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Final Exam (lecture) Flashcards

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1
Q

What is the difference between a high flow and low flow device?

A

High flow- meets pts needs
Low flow- does not meet pts needs

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2
Q

What type of device is a nasal cannula?

A

Low flow

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3
Q

What is the overall goal of O2 therapy?

A

To maintain adequate tissue oxygenation while minimizing cardiopulmonary work.

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4
Q

What is the most tangible objective of O2 therapy?

A

To correct hypoxemia

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5
Q

Why do COPD pts hypoventilate?

A

Because O2 administration resulting in increase arterial oxygen levels cause suppression of the hypoxic drive.

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6
Q

What else causes suppression of hypoxic drive?

A

the normal response to increase ventilation in the presence of high partial pressure of carbon dioxide (PaCO2) is blunted and the primary stimulus to breathe becomes a lack of O2 as sensed by the peripheral chemoreceptors.

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7
Q

What else happens as a result of increased O2 levels in these patients?

A

The increase in the blood O2 level in these patients suppresses peripheral chemoreceptors, depresses ventilatory drive, and elevates the PaCO2. High blood O2 levels in such patients may also disrupt the normal ventilation/perfusion balance and cause an increase in dead space–to–tidal volume ratio (VD/VT) and in PaCO2.

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8
Q

What are the liter flows and FiO2 for a nasal cannula?

A

1- 24
2- 28
3- 32
4- 36
5- 40
6- 44

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9
Q

What are the liter flows and FIO2 for a venturi mask?

A

2- 24
4- 28
6- 31
8- 35
8- 40
12- 50

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10
Q

What is the liter flow for an infant on nasal cannula?

A

Infant: <2 L/min

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11
Q

What is special about a Venturi mask?

A

•The flow rate varies, should be > 60 l/min
•Has a fixed (specific) FiO2 range
•High flow device

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12
Q

What is another name for a Venturi mask?

A

Air entrainment mask

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13
Q

What is special about a non-rebreather mask?

A

•Has flaps
•One way valve
•Short term humidity no humidifier

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14
Q

What is the flow rate and FIO2 for a nonrebreather mask?

A

Liter flow: 10-15
FIO2: 60-80%

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15
Q

What is the flow rate and FiO2 for a partial rebreather mask?

A

Liter flow: 10-15
FIO2: 40-70%

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16
Q

What is special about a partial rebreather mask?

A

•Has no flaps
•one-way valve
•short-term humidity no humidifier

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17
Q

What is the flow rate and FiO2 for a simple mask?

A

Liter flow: 5-10
FIO2: 35-50%

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18
Q

What are all the low flow systems?

A

Nasal cannula
Non- rebreather
Partial rebreather
Simple mask

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19
Q

What are all the high flow systems?

A

Venturi mask
Face tent
Trach mask
Aerosol mask

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20
Q

What is a high flow nasal cannula and its significance?

A

•It can give specific Fio2 and flow
•You can add heat to humidify and prevent drying of mucosa and enhance mucociliary clearance
•Prongs are wider and bigger for higher flow of gas

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21
Q

When do you use a humidifier?

A

On a nasal cannula 4 liters or above

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22
Q

What is the only device you use a humidifier on?

A

Nasal cannula

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23
Q

What is the flow rate and FIO2 of a face tent?

A

Flow rate: 12 to 15
FiO2: 40 to 50%

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24
Q

What is the flow rate and FiO2 for a trach mask?

