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Fundamentals of RT
Fundamentals of RT - Final Review - SPC
| Question | Answer |
|---|---|
| People in Respiratory Care | Priestly = Oxygen, Black = Carbon Dioxide, Beddoes = Father Inhalation Therapy |
| Organizations of RT | AARC = Professional org. , NBRC = Testing, CoARC = Program accredidation |
| Service Areas of RT | General Theraputics, Critical Care, Emergency Care, Diagnostic, Pulmonary Rehab |
| General Therapy | Aerosol, humidity therapy, Bronchial hygiene, IS, IPPB |
| Critical Care | Mechanical Vent, CPAP, pt transport, Airway care |
| Emergency Care | CPR, pt transport, Intubation |
| Diagnostic | Sputum collection, ABG, PFT, bedside monitoring |
| Pressure Conversion Formula | either multipy or divide by 1.36(from cm to mm, divide)(mm to cm, multiply)...mm to lbs = x14.7....mm to g/cm3 = x 1034 |
| Boyle's Law | P1V1 = P2V2 (Temp is Constant) Think "boil" water by temp |
| Charlie's Law | V1/T1 = V2/T2 (Pressure is Constant) Think Charlie lives in VT |
| Gay's Law | P1/T1 = P2/T2 (Volume is Constant) |
| Graham's Law | Inversely proportional to sq. root |
| Henry's Law | More P = more gas dissolves in Liquid |
| Combined Gas Law | (P1V1)/T1 = (P2V2)/T2, if BTPS, remember to take out 47 from P2 |
| Nasal Anatomy | Vestibular(entry), Olfactory(smell), Respiratory |
| Vestibular Region of Nose | Alae(wings), Vibrissae(hairs), Septum(seperator) |
| Respiratory Region | Where the warming occurs, Superior, Middle and Inferior Concha |
| Pharyngeal Region | Naso, Oro, and Hypo/Laryngo pharyngeals |
| Laryngeal Region | Epiglottis, Thyroid(adams apple), Cricoid. Glottis is space between vocal chords |
| Trachea | 16-20 "C" shaped cartliages. Seperates about 21-23 cm from mouth at Carina into mainstream R and L Bronchi |
| Lobar Bronchi | Right has 3 that branch into 10 segmental. Left has 2 that branch into 8 segmental. |
| Bronchioles | Thousands. the Terminal Bronchioles are the last of the Conducting Airways |
| Pulmonary Lobule | Gas exchange area. Alveolar ducts, sacs, alveoli |
| Diaphragm | Two muscles L and R hemidiaphragms innervated by the Phrenic Nerve |
| Accessory Inspiration Muscles | Think Neck/Chest. Scalenes, Sterno, Pectoralis Major |
| Accessory Expiration Muscles | Stomach muscles |
| Minute Ventilation | Tidal V x Frequency. Normal values are 500ml x 12 = 6L/M |
| Alveolar Ventilation | Take (Tidal V - body wt) x f or if given VD/VT, take Tidal V x (1 - VD/VT) x f |
| Pulmonary Shunt | Alveolar deadspace. Perfusion w/o ventilation. No gas exchange. Noted in pneumonia |
| Deadspace | Conduction Airways. Ventilation w/o perfusion |
| ABG normal values | pH 7.35-7.45, CO2 40, HCO3 24 |
| ECG | P wave = atrial depolorization, QRS wave = ventricular depolorization, T wave = Ventrical repolorization |
| Cardiac Anatomy | Blood in RA thru Tricuspid to RV to Pulmonary Art return Pulm veins to LA thru Bi(Mi)to LV out Aorta |
| Oxygen Content Calculation | 1.34 x g/Hb x SaO2(sat). Then add (PaO2 x .003)to the total |
| Apnea | Stop Breathing |
| Dyspnea | SOB |
| Eupnea | Normal Breathing |
| Hypervent | blowing off CO2 <35 |
| Hypovent | CO2 level up >45 |
| Orthopnea | breath only in upright position |
| Hypernea | VT >10L/M |
| Hypopnea | VT <5L/M |
| Bradypnea | f <10/M |
| Tachypnea | f >20/M |
| Causes of Resp. Acidosis | Hypovent(hang on to CO2), Narc drugs, anestesia, sedative drugs, obesity |
| Causes of Resp. Alkalosis | Faster breathing, anxiety, Acute Asthma, Pulm. Vasc. disease, Hypobarism |
| Causes of Met. Acidosis | Loss BiCarb, Diarrhea, Diabetic ketoacidosis, lactic acidosis |
| Causes of Met. Alkalosis | Increase in Base, Diuretic therapy, Vomitting |
| Gas Cylinder Volumes | E= 22, G= 187, H= 244, K= 275 |
| Cylinder Factors | E= .28, G= 2.41, H= 3.14 |
| Cylinder Calculation/Duration of Flow | (PSIG x Factor)/Flow |
| Liquid to Gas Conversion | 1LB of Liquid O2 = 344L Gaseous O2 |
