131-humidity final Flashcards by Christine Deihl

What is the point in the respiratory tract where inspired gas reaches body temperature, ambient pressure, saturated BTPS conditions

Isothermic Saturation Boundary

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Which of the following factors causes the isothermic saturation boundary to shift farther down into the airways?
I.  Decreased ambient temperature
II.  Increased tidal volume
III.  endotracheal intubation
a.  1 and 2
b.  2 and 3
c.  1 and 3
d.  1, 2, and 3

D all of the above

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What is the primary goal of humidity therapy?

a. decrease airway reactivity to cold
b. maintain normal physiological conditions
c. deliver drugs to the airway
d. reduce upper airway inflammation

b. maintain normal physiological conditions

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Indications for the warming of inspired gas include all of the following except:

a. treating a patient whose airways are reactive to cold
b. providing humidification when the upper airway is bypassed
c. treating a patient with a low body temperature (hypothermia)
d. reducing upper airway inflammation or swelling

ANS: D

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Inhalation of dry gases can do which of the following?

increase viscosity of secretions
impair mucociliary motility
increase airway irritability
a. 1 and 2
b. 3
c. 1 and 3
d. 1, 2, and 3

ANS: D
As the airway is exposed to relatively cold, dry air, ciliary motility is reduced, airways become more irritable, mucous production increases, and pulmonary secretions become inspissated (thickened due to dehydration).

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Which of the following inspired conditions should be maintained when delivering medical gases to the nose or mouth?

a. 50% relative humidity (RH) at 20° to 22° C
b. 100% RH at 20° to 22° C
c. 80% RH at 28° to 32° C
d. 100% RH at 32° to 35° C

ANS: A

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Which of the following inspired conditions should be maintained when delivering medical gases to the hypopharynx, as when administering oxygen by nasal catheter?

a. 50% relative humidity (RH) at 20° to 22° C
b. 100% RH at 20° to 22° C
c. 95% RH at 29° to 32° C
d. 100% RH at 32° to 35° C

ANS: C

See Table 35-1

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What device adds molecular water to gas?

a. agitator
b. humidifier
c. nebulizer
d. atomizer

ANS: B

A humidifier is a device that adds molecular water to gas.

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Which of the following inspired conditions should be maintained when delivering medical gases directly into the trachea through an endotracheal tube or a tracheotomy tube?

a. 50% relative humidity (RH) at 20° to 22° C
b. 100% RH at 37° to 42° C
c. 95% RH at 29° to 32° C
d. 100% RH at 32° to 35° C

ANS: D

See Table 35-1

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Clinical indications for delivering cool humidified gas include which of the following?

post-extubation edema
upper airway inflammation
croup (laryngotracheal bronchitis)
epiglottitis
a. 2, 3, and 4
b. 1, 2, and 3
c. 1, 2, 3, and 4
d. 2 and 3

ANS: C
The delivery of cool humidified gas is used to treat upper airway inflammation resulting from croup, epiglottitis, and post-extubation edema.

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. What is the most important factor determining a humidifier’s performance?

a. surface area
b. temperature
c. time of contact
d. gas flow

ANS: B

Temperature is an important factor affecting humidifier performance

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Gas leaving an unheated humidifier at 10° C and 100% relative humidity (absolute humidity = 9.4 mg/L) would provide what relative humidity at body temperature?

a. about 100%
b. about 60%
c. about 40%
d. about 20%

ANS: D
Although the humidifier fully saturates the gas, the low operating temperature limits total water vapor capacity to approximately 9.4 mg/L water vapor, equivalent to approximately 21% of body humidity

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What is the simplest way to increase the humidity output of a humidifier?

a. Increase the time that the gas and the water are in contact.
b. Increase the surface area between the water and the gas.
c. Decrease the water vapor pressure of the gas.
d. Increase the temperature of either the water or the gas.

