lab final

Question 1

What are the indications for SVN use

Answer 1

neonates and older
1. person unable to follow instructions
2. poor inspiratory capacity
3. incapable of inspiratory hold
4. rapid or unstable respiratory pattern
5. need to nebulize non stand drug solutions

Question 2

Indications for DPI use

Answer 2

3-4 years or older
1. inadequate coordination for MDI use
2. need for more portable alternative to SVN
3. subjects capable of high inspiratory flow rates >60
4. need for accurate dose monitoring
5. drug available in DPI formulation

Question 3

Indications for MDI

Answer 3

7 years or older
1. ability to follow instructions
2. ability to mechanically coordinate actuation and breathing
3. adequate inspiratory capacity >900 ml
4. capable of inspiratory hold
5. stable, calm respiratory pattern

Question 4

how do spacers/ holding chambers work?

Answer 4

Increases the distance between the MDI and the pts mouth, allowing aging of particles. incorporates a one way valve to prevent drug loss in pts with poor hand-breath coordination.

Question 5

What are regulators also called?

Answer 5

Pressure-reducing valves

Question 6

What do regulators do?

Answer 6

They are used in gas supply systems and mechanical ventilators to maintain constant pressure. They are also used on cylinders to reduce gas pressure from 2200 psi to a working pressure of 50 psi

Question 7

what is a single stage pressure reducing valve

Answer 7

High pressure chamber that is supplied with a safety relief valve preset to 200 psig

Question 8

what is a multiple stage pressure reducing valve

Answer 8

the first stage is to reduce pressure to 200-700 psig
the second stage reduces pressure to 50 psig

Question 9

Describe ASSS

Answer 9

The American standard safety system is used with large cylinders, and utilizes differing thread pitches, and internal and external threading to prevent accidental misconnections (wrench)

Question 10

Describe PISS

Answer 10

Pin index safety system is used with small compressed tank systems, it utilizes a yoke collar with varying pi placements to prevent accidental misconnections

Question 11

Describe DISS

Answer 11

diameter index safety system connections consist of an externally threaded body and a mated nipple with a nut that may be hand tightened, it used to prevent accidental interchange of low pressure <200
op- 50 max pressure- 200

Question 12

What is a bourdon gauge

Answer 12

A bourdon gauge measures flow based off of pressure, it has a fixed orifice and is typically used during transport.

Question 13

What are the three goals of oxygen therapy?

Answer 13

1. treat hypoxemia
2. decrease work of breathing
3. decrease myocardial workload

Question 14

What is a nasal cannula?

Answer 14

It is a low flow oxygen device that deliver flows 24-44% from 1-6 LPM there is a 4% increase per liter. more than 6lpm does not increase fio2 delivered to the patient. A humidifier need to be used at 4 or more lpm

Question 15

What is a simple mask

Answer 15

low flow oxygen device that delivered 35-55% oxygen from 6-10 LPM. There is a 5% increase per liter. A humidifier can be used at any liter. Cannot do less than 6 lpm due to build up of exhaled CO2 in the mask

Question 16

what is a nonrebreathing mask

Answer 16

low flow oxygen device that delivers 75-100% oxygen at flows of 8-15 lpm. Flow rates to the mask must be sufficient enough to keep reservoir bag 1/2-1/3 full at all times. This device is only used short term and should never be used with a humidifier

Question 17

What are the 7 factors that increase FiO2 delivered to patients

Answer 17

1. Higher O2 input
2. mouth-closed breathing
3. lower inspiratory flow
4. lower tidal volume
5. slow rate of breathing
6. small minute volume
7. long inspiratory time

Question 18

What are the 7 factors that decreases total FiO2 delivered to patients

Answer 18

1. lower O2 input
2. mouth-open breathing
3. higher inspiratory flow
4. higher tidal volumes
5. fast rate of breathing
6. large minute volume
7. short inspiratory time

Question 19

What are the five indications for using an incentive spirometer?

Answer 19

1. prevention and reversal of atelectasis
2. facilitate cough reflex
3. mobilize secretions
4. surgery
5. improve inspiratory muscle performance

Question 20

What are the 6 potential outcomes of using an incentive spirometer?

