spc
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| show | BTPS, the American thoracic society requires this
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| In a pt with severe obstructive lung disease, which would be higher the FVC ot SVC? | show 🗑
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| A decreased FEV1 could be seen in? | show 🗑
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| Indirect spirometry methods? | show 🗑
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| show | not work, can only measure volumes in communication with the conduction airways, you would have to use body plethysmography for accurate FRC
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| show | medium to small airways, later in expiratory maneuver, normal is 4-5 l/sec,<80% pt on way to developing airway disease
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| FEF 200-1200? | show 🗑
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| Your pt's FEF 25% 75% is below predicted, what does this indicate? | show 🗑
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| show | strength test for abdominal muscles and accessory expiratory muscles. if decreased pt may not be able to cough, normal is 80-100
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| show | strength test of the diaphragm, intercostals, and inspiratory accessory muscles. (most negative pressure generated with inspiratory effort)
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| show | weakened inspiratory muscles, neuromuscular disease, chest/spine abnormalities
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| show | <-60 (-61,-62,-63, etc...)
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| Normal % predicted TLC | show 🗑
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| show | 35-135, < restricted, > obstructed
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| FEV1(actual)/FVC(actual) < 80% = | show 🗑
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| FVC(actual) < 80% predicted = | show 🗑
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| Your subject's spirometry results shows a VC, FRC, RV, and TLC less than predicted. This indicates... | show 🗑
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| A patient has an increased TLC, RV,FRC and has a reduced peak flow. What does this suggest? | show 🗑
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| Body plethysmography? | show 🗑
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| Pt has a reduced VC, reduced FEV1/FVC, increased RV, FRC, and TLC, This indicates? | show 🗑
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| show | peak flow meter, a decreased peak flow indicates obstruction
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| VT? | show 🗑
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| show | volume forcibly inhaled past normal vt
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| ERV? | show 🗑
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| RV? | show 🗑
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| IC? | show 🗑
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| show | volume exhaled after max inhale (can be decreased in obstruction because pt cant get air out, SVC will be higher) VT+IRV+ERV
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| TLC? | show 🗑
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| FRC? | show 🗑
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| The borg scale measures? | show 🗑
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| show | determining extent of airway inflammation, asthma severity and success of treatment, higher the FeNO the more inflammation
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| show | Fowler method and Bohr method
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| The fowler method is? | show 🗑
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| The bohr method uses what equation? | show 🗑
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| show | the idea that the difference between the CO inhaled and exhaled is the amount that has diffused into the bloodstream
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| If an FRC measured in a body box is higher than an FRC measured from a gas dilution method, this means? | show 🗑
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| Why is soda lime used in a rebreathing circuit? | show 🗑
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| show | Obstruction
Restriction
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| show | obstruction, early is larger airways, later in smaller airways (exhale larger airways first)
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| show | pre and post bronchodilater study, an increase in FEV1 > 12% indicates positive response, used to determine if obstructive disease is reversibe
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| show | 25mlCO/min/mmhg
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| show | 80-120% normal 60-80% mild defect 40-60% moderate defect 20-40% severe <20% very severe
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| show | emphysema, cystic fibrosis, pulm resection, pulm/fat emboli, anemia, interstitial lung disease(asbestosis, sarcoidosis, fibrosis, pneumonitis) pulm hypertension/edema
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| show | supine position, increased pulm blood flow, exercise, pulm hemorrhage, polycythemia with increased Hb(chronic lung disease can cause polycythemia), left heart failure, left to right cardiac shunt, high altitudes that increase Hb, asthma will be normal or
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| Pulmonary disease will affect DLCO results? | show 🗑
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| show | Measures: pH, PO2, PCO2 Calculates: HCO3, base excess, hemoglobin saturation
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| show | Directly mesures TOTAL Hemoglobin(hb), Oxyhemoglobin(HbO2), Methhemoglobin(MetHb), Carboxyhemoglobin(COHB), and carbon monoxide also calculate 02 percent but does not directly measure it
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| Analyzer electrodes that measure? | show 🗑
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| show | Will lower C02 (because partial pressure is 0.023 in air we breathe), if blood P02 is low it will falsely raise it, if blood P02 is high it will falsely lower it, also depends on how large air bubble is
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| What are ventilation scans used for? | show 🗑
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| What are perfusion scans used for? | show 🗑
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| V/Q scans are used for? | show 🗑
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| show | iodine tagged colloids into the bloodstream
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| show | 0.3% CO, 10% He, 02 , and N2 (room air)
Single breath DLCO requires difficult breathing maneuver and is very effort dependent
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| show | pt maintains normal VT breathing, 0.1% CO, remaining is room air
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| show | record keeping
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| show | record keeping, calibration verification, quality control, proficiency testing, and performance validation
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| show | CAP
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| RV is a volume, PEFR is a flow, and MIP is a ? | show 🗑
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| show | The results are less affected by V/Q abnormalities or by changes in the pt’s lung volumes during the test
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| show | get an ABG and run it through a Co Oximeter, lidocaine causes methemoglobin, and a co oximeter measures all Hb, oxyhb, carboxyhb, methb
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| show | College of American Pathologists, Joint Commission for Healthcare Accreditation(JCAHO) , agency for healthcare administration, american thoracic society (ATS)
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| show | process of applying appropriate measures to correct errors with blood gas machines
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| show | They provide a visual indicator of the performance of the ABG machine. One can determine whether a QC sample that is out of range is a random error, part of a trend, or systemic error (bias) that is trending out of range
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| show | staff training and retraining, more frequent preventative maintenance, closer staff supervision.