ANS: D
Simply heating the humidifier to 40° C (Figure 35-3, right) increases its output to 51 mg/L, which is more than adequate to meet BTPS conditions

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Which of the following types of humidifiers are used in clinical practice?

heat-moisture exchanger
passover humidifier
bubble humidifier
a. 1 and 2
b. 2 and 3
c. 1 and 3
d. 1, 2, and 3

ANS: D
Active humidifiers typically include: (1) bubble humidifiers, (2) passover humidifiers, (3) nebulizers of bland aerosols and (4) vaporizers. Passive humidifiers refer to typical heat and moisture exchangers (HMEs).

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. What is the goal of using an unheated bubble humidifier with oronasal oxygen delivery systems?

a. Raise the humidity of the gas to ambient levels.
b. Fully saturate the inspired gas to body temperature, ambient pressure, saturated (BTPS) conditions.
c. Cool the gas down to below room temperature.
d. Fully saturate the inspired gas to ambient temperature, ambient pressure, saturated (ATPS) conditions

ANS: A
Unheated bubble humidifiers are commonly used with oronasal oxygen delivery systems (see Chapter 38) the goal is to raise the water vapor content of the gas to ambient levels.

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Why should you NOT heat the reservoirs of a bubble humidifier used with an oronasal oxygen delivery system?

a. Condensate will obstruct the delivery tubing.
b. Heating will melt the reservoir or cause a fire.
c. Heating will absorb the extra water vapor.
d. Heating will causes too much aerosol impaction

ANS: A
Heating the reservoirs of these units can increase humidity content but is not recommended because the resulting condensate tends to obstruct the small-bore delivery tubing to which they connect

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To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate which of the following?
To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate which of the following?
a. HEPA outlet filter
b. pressure relief valve
c. automatic hygrometer
d. electronic alarm system

ANS: B

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When checking an oxygen delivery system that incorporates a bubble humidifier running at 6 L/min, you occlude the delivery tubing, and the humidifier pressure relief immediately pops off. What does this indicate?

a. malfunctioning humidifier
b. normal, leak-free system
c. malfunctioning flowmeter
d. leak in the delivery tubing

ANS: B

If the system is obstructed at or near the patient interface and the pop-off sounds, the system is leak free

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A design that increases surface area and enhances evaporation by incorporating an absorbent material partially submerged in a water reservoir that is surrounded by a heating element best describes what type of humidifier?

a. bubble
b. wick
c. cascade
d. hygroscopic

ANS: B

Typically a wick is placed upright with the gravity-dependent end in a heated water reservoir.

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Which of the following are types of heat-moisture exchangers (HMEs)?
Which of the following are types of heat-moisture exchangers (HMEs)?
1. simple condenser
2. hygroscopic condenser
3. hydrophobic condenser
a. 1 and 2
b. 2 and 3
c. 1, 2, and 3
d. 3

ANS: C
There are three basic types of HMEs: (1) simple condenser humidifiers, (2) hygroscopic condenser humidifiers, and (3) hydrophobic condenser humidifiers

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A heat-moisture exchangers has an efficiency rating of 80%. What does this mean?

a. Of the exhaled water vapor, 80% returns to the patient on inspiration.
b. The inspired temperature is 80% of the expired temperature.
c. Of the exhaled water vapor, 20% returns to the patient on inspiration.
d. The device provides 80% relative humidity at body temperature.

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ANS: A

According to the National Institute of Standards and Technology of the U.S. Department of Commerce, a gas cylinder that is color-coded brown and green should contain which of the following?