| Cubic Feet to Liters | 1Cu foot of Gaseous O2 = 28.3L of Gas |
| NFPA | Regulates storage and Handling of cylinders as well as central supply gas and piping |
| DOT | Regulates cylinder construction, testing and transport |
| CGA | Sets all safety standards...ASSS, PISS, DISS |
| FDA | Sets medical gas purity standards |
| Thorpes Tubes Flowmeter | COMPENSATED, will jump, needle distal to valve, reads accurately in back pressure |
| Oxygen Concentrators | Electrically powered, use molecular sieves containing ZEOLITE to absorb N2 as well as H2O and CO2 from air. <6L/M = 92-96% delivered |
| Alveolar Air Equation | Quick and dirty 7 x FiO2 - CO2 from Bl. gas |
| Clinical Manifestations of Hypoxemia | Tachycardia, Tachypnea, Cyanosis, Pulmonary Hypertention, Restlessness/Confusion |
| Refractory Hypoxemia | Minimal response w/ increase FiO2. Due to Shunting. Use PEEP or CPAP |
| Responsive Hypoxia | Significant increase in PaO2 w/increase in FiO2. Due to V/Q mismatch or diffusion defect. Use Hi or Low flow device |
| Total Flow | Remember Magic Box from Clinicals100 Percent20Then cross substact, add then x flow |
| AARC CPGs for Hypoxemia | Documented = PaO2 < 60mmHg, SaO2 <90%. Suspected = Acute M/I, Severe Trauma |
| Low Flow Systems Under 15L | NC= 2-4L, Transtracheal O2 Cath, Simple= 6-10L, Partial and Non-Rebreathing Masks= 12-15L |
| High Flow Systems | Will meet pts peak Insp. needs. AEM <.40/Venti, AE Nebs - High Flow <.40 |
| Oxygen Analyzers | Polargraphic and Galvanic Fuel Cell |
| Polargraphic | Used in Bl. Gas machines, Clark electrode, vent circuits, O2 analyzers. Fast because of Battery. Under 30 secs. Silver Anode, Platinum Cathode KCl solution |
| Galvanic Fuel Cell | No Voltage. Found Vent circuits O2 analyzers. Lead Anode, Gold Cathode, teflon membrane, SLOWER |
| HeOx Therapy | Decrease turbulence and WOB, Stidor(post extubation), Croup, Foreign body aspiration, Upper airway masses, Diffuses faster than O2 or air |
| Pulse Ox | Spectro= light, S= spectrum.Photo= Pulse |
| Hyperinflation Calculation` | VC= ml/kg. If VC >10-15 and clear= ISVC >10-15 w/secrections PEP, VC <10-15 and clear= IPPB |
| Bronchial Hygiene Devices | Oscillation, HFCC(Hi Freq Closed Chest), HFO(Flutter Valve)= CHEAP, IPV(used for tx w/hygiene therapy), MIE(mechanical couch), HUFF(Forced Ex. Techniques), Autogenic Drainage(AD) uses series of steps |
| Categories of Nebs | Pneumatic(powered by gas) include Jet,SVN, LVN(SPAG for Ribavirin and HEART for continuous Broncho Di), MDI, DPI. Electric- ultrasonic |
| Percent Drug Solution | divide mg/ml/10 for % solution or % solution x 10= mg/ml |
| What are Adrenergics? | Sympathetic. Receptor sensitive to norepinephrine. Increase HR and contraction, bronchodilate, Vasoconstriction |
| Adrenergic Drugs | Catecholamines - Racemic(All receptors), Noncatecholamines - Alupent, Albuterol, Levalbuterol, Salmeterol, Formoterol, Brovana, Tornalate, Maxair |
| What are Anticholinergics? | Block Parasympathetic receptor sensitive to acetylcholine. Broncho Di, Increase HR, Dry secretions. Atrovent and Spiriva(Tiotropium BR) DPI |
| What are Asthma Maintenance Drugs? | Glucocorticosteroids= Prednisone(Tab) and Pulmicort(MDI/DPI. Also Mast cell stabilizers Intal and Tilade. And Leukotriene blockers Accolate, Zyflo and Singulair. Fight all inflammation. |
| Proteolytic Agent | Dornase Alpha(Pulmozyme) NEB, infectious secretions, digest DNA |
| Wetting Agents | Use Ultrasonic Neb, Iso and Hypo both Thin secretions and Hyper induces sputum |
| Biological Indicators | Spore strips used to determine sterilization |
| Chemical Indicators | ETO exposure |
| Disinfectants | Low-level in Home Acetic Acid(Vinegar), Glutaraldehyde (sterilizing agent for vent tubes, scopes, bags), Auto- claving(true sterilization process in central supply, damages rubber and plastic), Ionizing(High cost, long time), Ethylene(heat sensitive), |
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