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Midterm
RTH 190
| Question | Answer |
|---|---|
| pulsus alternans | pulse alternates between strong and weak -L heart failure |
| bounding pulse | high blood volume -arterial sclerosis |
| pulsus paradoxus | pulse decrease on inhale -COPD |
| thread pulse | low blood volume -hypovalemic |
| causes for thread pulse | 1.shock 2.dehydrated 3.hemorrhage |
| causes for bounding pulse | 1.exercise 2.fever 3.anxiety 4.high BP |
| adult pulse range | 60-100 |
| child pulse range | 80-120 70-110 |
| newborn pulse range | 90-160 |
| neonate pulse range | 120-160 |
| what can cause arterial blood pressure to vary | 1.age 2.blood volume 3.exercise 4.worry 5.change position 6.wrong BP cuff size |
| causes of bradycardia | 1.hypothermia 2.heart disorder 3.athletes 4.old age |
| bradycardia sign of what in only premies | hypoxemia |
| Causes of tachycardia | 1.hypoxemia 2.fever 3.blood loss 4.anxiety 5.exercise |
| how do you check for cerebral perfusion` | pupillary reactivity -PERLA |
| biological indicator for ETO gas | bacillus sabtillus |
| what does the indicator tape say about the equipment | that it has gone through the process |
| ETO mixed with water creates what | Ethylene Oxide |
| PVC plus ETO mixed together create what | ethylene chloride |
| ETO criteria | temp- 50 time- 3/4 hr humidity-50% concentration-100% |
| Autoclaving criteria | temp-121 pressure-15 time-15min temp-134 pressure-29.4 time-3min |
| what does activated gluteraldehyde | 1.cell wall is destroyed in 10 hours- sterilization 2.high level disinfection |
| other name for activated gluteraldhyde | cidex |
| how long does cidex take to disinfect | 12 min @ 20 degree celcius |
| what is the least likely sterilization/disinfectant method to be used | steam autoclaving |
| why is steam auto claving not used on resp equipment | it will melt the equipment |
| how long does ETO have to air out if not put in an aerator | 7 days |
| does pasteurization kill spores | no |
| handwashing can prevent what | nosocomial infections |
| what position helps minimize hypoxemia in CHF patients | semi-fowlers |
| consolidation | dull-pneumonia |
| pleural effusion | flat-fluid |
| pneumothorax | hyperresenonce-air |
| hyper-inflated | hyperresenonce |
| atelectasis | dull |
| protocol if error in medical record | 1.draw line through 2.initial |
| protocol if error in EMR | 1.edit 2.correct 3.why change 4.initial |
| increased WBC means | bacteria |
| decreased WBC means | infection |
| purpose of C&S | test sputum for bacteria |
| culture says what | what kind of bacteria |
| sensitivity says what | what antibiotics will work to kill bacteria |
| pseudomonas secretions | 1.green 2.thick 3.smells |
| pulmonary edema | pink and froathy |
| lung cancer | red/bloody |
| bronchiectasis | 3 layered 1.green 2.yellow 3.frothy |
| smoker | gray |
| URI | yellow thick |
| chest formation and x-ray for emphysemia pt | 1.barrel chest 2.flattened diaphragm 3.hyperinflation 4.increased A-P diameter 5.widened ribs |
| dysphagia | hard swallowing |
| anorexia | no appetite |
| orthopnea | SOB laying |
| platypnea | SOB sitting |
| dyspnea | SOB |
| bradypnea | slow breathing |
| hypopnea | shallow breathing |
| hyperpnea | deep breathing |
| tachypnea | fast breathing |
| eupnea | normal breathing |
| kussmals | deep fast breathing from DKA |
| Biots | irregular breathing with apnea |
| cheyne-stokes | increase depth and rate of breathing with apnea |
| macroglossia | enlarged tongue |
| normal RR | 12-20` |
| normal NIF | 80-100 |
| normal VT | 5-8 |
| normal VC | 65-75` |
| normal Ve | 5-6 |
| what is the criteria needed to be considered for extubation | rr= <25/min NIF=>-20 Vt=>5ml/kg VC=>10ml/kg Ve=<10L/min |
| formulas for RSBI | RR/Vt |
| complication from extubation | stirdor |
| how do you know if a patients ETT is in the right place | 1.CO2 detector 2.bilateral breath sounds 3.bilateral chest movement X-ray |
| on an x-ray where is the end of the ETT | 1.4th rib 2.4th thoracic vertebrae 3.2-3 cm above carina 4.2cm aortic noch |
| sins of a complete airway obstruction | 1.no talking 2.accessory muscle use 3.universal sign 4.supraclavular retraction |