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He Oxide

The gauge on an E cylinder of O2 reads 800 psig. About how long would the contents of this cylinder last, until completely empty, at a flow of 3 L/min

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Formula: Pressure x cylinder factor / flow l/min
Answer: 74.666 or 1 hour 14 min
Note the cylinder factor is 0.28 for E cylinder

What do the components of a liquid O2 bulk storage tank include?
I. inner and outer steel shells, separated by a vacuum
II. safety system that vents O2 if warming occurs
III. vaporizer system that converts liquid O2 to gas
IV. pressure-reducing valves to lower pressure to 50 psig
A. I, II, and III
B. II and IV
C. I, II, III, and IV
D. III and IV

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C-all of the above

23. What safety system is represented by this image? Know the 2 safety systems according to tank size & name them:

ASSS--large cylinders PISS--small cylinders, aa through E DISS--low pressure outlets on both size tanks

Specific clinical objectives of oxygen (O2) therapy include which of the following? A Correct documented or suspected acute hypoxemia B Decrease symptoms associated with hypoxemia C Decrease the workload hypoxemia imposes on cardiopulmonary system D All of the Above

D. All of the above

``` . Which of the following signs and symptoms are associated with the presence of hypoxemia? .A. Tachypnea B. Tacyhcardia C. Cyanosis D. All of the above ```

D. All of the above

A patient with chronic hypercapnia placed on an FIO2 of 0.6 starts hypoventilating. What is the probable cause of this phenomenon?

O2 Induced Hypoventilation

Which of the following is false about absorption atelectasis? A) It can occur only when breathing supplemental O2 B. Its risk is increased in patients with low tidal volumes C. Its risk is decreased through the sigh mechanism D. It results in an increase in physiological shunt fraction

A) It can occur only when breathing supplemental O2

. Delivery systems that provide only a portion of a patient’s inspired gas are referred to as what?

Variable Performance Systems

``` . A 27-year-old woman received from the emergency department is on a nasal cannula at 5 L/min. Approximately what FIO2 is this patient receiving? A. 50% B. 28% C. 40% D. 21% ```

C 40% Note each 1 lpm is an increase in 4% beginning with 20% of room air

``` What is the minimum flow setting for a simple mask applied to an adult? A. 5 L/min B. 1 L/min C. 10 L/min D. 6 L/min ```

a. 5 L/min

What is the air to oxygen ratio for a 35% air entrainment mask a. 1:5 b. 1:3 c. 5:1 d. 3:1

5:1

``` . A patient is receiving O2 through a nonrebreathing mask set at 10 L/min. You notice that the mask’s reservoir bag collapses completely before the end of each inspiration. Which of the following actions is appropriate in this case? A. Change to a different mask B. Decrease the flow C. No action is needed D. Increase the liter flow ```

d Increase the liter flow

. A patient receiving 35% O2 through an air-entrainment mask set at 6 L/min input flow becomes tachypneic. Simultaneously, you notice that the SpO2 has fallen from 91% to 87%. Which of the following actions would be most appropriate in this situation? A. Decrease the flow to increase the FIO2 B. Increase the devices input flow to 10 L/min C. Change the air entrainment port D. Add a tandem unit

B. Increase the devices input flow to 10 L/min

``` An O2 delivery device takes separate pressurized(50psi) air and O2 sources as input, then mixes these gases through a precision valve. What does this describe? A. Oxygen tank B. Humidifier C. O2 blending system D. LVN ```

C O2 blending system

``` If the oxygen: air entrainment ratio is 1:10, what is the FIO2? a. 24% B. 28% C. 10% D. 90% ```

28%

With which of the following devices are therapeutic aerosols generated? 1. atomizers 2. nebulizers 3. humidifiers a. 1 & 2 b. 1 & 3 c. 2 & 3 d. 1, 2, 3

ANS: A | In the clinical setting, medical aerosols are generated with atomizers, nebulizers, or inhalers

Which of the following factors affect pulmonary deposition of an aerosol? 1. size of the particles 2. shape and motion of the particles 3. physical characteristics of the airways a. 1 & 2 b. 1 & 3 c. 2 & 3 d. 1, 2, & 3