The punishment must fit the crime though!
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| show | 02 uptake, it is a multiple of resting 02 consumption.
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| What are MET's? | show 🗑
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| Metabolism requires the consumption of 02 to produce ATP, because it requires 02 it is called? | show 🗑
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| What is anaerobic metabolism? | show 🗑
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| show | the muscle reaches the anaerobic threshold and begins anaerobic metabolism, the greatest 02 consumption work level that can be achieved without producing lactic acid
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| The anerobic threshold? | show 🗑
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| show | VC02 200ml/min, V02 250ml/min RQ= 0.8
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| show | lactic acid build up, lactic acidosis, increased C02 production, increased VE and increased work on the lungs ( to get rid of C02), delayed onset muscle soreness ( due to lactic acid)
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| Your ventilated patient is having problems maintaining a low enough CO2 level. You want a diet that is? | show 🗑
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| show | fat 0.7, carbs 1, protein 0.8
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| show | place pressurized scope in sterile water, look for bubbles. If the scope bubbles during a leak test, this means? there is a leak, cannot be used, poses an infection risk to patient, must be sent out for repair
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| show | checking for damage to the optics or scope channels, If you see black dots when looking through the scope then the fiber optic bundles have been damaged and it should not be used
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| What two diseases are involved in an overlap syndrome? | show 🗑
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| show | hyperventilation and cardiac stress
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| What is the maximum voluntary ventilation? | show 🗑
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| A sleep study report is made on a ? | show 🗑
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| What is the most commonly used method of calorimetry on vented patients? | show 🗑
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| show | the airway for bronchoscopy
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| show | compares one blood gas analyzer to another
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| show | neuromuscular disease
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| What axis is volume and flow on a flow volume loop? | show 🗑
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| What are advantages of a liquid 02 system? | show 🗑
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| show | treat or solve a medical issue....verifying et tube placement is also therapeutic, assist with intubation, laser reduction of obstruction from cancer, etc...
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| show | used to establish the cause of a problem..bronchoalveolar lavage to collect sample, tissue samples, evaluate infections, etc..
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| What are some indications for bronchoscopy? | show 🗑
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| You would use bronchoscopy to | show 🗑
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| show | hypoxemia, irregular heart rhythms, bleeding, pneumothorax, fever, nausea, vomiting, pneumonia, medication complication, airway edema, respiratory arrest, vocal cord injury, death
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| Post bronch recovery? | show 🗑
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| If the patient is on a ventilator receiving a bronchoscopy, you should? | show 🗑
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| show | Insert oral airway so pt does not bite scope, adjust pt's 02, prepare scope (sterile, leak test, no damage) prepare meds and lavage's, insert and direct forceps and brushes, collect and label samples, record vitals and lavage types and amounts
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| show | minor sleep disturbances to desaturation, pulm htn, rt heart failure, excessive daytime sleepiness
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| The most common sleep disorder is sleep apnea, it is defined as? | show 🗑
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| Obstructive sleep apnea is caused by? Central sleep apnea is caused by? | show 🗑
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| show | small/unstable pharyngeal airway due to soft tissue problems (obesity, tonsillar hypertrophy, skeletal factors like small chin)
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| show | brain stem lesions, cardiovascular disorders, cerebrovascular disease, spinal cord lesions, elderly, thyroid disease, narcolepsy, cheyne stokes respirations
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| What kind of drugs may be given for a bronchoscopy? | show 🗑
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| show | No consent unless an emergency, no experienced bronchoscopist, lack of adequate facilities, inability to oxygenate patient, coagulopathy, refractory hypoxemia, unstable hemodynamic status
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| show | infection control and avoidance, nutrition, 02 therapy, smoking cessation, managing stress, recreation, leisure activities, exercise program, medical test and medication education
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| What are contraindications for a sleep study? | show 🗑
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| What does indirect calorimetry measure? . | show 🗑
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| show | direct calorimetry - amount of heat produced by a subject enclosed within a small chamber.
indirect calorimetry -amount of heat produced by a subject by determination of the amount of oxygen consumed and the amount of carbon dioxide eliminated.
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| What are the primary forms of home respiratory care? | show 🗑
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| What kind of 02 devices are used in the home? | show 🗑
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| Trans tracheal 02 catheters or SCOOP benefits? | show 🗑
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| RV and FRC measurements are made using indirect spirometry techniques ( cannot be done with direct because pt cant exhale these) . What are the techniques to measure this? | show 🗑
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| Fowler (single breath N2 washout) and bohr measure? | show 🗑
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| How is the open circuit indirect spirometry done? | show 🗑
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| Closed circuit indirect spirometry is? | show 🗑
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| show | takes the deepest breath possible in of a special gas mixture. The subject then holds their breath for 10 seconds, then exhales back down to the RV level.
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| show | a subject's diffusion are referred to as DLCO studies, single breath, steady state, and rebreathing
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| show | light transmission, visualizing, and multipurpose (aspiration, 02, tissue sampling, etc..) multipurpose is the functional channel
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| Trained althletes may not reach their anearobic threshold until? | show 🗑
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| What two 02 devices are used in the home? | show 🗑
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| show | 24-40% and no more than 6lpm. Must be humidified after 4 lpm. Infants are limited to 2lpm and must always be humidified
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| show | resevoir/pendant cannulas, and pulse dose/ demand regulators
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