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Flashcards in ch 36 Deck (34)
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1
Q

The mass of aerosol particles produced by a nebulizer in a given unit time best describes which quality of the aerosol?

A

output

2
Q

What measure is used to describe the variability of particle diameters in an aerosol?

A

GSD geometric standard deviation

3
Q

What is the retention of aerosol particles resulting from contact with the respiratory tract mucosa called?

A

deposition

4
Q

factors affect pulmonary deposition of an aerosol

A
I.
size of the particles
II.
shape and motion of the particles
III.
physical characteristics of the airways
5
Q

What is the primary mechanism for deposition of large, high-mass particles (greater than 5 ⎧m) in the respiratory tract?

A

inertial impaction

6
Q

What is the primary mechanism for central airway deposition of particles in the 1- to 5-⎧m range?

A

sedimentation

7
Q

As hygroscopic aerosol particles enter the respiratory tract, what do they tend to do?

A

increase in size because of the absorption of molecular water

8
Q

A patient with chronic bronchitis is receiving heated water aerosol treatments through a jet nebulizer four times daily to aid in mobilizing retained secretions. After each treatment, you note a dramatic increase in the magnitude of coarse crackles heard on auscultation. Which of the following recommendations would you make to the physician?

A

Add coughing and postural drainage to the therapy.

9
Q

What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?

A

metered-dose inhaler

10
Q

Immediately after firing, the aerosol particles produced by most metered-dose inhalers are about how large?

A

35 ⎧m

11
Q

Each firing of a typical metered-dose inhaler delivers about what output volume?

A

30 to 100 ⎧l

12
Q

Most of the spray generated by the majority of metered-dose inhalers consists of which of the following?

A

propellant

13
Q

About what range of drug dosages can be provided with each firing of a metered-dose inhaler?

A

50 ⎧g to 5 mg

14
Q

Which of the following particle distributions is produced by a typical metered-dose inhaler?

A

3- to 6-⎧m mean mass aerodynamic diameter (MMAD)

15
Q

When fired inside the mouth, what percentage of the drug dose delivered by a simple metered-dose inhaler (MDI) deposits in the oropharynx?

A

about 80%

16
Q

When using a metered-dose inhaler without a holding chamber or a spacer, the patient should be instructed to fire the device at what point?

A

immediately after beginning a slow inspiration

17
Q

Before inspiration and actuation of a metered-dose inhaler, the patient should exhale to which of the following?

A

functional residual capacity

18
Q

Which of the following agents has been associated with increased intraocular pressure?

A

anticholinergics

19
Q

What is a potential limitation of flow-triggered metered-dose inhaler devices?

A

high flows necessary for actuation

20
Q

The key difference between a metered-dose inhaler (MDI) holding chamber and a spacer is that the holding chamber incorporates which of the following?

A

one-way inspiratory valve

21
Q

After actuating a metered-dose inhaler with a holding chamber, what should the patient be instructed to do?

A

Continue to breathe through the device for three breaths.

22
Q

What is the average amount of dead volume in a small-volume jet nebulizer after the device runs dry?

A

0.5 to 3.0 ml

23
Q

things that do not affect the performance of small volume jet nebulizers

A

potency and viscosity

24
Q

You increase the fill volume from 2 to 4 ml in a small-volume jet nebulizer being used to administer a bronchodilator agent with an aerosol. What effect will this have on the amount of drug delivered?

A

increase

25
Q

Which of the following is the effect of aerosol particles entrained into a warm and fully saturated gas stream?

A

increase in size

26
Q

To decrease the VDS of a small-volume jet nebulizer during drug administration, what should you do?

A

continue treatment until nebulizer begins to sputter

27
Q

A patient with an acute exacerbation of asthma is not responding to the standard dose and frequency of an aerosolized bronchodilator and is now receiving small-volume jet nebulizer (SVN) therapy every 30 minutes. Which of the following would you recommend to the patient’s physician at this time?

A

Consider continuous nebulization of the drug.

28
Q

What is the major problem with using large-volume nebulizers for continuous aerosol drug therapy

A

drug reconcentration and toxicity

29
Q

A physician has ordered the antiviral agent ribavirin (Virazole) to be administered by aerosol to an infant with bronchiolitis. Which of the following devices would you recommend in this situation?

A

small-particle aerosol generator (SPAG)

30
Q

The small-particle aerosol generator (SPAG) produces a small monodisperse aerosol through which of the following?

A

particle evaporation in a glass drying chamber

31
Q

When using a small-particle aerosol generator (SPAG) to administer ribavirin (Virazole) to an infant, which pair of flow settings is correct?

A

7 L/min with total flow no less than 15 L/min

32
Q

Which of the following are true about a solution that is being aerosolized by an ultrasonic nebulizer?

A

II.
The temperature of the solution increases.
III.
The solute concentration increases.

33
Q

Advantages of small-volume ultrasonic nebulizers for drug delivery include all of the following except:

A

decreased cost

34
Q

What is the average mean mass aerodynamic diameter (MMAD) generated by the vibrating mesh nebulizers?

A

2 to 3 ⎧m