humidity?
(absolute humidity / 44mg/L) x 100
27
What is a humidity deficit?
the amount of water vapor the body must add to the inspired gas to achieve saturation at body temp (37C)
28
What does the interview part of patient assessment aid in?
- establishes patient rapport between the clinician and the patient - obtains essential diagnostic information - helps monitor changes in the patient's symptoms and response to therapy
29
Where is the introduction of the interview done?
social space (4-12 feet from patient)
30
Where does the interview begin?
personal space (2-4 feet from patient)
31
What do you look for during the physical assessment?
- general appearance - LOC - vital signs (RR, BP, HR, BS) - body temp - cyanosis - dyspnea - edema - hemoptysis - cough and sputum production
32
What is eupnea?
normal, relaxed breathing
33
What is hypernea?
increased depth of breathing
34
What is orthopnea?
shortness of breath when lying flat
35
What is platypnea?
shortness of breath when sitting up
36
What is dyspnea?
shortness of breath
37
What is paradoxical nocturnal dyspnea?
severe shortness of breath and coughing that generally occurs at night
38
What is biot's breathing?
abnormal pattern of breathing that includes quick, shallow inspirations followed by regular or irregular patterns of apnea
39
What is cheyne stokes breathing?
deep, fast breathing followed by irregular periods of apnea
40
What is kussmal's breathing?
deep and labored breathing, and is a form of hyperventilation and occurs with metabolic acidosis
41
What is PISS?
pins that prevent misconnection
42
What is DISS?
screw type safety system found on flowmeters and gas outlets
43
What are the indications of IS?
- presence of conditions predisposing to the development of pulmonary atelectasis (upper abdominal surgery, thoracic surgery, surgery in COPD patients) - presence of pulmonary atelectasis - presence of restrictive lung defect associated with quadriplegia or dysfunctional diaphragm
44
What are the hazards of IS?
- hyperventilation - fatigue - barotrauma - hypoxia - exacerbation of bronchospasm - discomfort secondary to inadequate pain control
45
What are the physiologic effects of IS?
- absence or improvement in signs of atelectasis - increased VC and peak expiratory flows - increased FVC - restoration of preoperative FRC or VC
46
What are some low flow devices?
- nasal cannula - simple mask - partial and non rebreathers
47
What is a nasal cannula?
- FiO2 24-40% - up to 6L/min - over 4L/min must use a humidifier
48
What is a simple mask?
- FiO2 35-50% | - 5-10L/min
49
What is a partial rebreather?
- FiO2 40-70% | - minimum of 10L/min
50
What is a non-rebreather?
- FiO2 60-80% - minimum of 10L/min - bag must be full during inspiration to prevent from collapsing
51
What liter flow is run for a SVN?
6-8L/min
52
What is normal flow?
30L/min
53
What do low flow devices provide?
only a portion of a patient's inspiratory flow
54
What do high flow devices provide?
equal to or exceeds the patients inspiratory flow and FiO2 is stable/fixed
55
The bigger the jet nozzle, the ____ the FiO2
higher
56
What is the cylinder factor for an E cylinder?
0.28
57
What is the cylinder factor for a H/K cylinder?
3.14
58
How do you calculate the air to oxygen ratio?
(100-x) / (x-21)
59
How do you calculate total flow?
(air + o2) x flow
60
How do you calculate the duration of flow?
(pressure x cylinder fact) / flow
61
What is the formula for finding PAO2?
(Pb-47)xFiO2 - (PACO2x1.25)
62
What is the formula for the a/A ratio?
PaO2 / PAO2 (normal >60%)
63
What does O2 therapy do?
- decrease WOB, shortness of breath - decreases HR and RR - increase SpO2 and PaO2
64
What sound indicates a leak or that the tubing is obstructed?
whistling
65
What does condensation or kinking in the tubing do to flow and FiO2?
- decreases flow - increases FiO2 - increases RAW
66
What is the alkalosis equation?
7.40+(40-CO2)*.01
67
What is the acidosis equation?
7.40-(CO2-40)*.006
68
If trending in opposite directions, what kind of problem is it?
metabolic
69
If trending in same direction, what kind of problem is it?
respiratory
70
When the pH, CO2 and HCO3 are all abnormal, what is it?
partially compensated
71
When the pH is abnormal and everything else is normal, what is it?
uncompensated
72
When only the pH is normal, what is it?
fully compensated
73
When the pH is calculated to be worse than expected, what does it mean?
combined metabolic and respiratory
74
What are the indications for USN?
- presence of upper airway edema - subglottic edema - postextubation edema - postoperative management of upper airway - presence of bypassed airway - need for sputum specimen or mobilization of secretions
75
What are the hazards of USN?
- wheezing or bronchospasm - infection - patient discomfort - edema of the airway wall - overhydration - bronchoconstriction
76
What are the physiologic effects of USN?
- improved vital signs - improved O2 saturation - decreased WOB - decreased dyspnea
77
What are the clinical findings of mild asthma (stage 1)?
- PaO2 normal - PaCO2 decreased - pH increased
78
What are the clinical findings of moderate asthma (stage 2)?
- PaO2 decreased - PaCO2 decreased - pH increased
79
What are the clinical findings of severe asthma (stage 3)?
- PaO2 decreased - PaCO2 normal - pH normal
80
What are the clinical findings of very severe asthma (stage 4)?
- PaO2 decreased - PaCO2 normal - pH decreased
81
What are the clinical findings of COPD stage 1?
- FEV1/FVC <70% | - FEV1 80% predicted
82
What are the clinical findings of COPD stage 2?
- FEV1/FVC <70% | - FEV1 50-79% predicted
83
What are the clinical findings of COPD stage 3?
- FEV1/FVC <70% | - FEV1 30-49% predicted
84
What are the clinical findings of COPD stage 4?
-FEV1/FVC <30% predicted
85
What are the clinical findings of emphysema?
- FEV1 decreased - FEV1/FVC decreased - lung volumes increased - residual volumes increased
86
What is cleaning?
removing of all foreign material (e.g., soil, organic material) from objects
87
What is disinfection?
a process that destroys vegetative forms of all pathogenic organisms on an inanimate object except bacterial spores
88
What is sterilization?
a process that destroys all microorganisms on the surface of an article or in a fluid. forms of sterilization include steam (autoclaving), flash and low temperature
RTH 190
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