| PISS | pin index safety system |
| why is PISS used | to prevent missconnect |
| where is PISS used | E and smaller |
| what are the pin numbers for PISS for O2 | 2 and 5 |
| why crack the cylinder | to clear debris |
| how can you check O2 levels in tank | read pressure gauge |
| psi tank formula | psi x (.28/3.14)/Lpm |
| after the tank formula how do you find out how long the tank will last | divide by 60 |
| what is a 2 stage regulator | 2 stages to reduce psi |
| how can you tell how many stages a regulator has | number of pop off valves |
| how can a venture FIO2 be high | if air entrainment ports are blocked |
| if a pt can't feel O2 coming out of NC | 1.check connections for malfunction 2.put in water to see bubbles |
| what is oxygen induced hypoventilation | 1.O2 kicks out hypoxic drive |
| 2 goals of oxygen therapy | 1.decreased WOB 2.decreased cardio work |
| why give a pt heliox | bypass an obstruction because heliox is lighter than O2 |
| flow rate formula for 20/80 heliox | lpm x 1.8 |
| flow rate formula for 70=30 heliox | lpm x 1.6 |
| what device do you use to deliver heliox | nonrebreather |
| if you remove the oneway valve to the reservior from a nonrebreather | it is an partial rebreather |
| if a patient doesn't like wearing a simple mask, what is a replacement | a nasal cannula |
| how do you cure sangulation | carbon dioxidee |
| how do you deliver carbon dioxide to the patient | nonrebreather |
| can you leave a patient on carbon dioxide for 3 hours | no more then 15 min and stay with them the whole time |
| what should be monitored with a patient on carbon dioxide therapy | 1.RR 2.pulse 3.depth of respirations |
| if a patient is spontaneously breathing and needs 100% FIO2 what device should they be put on | nonrebreather |
| what is a low flow oxygen device | one that obly give a portion of patients inspired air and varies with patient effort |
| what are 2 requirements for a device to be considered high flow | 1.provides all of inspired air 2.consistant FIO2 regaurdless of patient effort |
| 4 examples of low flow devices | 1.NC 2.nasal catheter 3.simple mask 4.partial rebreather |
| 6 examples of a high flow device | 1.high flow NC 2.venturi mask 3.trach collar 4.face tent 5.nonrebreather 6.T piece (briggs) |
| if a patient is breathing fast and shallow what oxygen device would be the best choice | 1.venture- high flow that will give the same FIO2 reguradless of patient efforts |
| what are 4 complications of giving oxygen to patients | 1.O2 toxicity 2.O2 hypoventilation 3.retrotenal fibroplasia 4.absorption atalectasis 3.ret |
| when can oxygen toxicity occure | if patient is on oxygen for more then 12-24 hours |
| when can O2 hypoventilation occur | with COPD patients, there hypoxic drive will be messed up and they will stop breathing |
| who is effected by retrotenal fibroplasia | infants if O2 is too high and they become blind |
| what is absorption atelectasis | too much O2 pushes out Nitrogen which holds open alveoli and then they collapse |
| if a patients nonrebreather mask collapses when they inhale what should be done to correct it | increase the flow |
| if a patients nonrebreather mask collapses when they inhale what is happening to the patient | they are not getting enough air |
| 2 ways to increase te output of an aresol nebulizer | 1.put a heater on it 2.use a tandum set up |
| what does a tandum set up do for an aresol neb | increases the flow |
| why put a heater on an aresol setup | increases the humidity which is the amount of moisture the air can hold thus giving the patient more aresol |
| 4 ways to keep nosocomial infections down when using aresol devices | 1.hand hygiene 2.change equipment 3.use equipment sterile 4.don't tough the inside of sterile equipment |
| 2 devices that can give 100% body humidity to a patient | 1.Wick 2.Cascade |
| 100% body humididty | 44ml/L 47mmHg |
| 24% | 25:1 |
| 28% | 10:1 |
| 30% | 8:1 |
| 35% | 5:1 |
| 40% | 3:1 |
| 45% | 2:1 |
| 50% | 1.7:1 |
| 60% | 1:1 |
| 70% | .6:1 |
| total flow rate formula | air + O2 x LPM |
| why heat a nebulizer | increases humidity so the amount of aresol delivered goes up=more mist |
