Exam One

Question 1

What is the liter flow and FIO2 of a simple mask?

Answer 1

6-10 LPM (Variable FIO2 of 0.35 to 0.5)

Question 2

What are the two types of resevoir mask?

Answer 2

Partial rebreathing mask, Non rebreathing mask (flow of 6-15) provides almost 100% oxygen

Question 3

Can the air-entrainment mask be considered high flow, low flow, or both?

Answer 3

Both, ranging from 24-50%

Question 4

What are the ABG values to support <1500 grams premature infant to late term infant?

Answer 4

<1000 g premature infant (<28 weeks of GA): pH >7.25 paco2 45-55 pao2 45-65 HCO3 15-18

<1500 g premature infant to late term infant (28-40 weeks of GA): pH >7.25 paco2 45-55 pao2 50-70 HCO3 18-20

Term infant to toddler pH 7.30-7.40 paco2 30-40 pao2 80-100 HCO3 22-26

Question 5

Uncuffed landmark data

Answer 5

For patients under 8 years old

Tube in the middle of the third of the trachea, about half way between the vocal cords and carina (T2-T4)

Question 6

Cuffed landmark data

Answer 6

Cuff is below the vocal cords, placing the tip of the tube in the middle of the third of the trachea (2 cm above the carina or 4-5 or 3-5 be flexible)

Question 7

Pre and post ductal spo2 measurements in regard to what occurs in the body pre and post

Answer 7

Preductal oxygen saturation reflects an infants blood state before the ductus arteriosus and before it has a chance to be mixed with deoxygenated blood

Postductal oxygen saturation is a measurement taken after the ductus arteriosus and has been mixed with deoxygenated blood from the pulmonary circulation

Difference- can reflect the degree of shunting, response to therapy and degree of intervention

Question 8

Miller definition

Answer 8

Lift the epiglottis directly

Question 9

Macintosh definition

Answer 9

Placed in the vallecula and the epiglottis is lifted indirectly

Question 10

What is the sellick maneuver?

Answer 10

The Sellick Maneuver is performed by applying gentle pressure to the anterior neck (in a posterior direction) at the level of the Cricoid Cartilage. The Maneuver is most often used to help align the airway structures during endotracheal intubation.

Indicated if the larynx is not easily visualized

Question 11

SPAG data

Answer 11

Ribavin (Virazole) Antiviral agent drug ONLY FOR RSV

RSV (Respiratory Synctial Virus)

Drug delivered 12-18 hrs per day for 3 days-1 week

Equipment Needed: Hood, O2 tent or face tent

SPAG reduces the 50 psi to 26 psi

Two flow meters that control flow to nebulizer and drying chamber

Flow nebulizer is adjusted to max of 7 LPM with total flow of 15 LPM

Question 12

IPPB information

Answer 12

May be indicated if VC is less than 10mL/kg

VTE measured through wrights (12-15 hyperinflation 5-7 normal mL.kg)

Sensitvity- Too hard too easy to breathe. Nose clips and seal mean closed system

Airmix in get 100%

Normal chest excursion 3-5

Rate determines E time

With leak wont hit appropriate pressure

Question 13

Identify upper lobes apical segment

Answer 13

Image A

Question 14

Identify upper lobes posterior segment

Answer 14

Image B

Question 15

CPAP is also known as…

Answer 15

Continuous Distending Pressure

Question 16

What is the aneroid manometer used to obtain?

Answer 16

MEP or MIP

Question 17

What is the difference between these PEP devices?

Answer 17

Blue for flow rates of <15 LPM
Green for flow rates of >15 LPM

Both prevent dynamic airway collapse and improves clearance of mucus (can give tx with this even in line)

Question 18

What position is this x-ray displaying?

Answer 18

AP- Notice the scapulas are in the lung fields and the clavicals are horizontal

Question 19

Give an example of a correct coffalator order

Answer 19

PIP- 15-25 peds can bleed in o2 and breath hold is 1-2 seconds

Example: +20 Inhalation 2.0 seconds, -20 Exhalation 2.0 seconds 4 sequences QID

Question 20

What are some complications of airway clearance therapy?

Answer 20

Contraindications include: Frank hemoptysis, empyema, foreign body aspiration, and untreated pneumo

Complications: Trauma to ribs and skin, cold stress, trauma to airway during deep suctioning, hypoxemia is new borns

Question 21

What is the reasoning for this x-ray?

Answer 21

Lateral decubitusThe downward side can be evaluated for presence of fluid, such as a mobile pleural effusion, and the upward side will demonstrate free air, such as in the case of a pneumothorax (air in the pleural cavity)

Question 22

Identify the name of the exam and what it is used for

Answer 22

Forced expiratory Image used to evaluate the presence of a pneumo and foreign body aspiration

Question 23

Use the image to identify the condition and treatment plan

Answer 23

Epiglottis- intubate immediately don’t do anything to mouth as it will close up immediately.

Question 24

Use the image to identify the disease to support mark airway obstruction

Answer 24

Croup think stridor, administer racemic epinephrine 2.25% (0.5 mL) nebulized and heliox 80/20 via NRBM, dont forget coolmist if situation permits but DO NOT choose this for boards

Question 25

Use the image to identify the disease

Answer 25

Meconium aspiration syndrome

Coarse, patchy opacities, and areas of hyperinflation

Question 26

What is a potential treatment plan for this disease?

Answer 26

Asthma administer continuous albuterol 20 mg for 4 hours, administer prednisone 1mg/kg, and magnesium sulfate 4-6 g followed by intravenous infusion 2-4 g/hour