A

Flow rate: 10 to 15 LPM
FiO2: 35 to 60%

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25
What is the liter flow and FIO2 for an aerosol mask?
Flow rate: 10-15 FIO2: 21-100%
26
What are the colors for a Venturi mask?
Blue Yellow White Green Pink Orange (Babe you would get pulled over)
27
What are the 3 components needed for a HFNC?
1. a patient interface, such as nasal prongs 2. a gas delivery device that regulates FiO2 3. a humidifier
28
What are the 4 main features of a HFNC?
1. delivery of a high FiO2 2. meeting or exceeding the patient’s minute ventilation and therefore acting as a fixed oxygen delivery device 3. generating a distending, positive end-expiratory airway pressure (PEEP) of approximately 1 cm H2O for each 10 L/min. of flow 4. washout of carbon dioxide from anatomic dead space.
29
What are the 2 factors for Heliox?
70/30 80/20
30
Why do we use hyperbaric chamber (HBO) therapy?
Hyperoxia &
31
Why do we use heliox therapy?
Acute obstructive disorders Ex. Strider, asthma, and croup
32
What is the function of the nose?
Humidifies gas on inspiration it cools the gas and reclaims water of the gas that is exhaled
33
What is the goal of humidity therapy?
To maintain normal physiological conditions in lower airways
34
What are the indications for humidity therapy?
35
What are the hazards and complications for humidity therapy?
36
What are the signs and symptoms of inadequate airway humidification?
37
What is a humidifier?
A device that adds molecular water to gas
38
What are the 4 principles governing humidifier function?
39
What are the four types of humidifiers?
1. Bubbler 2. Pass-over 3. Nebulizers of bland aerosols 4. Vaporizers **A.k.a active humidifiers**
40
What are passive humidifiers?
HME
41
What are the 3 types of pass-over humidifiers?
1. Simple reservoir 2. Wick type 3. Membrane type
42
Why do you need enough sterile water?
To make sure humidifier works properly and runs appropriately
43
Where do we use HMEs?
On vents
44
Can you add heat to a heated wire circuit?
Yes
45
What are the 3 types of HMEs?
1. Simple condenser 2. Hygroscopic condenser 3. Hydrophobic condenser
46
Hygroscopic materials, absorb moisture from the air. Hygroscopic condensers HME units use materials that…
1. Incorporate condensing element of low thermal, connectivity (ex. paper, wool or foam). 2. Impregnate this material with a hygroscopic salt (calcium or lithium chloride).
47
What can make humidifier to stop working?
Too much heat
48
What are manual systems?
Simple reservoir systems that have to be filled manually with sterile water and checked often for cross contamination. Mechanical ventilation is required and changes in volume that frequently occur can alter the gas compression
49
What are automatic systems?
Level- compensated reservoir that does not need to be manually filled or constantly checked. External reservoir is aligned with humidifier maintaining relatively consistent water levels between reservoir and the humidifier chamber
50
Why do we have to use the DISS index system for LVN?
Because it’s attached (threaded) onto a flow meter
51
What measures humidity?
Hygrometer
52
Why is overhydration a problem?
53
What factors affect particle size?
1. Substance for nebulization 2. Method used to generate aerosol 3. Environmental conditions surrounding the particle
54
What is deposition?
When aerosol particles leave suspension in gas they deposit on (attach to) a surface
55
What is inhaled dose?
Amount inhaled from nebulizer
56
What is emitted dose?
Amount emitted from nebulizer
57
What is respirable dose?
Amount that reaches the lungs
58
What happens when gas (temp) increases?
Capacity to hold water increases
59
Where do we want the wire probe when giving treatment?
Closest to patient
60
What should we always have the patient do when doing MDI or DPI?
Inspiratory hold
61
What is significant about PEP therapy?
You can hook it up with nebulizer to give treatment
62
When do we do a peak flow?
At the beginning of treatment
63
What is an example of an adrenergic drug?
Albuterol
64
What is another word for adrenergic?
Sympathetic
65
What is another word for cholinergic?
Parasympathetic
66
What is an agonist?
Stimulating agents
67
What is an antagonist?
Blocking agents
68
What is an adrenergic?
Drug that stimulates a receptor responding to norepinephrine or epinephrine
69
