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RES 260
RES 260 Final Exam Study Guide
| Question | Answer |
|---|---|
| List the symptoms of hypovolemic anemia. | Nose, mouth, throat, and other mucous membranes drying out Skin loosing it's elasticity,Urine output decrease,Pale,Rapid Heart Rate |
| Define hypovolemic anemia. | Hypovolemic anemia or hypovolemia is a decrease of the volume of fluid in the body. Due to a loss of body fluids (diarrhea & vomiting) are common causes of body fluid loss. There could also be blood loss due to an injury or internal bleeding. |
| List the indications for administration of a bronchodilator. | decreased breath sounds, decreased chest expansion, presence of wheezes and retractions, increased RR, nasal flaring, grunting, increased ventilatory pressures, increasing FiO2 requirements, and increasing PaCO2. |
| the signs of a Pneumomediastinum. | A pneumomediatinum occurs when extra-alveolar air dissects through the lung interstitium and ruptures into the mediastinum. |
| symptoms of a Pneumomediastinum. | distant, crackly heart sounds.There will usually be shifted heart sounds |
| List the reasons for giving bicarbonate | is used to buffer the metabolic acidosis that often accompanies hypoxia. |
| HCO3 Normal value? Range? | HCO3 Normal=24mEq/L Range= 22-26mEq/L |
| If the TcPO2 is consistently lower than the actual PaO2 is this normal | general, transcutaneous PO2 levels are lower than PaO2 values. |
| If the TcPO2 is consistently lower than the actual PaO2, what could be the cause of this inconsistency? | the TCM is measuring tissue oxygenation, inappropriate electrode temperature, poor hemodynamics, pressure on the TCM site. |
| What is the minimal liter flow used with an oxyhood? | a flow of 7 L/min or more |
| What is the minimal liter flow used with an oxyhood? Why? | If too low a gas flow is used, there is a chance of CO2 retention in the hood. |
| The heart rate of a neonate during a resuscitation is 18 beats in a 15-second period. What is the next step in the resuscitation? | convert the heart rate 18bpm x by 4 (15sec) HR 72 bpm Since heart rate range 60- 100 vent with ppv with 100% oxygen for 15-30 sec.since heart rate is below 80 vent/ initiate meds/HR below 80 af30 sec/ppv /100% oxygen chest compressions. |
| Name the drug that would produce anesthesia for a bronchoscopy. | Fentanyl citrate |
| Adverse effects of Fentanyl citrate include | seizures, musle rigidity, hypotension, and bradycardia |
| Define systolic murmur, | a systolic heart murmur is a murmer during systole which involves stenosis of the semilunar valves or regurgitation of the atrioventricular valves, |
| Define diastolic murmur | while a diastolic heart murmur is heard during distoli involving narrowing of the atrioventricular valves or regurgitation of the semilunar valves |
| Define primary murmur | A heart murmur is a swishing noise heard during auscultation of the heart when there is turbulent, or abnormal flow across the heart valve. |
| You have a patient on a ventilator, if the CXR shows air trapping, what do you decrease on the ventilator to help with this problem? | decrease minute volume or increase expiratory time, |
| Define acrocyanosis | condition in the newborn in which the body is pink, but the feet and hands will still be blue. It is commonly seen in the first 24 hours after birth. |
| . If a neonate has strong and equal brachial pulses and decreased femoral pulses, what is the most likely cause of this? | could be an indication of heart anomaly such as coarctation of aorta or patent ductus arteriosus. |
| What is the normal systolic blood pressure for a 1000 g neonate? | normal systolic BP would be 39-59 MM HG. |
| A neonate being ventilated on a pressure limited, time cycled ventilator has the following ABG: PH:7.29, PaCO2: 52 torr, PaO2: 75 torr. Which of the following changes would you make on the ventilator to improve this blood gas? | increase the peak pressure, |
| Define diaphragmatic hernia | herniation the neonate may have due to an embryologic formation of the diaphragm through the thorax. |
| diaphragmatic hernia include signs and symptoms. | Symptoms including:cyanosis, bowel sounds in the chest, polyhydramnios and it is verified by a chest X-ray. |
| What is the normal suction regulator pressure for a three-week-old? | neonate is -60 to -80 mm Hg. |
| Define PG | PG stands for phosphatidylglycerol which is a glycerophospholipid found in pulmonary surfactant. It is the precursor of surfactant and its presence in the amniotic fluid indicates fetal lung maturity. |
| State what is required when attempting an intubation on a newborn | laryngoscope and blade, pediatric bronchoscope, resuscitation bag and mask, suction equipment |
| What is Ribavirin indicated for? | Respiratory Syncytial Virus(RSV), · severe distress,apnea,worsening blood gas values |
| When weaning a patient from a mechanical ventilator the neonate becomes tachycardic with an increasing PaCO2. What is the most appropriate recommendation? | continue weaning, obtain a stat chest film, reinstitute mechanical ventilation, extubate the patient |
| Define the Silverman-Anderson Index. | evaluate respiratory distress in the newborn |
| For which of the following would you recommend CPT | pleural effusion |
| Name the hazards of oxygen. | Retinopathy of prematurity-Bronchopulmonary dysplasia-Cerebral vasoconstriction- |
| If no pressure is generated when the patient connection is occluded and the bag is compressed on a flow inflating resuscitation bag, which of the following is NOT a possible problem | the valve seat is not tightened |
| If a patient’s heart rate drops during suction. What are the most probable causes of this drop? | Excessive suction pressures, hypoxia, hypothermia, vagal stimulation |
| Define secondary apnea. | Secondary apnea is defined as a cessation of breathing accompanied by bradycardia |
| A respiratory care practitioner is administering oxygen to a 40-week neonate by attaching oxygen tubing from a flowmeter to an incubator. The practitioner is unable to achieve an FiO2 greater than 0.40.? | The RRT is using an older incubator and must lift the arm with the attached red flag |
| When asked to recommend a parasympathetic drug for inhalation. What is the best recommendation? | (Ipatropium bromide (Atrovent),acts by blocking acetylcholine receptors, thus inhibiting parasympathetic stimulation.less side effects, |
| If the rate of the neonatal ventilator slows when the inspiratory time is increased what is the most probable cause? | The ventilator uses an expiratory timer. |
| What is the ‘classic method’ of measuring lung compliance and airway resistance on a neonate to estimate pleural pressure? | esophageal balloon |
| State the correct flow for an oxygen hood. | flow of 7 l/m to avoid build up of Co2 in the oxyhood. |
| Before extubation of a pediatric patient with a cuffed ETT, what do you do first? | deflate the cuff, suction etc |
| What is the appropriate size ETT for a 1400 g neonate? | 3.0 |
| The warmer on a 28-week neonate low temperature alarm activates. What is the most likely cause for the alarm? | check the heater probe |
| You are asked to obtain an ABG on an infant with a PDA. Where would you draw blood from that would best reflect preductal blood flow? | right radial arterial sample |
| You have some home apnea monitoring equipment and the monitor has multiple false alarms. What is your initial action? | caused by loose, misapplied, or broken electrodes. |
| calculate the CORRECTED TIDAL VOLUME | |
| While performing CPT on a neonate the patient requires a 30% increase in their FiO2. What do you do? | Treatment should be stopped |
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