| if water is trapped in the venturi what does it do to the FIO2 | increases the FIO2 because it take up the area where air would be entrained, so all patient is getting is the O2 |
| what does the reservior tubing at the end of a T piece do | it maintains the FIO2 |
| fluid reserviors are most often contaminated with | psuedomonas |
| why id=s the loop below patient level on a large bore aresol neb | to keep condensation following gravity and go down into the water trap to prevent patient aspiration |
| 6 things that can happen to patient tracheobronchial tree when humidity deficit is present | 1.tenacious secretions 2.decrease bronchial clearance 3.increase viscosity 4.possible atelectasis 5.possible infection 6.possible increase WBC |
| disadvantages and side effects of aresol therapy | 1.increase bacterial infections 2.increase bronchospasm 3.increase body weight |
| 3 things that can be obtained from an ABG | 1.ph 2.pao2 3.paco2 |
| why is ph important to therapist | acid base balance of body, lets us know if something is wrong with the body and find out what it is so we can fix it |
| why is pao2 important | how well is pt oxygenating |
| why is paco2 important | how well pt is ventilating |
| systol | vent. contraction |
| dystol | vent. @ rest |
| if the cuff is too tight what happens to blood pressure | High reading |
| if the cuff is too big what happens to the BP | low reading |
| total cycle time = | 60 divided by RR |
| I time | total cycle time/(I+E) |
| E time | Total cycle time - I time |
| tracheal shifts with pneumothorax | away |
| tracheal shifts with pleural effusion | away |
| tracheal shifts with atelectasis | towards |
| tracheal shifts with emphysema | none because it effects both lungs |
| tracheal shifts with lung tumors | towards |
| tracheal shifts with pneumonia | towards |
| formula for VD/Vt | PaCO2-PeCO2/ PaCO2 |
| formula for Vt | Ve/Rates |
| formula for MAP | 2Dystol + 1Systol/3 |
| formula for pack years | packs per day x years smoked |
| formula for total flow rate | (air + O2) x Lpm |
| formula for IBW | 50 + (2 x height over 5ft) |
| formula for alveolar Vt | Vt-dead space |
| formula for average VC | 65-75 ml/kg |
| formula for RSBI | RR/Vt |
| what are the 4 capacities preformed in a PFT | 1.vital capacity 2.inspirator capacity 3.functional residual capacity 4.total lung copacity |
| what are the 4 volumes preformed in a PFT | 1.inspiratory reserve volume 2.tidal volume 3.expiratory reserve volume 4.residual volume |
| what is the IRV | deepest breath possible on top of Vt |
| what is Vt | normal breath |
| what is ERV | exhale as much as possible |
| what is RV | what is left in your lungs after exhale |
| formula for TLC | Vt + IRV + ERV +RV |
| formula for FRC | ERV + RV |
| formula for IC | VT + IRV |
| formula for VC | VT + IRV + ERV |
| what is VC | maximal exhale after maximal inhale |
| what conditions can affect puls ox readings | 1.acrylic nails 2.dark nail polish 3.poor perfusion 4.methemoglobin 5.carboxyhemoglobin |
| 4 things that can affect a patients PO2 | 1.age 2.FIO2 3.altitude 4.CO2 |
| advair | fluticasone propionat and salmeterol or flovent and salmeterol |
| abuterol names | 1.ventolin 2.proair 3.proventil |
| vanceril | beclomethosone |
| solumedrol | methyylpredisolone |
| how is methylprednisolone delivered | 1.IV 2. oral |
| when is methylprednisolone delivered via IV | acute asthma attack |
| flunisolide | aerobid |
| xopenex | levalbuterol |
| xopenex dosages | .63 and 1.25 |
| duo neb | ipitropuim bromide and albuterol or ipitropium bromide and fenoterol |
| atrovent | ipitropium bromide |
| beta agonists | peak early and end early |
| anticholernergics | peak late and last longer |
| patients ability to follow instructions | preforms tasks on command |
| patients ability to say their name | orientation to person |
| patiens ability to know where they are | awareness of location |
| patients ability to know date and time | awareness of time |
| when do CPR on an infant | when their HR is less than 60bpm |
Created by:
Kataleshire
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