What is a anti-adrenergic?
Drug that blocks a receptor for norepinephrine or epinephrine
70
What is cholinergic?
Drug that stimulates a receptor for acetylcholine
71
What is anti-cholinergic?
Drug that blocks a receptor for acetylcholine
72
What is muscarinic?
Drug that stimulates acetylcholine receptors specifically at one of the two types of acetylcholine receptors called the muscarinic receptors
73
What is an example of a cholinergic drug?
Atrovent
74
What are the three phases of a drug?
1. drug administration phase 2. pharmacokinetic phase 3. pharmacodynamic phase
75
What is the drug administration phase?
It describes the method by which a drug is made available to the body
76
What is the pharmacokinetic phase?
Describes the time, course, and disposition of a drug in the body, based on its absorption, distribution, metabolism, and elimination
77
What is the pharmacodynamic phase?
Describes the mechanisms of drug action by which a drug molecule causes it’s effects in the body
78
Table 36.1
79
What’s the largest group of aerosol therapy?
Adrenergic bronchodilators
80
What are the 2 dosages for acetylcysteine?
10 & 20 %
81
Table 36.4
82
How does dornase Alfa work?
By digesting extracellular DNA material. It can reduce extracellular DNA and F -actin polymers. **it is a genetically engineered clone of the DNase enzyme**
83
Table 36.5
84
Why do we do and I.S. or lung expansion therapy?
To prevent or correct atelectasis
85
What is the common goal that all lung expansion therapies share?
To increase functional residual capacity (FRC).
86
Which patients will have the most trouble doing an I.S.?
•Neuromuscular pts •Postoperative pts
87
What are the 4 phases of a cough?
•Irritation •Inspiration •Compression •Expulsion
88
What colors will infiltrates be on an x-ray?
White
89
Can hyperinflation help with O2 therapy?
Yes but only if O2 sats are very close to normal range?
90
What does CPT & PD use to drain secretions?
Gravity
91
How long do you hold a patient in that position for PD?
3-15min **longer in special situations such as CF**
92
What is important after doing CPT or PD?
Have the patient cough
93
What is the indication for CPT?
•Copious secretions •The inability to mobilize and expectorate secretions •Pulmonary disorders associated with retained secretions
94
What are some pulmonary disorders associated with CPT?
CF, bronchiectisis, and ciliary dyskinetic syndromes
95
If patient is not stable or can’t tolerate treatment what do we do?
Choose another method of ACT
96
What is the triple S rule?
97
How do we give racemic epi?
Through nebulizer
98
What does Q4 mean?
Every 4 hours
99
What does BID mean?
Twice a day
100
What does TID mean?
3 times a day
101
What is another name for vest therapy?
High frequency chest wall compression HFCWC
102
What is the position for anterior upper lobe segments?
Pt supine with pillow under knees and bed in Semi Fowler
103
What is the position for posterior apical segment?
Bed flat but pt is sitting up but hunched over, w/ pillow under knees
104
What is the correct position for anterior segments?
Bed flat with patient supine and pillow under knees
105
What is the correct position for the right posterior segment?
Bed flat with patient slightly titled on left side
106
What is the correct position for the left posterior segment?
Bed in semi Fowler with pt prone and pillow under stomach
107
What is the correct position for the right middle lobe?
Bed raised 12 inches, head down, patient supine and slightly tilted to the left with pillow under back
108
What is the correct position for the left lingular?
Bed raised 12 inch pt supine and slightly tilted to right with pillow under back
109
What is the correct position for the anterior segments (lower lobes).
Bed raised 18 inch in trendelenburg pt supine w/ pillow under knees head down
110
What is the correct position for the right lateral segment?
Bed raised 18 inches pt on left side head down
111
What is the correct position for the left lateral segment?
Bed raised 18 inch pt on right side head down pillow under side
112
What is the correct position for the posterior segments?
Bed raised 18 inches pt prone head down pillow under feet and stomach
113
What is the correct position for the superior segments?
Bed flat pillow under feet and stomach pt prone

Fundamentals (5 decks)

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