Ch. 15 Respiratory Home Care Flashcards
Which of the following backup O2 systems should be used in case of a power outage for a home care patient receiving O2 with a concentrator?
A. Air compressor
B. Liquid O2
C. H cylinders
D. E cylinders
E cylinders
Small, easy-to-handle tanks should be employed as backup systems should a power failure occur. Large H tanks are too difficult for patients to handle. Liquid O2 should not be used for backup because the contents will evaporate over a period of time.
Which of the following is the LEAST important area for the respiratory therapist (RT) to discuss with the home care patient?
A. Pathology of the disease process
B. Cleaning of equipment
C. Side effects of prescribed therapy
D. Importance of proper therapy techniques
Pathology of the disease process
It is much more important to make sure that home care patients are familiar with the equipment, medica- tions, medication side effects, and proper treatment administration than the pathology of their disease.
An improved quality of life is dependent on their knowledge of treatment modalities.
Diaphragmatic breathing exercises should result in which of the following?
- Increased VT
- Less dependence on the diaphragm during quiet
breathing - Increased FRC
- Decreased respiratory rate
A. 1 and 2 only
B. 1 and 4 only
C. 2, 3, and 4 only
D. 1, 2, and 4 only
- Increased VT
4.Decreased respiratory rate
Diaphragmatic breathing exercises are beneficial for
patients with emphysema. Air-trapping caused by the disease increases FRC and lung volume, which pushes the diaphragm down and makes it flat rather than maintaining its normal dome shape. This renders the diaphragm almost useless, and the accessory muscles become the primary muscles of ventilation. Teaching the patient to concentrate on using the diaphragm through exercises will increase VT and reduce respira- tory rate. Diaphragmatic exercises are coupled with pursed-lip breathing so that FRC also decreases.
A home care patient on O2 is concerned about the cost of using O2 continuously in his home. Which of the following should be suggested to help the patient conserve his O2 demands?
A. Pulse-dose O2 system
B. Liquid O2
C. Instruct the patient to only use O2 while awake
D. Decrease the liter flow while sleeping
Pulse-dose O2 system
A pulse-dose system allows the patient to receive O2 flow only during inspiration. Flow stops during exhalation and between breaths, conserving the amount of O2 used. Patients should never adjust the flow rate without an order from their physician.
The respiratory therapist is instructing a patient
who is about to be discharged from the hospital on the proper method for cleaning equipment in the home. Which of the following should be included in the procedure?
A. The equipment should be towel dried immediately after it is removed from the liquid disinfectant.
B. After soaking the equipment in a vinegar solution for 30 minutes, it should be rinsed and allowed to air dry.
C. The equipment should be disinfected after each use.
D. An autoclave should be purchased to ensure adequate cleaning of the equipment.
After soaking the equipment in a vinegar solution for 30 minutes, it should be rinsed and allowed to air dry.
Vinegar, often referred to on the exam as acetic acid, is a liquid disinfectant that is the disinfectant of choice for patients in the home. It is easily obtainable and easy to use. It is also effective against specific strains of Pseudomonas sp. Vinegar is typically mixed with distilled water. The distilled water to vinegar ratio is3:1.
Pursed-lip breathing exercises benefit patients by:
A. Increasing inspiratory flows
B. Providing a slight back pressure in the airway allowing for an increased expiratory time
C. Increasing FRC
D. Making expiratory time shorter
Providing a slight back pressure in the airway allowing for an increased expiratory time
Pursed-lip breathing can be beneficial in reducing dyspnea, decreasing air-trapping, and increasing VT in patients with emphysema by propping the airway open longer.
Which of the following is most indicated to aid in the mobilization of secretions for a cystic fibrosis patient?
A. HFCWO
B. Acapella
C. Postural drainage
D. Flutter valve
HFCWO
While chest percussion and postural drainage was once the hallmark care for CF patients, high-frequency chest wall oscillation is better tolerated and mobilizes secretions just as effectively as CPT. Other alternatives to CPT are PEP devices, such as the flutter valve and Acapella, which are vibratory PEP devices.
Which of the following statements regarding sieve O2 concentrators is FALSE?
A. The concentrator is connected to an electrical wall outlet.
B. When the flow is increased, the delivered O2 percent increases.
C. The maximum O2 percent delivered by most con- centrators is 95%.
D. Concentrators are primarily devices used to adminis- ter O2 in the home setting.
When the flow is increased, the delivered O2 percent increases.
Concentrators utilize an air compressor to draw in room air. As the air enters the concentrator, it passes through a sieve bed that contains nitrogen-absorbent material that removes most of the nitrogen so that up to 95% O2 leaves the outlet. However, the higher the flow used, the faster the air passes through the absor- bent material, allowing less time for nitrogen to be ab- sorbed. Therefore more nitrogen passes through the concentrator along with the O2, and the percent of O2 leaving the concentrator decreases. Generally, using1 to 2 L/min will provide 95% O2. As flow is increased, the O2 percent will drop to 80% to 90%.
To aid in monitoring an infant for sudden infant death syndrome (SIDS) while sleeping, which of the following should be recommended?
A. TcPO2 monitor
B. Pulse oximetry
C. Capnography monitoring
D. Apnea monitor
Apnea monitor
An apnea monitor should be used on infants who have experienced apnea at night or are siblings of infants who have died from sudden infant death syndrome (SIDS).
Which of the following will best determine a patient’s compliance with the smoking cessation program?
A. SpO2
B. CO monitoring
C. PaO2
D. FEV1
CO monitoring
Monitoring the patient’s CO level by having the patient blow through a CO detector will prove whether the patient is still smoking. Smokers’ CO levels can be as high as 10% with normal being 0.5% to 1%.
An elevated level indicates the patient is still smoking.