ANS: D Whether aerosol particles that are inhaled into the lung are deposited in the respiratory tract de-pends on the size, shape, and motion of the particles and on the physical characteristics of the airways and breathing pattern.

``` What is the primary mechanism for deposition of large, high-mass particles (greater than 5 µm) in the respiratory tract? A. inertial impaction B. sedimentation C. diffusion D. Brownian motion ```

a. inertial impaction

. Most of the spray generated by the majority of metered-dose inhalers consists of which of the following? a. active drug b. propellant c. surfactant agents d. water solution

b. propellant

To decrease the likelihood of an opportunistic yeast or fungal infection associated with metered-dose inhaler (MDI) steroids, what would you recommend that a patient do 1. Cut in half the number of puffs or treatments. 2. Use a spacer or holding chamber. 3. Rinse the mouth after each treatment? a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

ANS: C The high percentage of oropharyngeal drug deposition with use of steroid pressurized MDIs (pMDIs) can increase the incidence of opportunistic oral yeast infection (thrush) and changes in the voice (dysphonia). Rinsing the mouth after steroid use can help avoid this problem, but most pMDI steroid aerosol impaction occurs deep in the hypopharynx, which cannot be easily rinsed with gargling. For this reason, steroid pMDIs should not be used alone but always in combination with a spacer or valved holding chamber.

During aerosol drug delivery using a small-volume jet nebulizer (SVN) set at 8 L/min input flow, a patient asks that the head of the bed be lowered to a semi-Fowler’s position. Immediately after doing so, you observe a significant drop in SVN aerosol output, despite there being at least 3 ml of solution left in the reservoir. What would you do to correct this problem? a. Add 1 to 2 ml more diluent to the nebulizer reservoir. b. Increase the nebulizer input flow to 10 to 12 L/min. c. Reposition the patient so that the SVN is more upright. d. Decrease the nebulizer input flow to 3 to 4 L/min.

ANS: C | Some SVNs stop producing aerosol when tilted as little as 30 degrees from vertical

Normally, when using a 50-psi flowmeter to drive a small-volume jet nebulizer, to what should you set the flow? a. 2 to 4 L/min b. 4 to 6 L/min c. 6 to 10 L/min d. 8 to 10 L/min

b. 4-6 l/min

Persistant breathing of small tidal volumes can cause: a. reabsorption atelectasis b. spontaneous pneumothorax c. compression atelectasis d. respiratory alkalosis

ANS: C | Compression atelectasis is primarily caused by persistent use of small tidal volumes by the patient.

Correct instruction in the technique of incentive spirometry should include which of the following a. use of accessory muscles at high inspiratory flows b. diaphragmatic breathing at slow to moderate flows c. “panting” at volumes approaching total lung capacity d. use of accessory muscles at low inspiratory flows

B. Diaphragmatic breathing at slow to moderate flows

Which of the following is/are necessary for normal airway clearance? 1. patent airway 2. functional mucociliary escalator 3. effective cough a. 1 and 2 b. 1, 2, 3 c. 2 and 3 d. 2

B. Patent airway, functional mucociliary escalator, effective cough

Retention of secretions can result in full or partial airway obstruction. Mucus plugging can result in which of the following? 1. hypoxemia 2. atelectasis 3. Shunting a. 1, 2, and 3 b. 1 and 2 c. 1 and 3 d. 2 and 3

ANS: A | Full obstruction, or mucus plugging, can result in atelectasis and impaired oxygenation due to shunting

During chest physical therapy, a patient has an episode of hemoptysis. Which of the following actions would be appropriate at this time? a. continue treatment & chart finding b. continue therapy while administering O2 c. Switch treatment to a different area d. stop therapy, sit the patient up, give O2 and contact the physician

D) Stop therapy, sit the patient up, give O2, and contact the physician

Percussion should NOT be performed over which of the following areas? 1. surgery sites 2. bony prominences 3. fractured ribs a. 3 b. 1 and 2 c. 2 and 3 d. 1, 2, and 3

ANS: D

131-humidity final Flashcards

(50 cards)