Answer 20

1. absence or improvement in signs of atelectasis
2. improved PaO2
3. presence or improvement in previously absent or diminished breath sounds
4. increased vital capacity and peak expiratory flows
5. attainment of prep flow and volume levels
6. improved inspiratory muscle performance

Question 21

What is the most common pressure that most hospitals equipment operates

Answer 21

50 psig

Question 22

what color gas is oxygen

Answer 22

green

Question 23

what color gas is carbon dioxide

Answer 23

gray

Question 24

what color gas is nitrous oxide

Answer 24

blue

Question 25

what color gas is cyclopropane

Answer 25

orange

Question 26

what color gas is helium

Answer 26

brown

Question 27

what color gas is nitrogen

Answer 27

black

Question 28

what color gas is air

Answer 28

yellow

Question 29

what color gas is helium/oxygen

Answer 29

brown and green

Question 30

what color gas is carbon dioxide/oxygen

Answer 30

gray and green

Question 31

what color gas is nitric oxide

Answer 31

teal and black

Question 32

what is hypoxemia

Answer 32

relative deficiency of oxygen in the blood

Question 33

what is hypoxia

Answer 33

oxygen deficiency at the tissue level

Question 34

what is hypoxemia hypoxia

Answer 34

oxygen deficit at the tissues due to increase altitude, suffocation, drug overdose, neurological injury that results in hypoventilation, and lung disease.

Question 35

what is stagnant (circulatory) hypoxia

Answer 35

oxygen deficit at the tissues due to shock and cardiac arrest

Question 36

what is anemic hypoxia

Answer 36

oxygen deficit at the tissue due to anemia, blood loss, and carbon monoxide poisoning

Question 37

what is histotoxic hypoxia

Answer 37

oxygen deficit at the tissues due to cyanide poisoning

Question 38

What is a variable performance oxygen delivery device

Answer 38

It is a Low flow oxygen device, that gas flow of the apparatus is insufficient to meet all of an individuals inspiratory requirements. Room air is entrained to augment gas flow from the device

Question 39

what is a fixed performance oxygen delivery device

Answer 39

High flow oxygen device, gas flow of the apparatus is sufficient to meet all of an individual inspiratory requirements. room air is not entrained

Question 40

what are the four hazards of oxygen therapy

Answer 40

1. oxygen toxicity 2. retinopathy of prematurity 3. oxygen-induced hypoventilation (COPD patients) 4. Absorption atelectasis ( mucus plugging)

Question 41

what does a large entrainment port do

Answer 41

it takes in more room air, and decreases total FiO2 delivered

Question 42

what do small air entrainment ports do

Answer 42

it takes in less room air, increasing the total FiO2 delivered

Question 43

what does a small jet orifice do

Answer 43

it lowers oxygen flows delivered through the device

Question 44

what does a large jet orifice do

Answer 44

it raises oxygen flows through the device

Question 45

what is the difference between asepsis and sterile

Answer 45

sterile is the complete absence of all forms of microorganisms while asepsis is the absence of disease producing microorganisms

Question 46

where does aerosol deposition occur for >15 microns

Answer 46

completely removed above the larynx with mouth breathing

Question 47

where does aerosol deposition occur for 10-15 microns.

Answer 47

completely removed above the larynx with nose breathing

Question 48

where does aerosol deposition occur for 5-10 microns

Answer 48

enter the lower respiratory tract with mouth breathing

Question 49

where does aerosol deposition occur for 1-5 microns

Answer 49

they deposit in the lung periphery

Question 50

what is the optimal particle size

Answer 50

2-5 microns

Question 51

what are the effects of low humidity on the airways

Answer 51

1. long exposure to dry gases will cause heat/water loss changes to the epithelial layer 2. ciliary activity is impaired when the BH% falls below 70% 3. ciliary activity ceases when the BH% falls below 30%

Question 52

what is the action of a baffle in a nebulizer

Answer 52

the number of baffles allow larger particles to impact (while small particles remain in suspension)

Question 53

what are the 7 signs of humidity deficit

Answer 53

1. dry, hacking, nonproductive cough 2. inspissated secretions 3. earache 4.sore throat 5.substernal pain 6. dryness of skin 7. unstable control of bodily fluids

Question 54

why are the standard precautions used

Answer 54

to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals

Question 55

what are the three factors that effect humidity output

Answer 55

1. temperature 2. surface area 3. contact time

Question 56

what are the three factors that influence particle size produced by jet nebulizer

Answer 56

1. change in gas flow (increase=decrease in particle size) 2. jet size= (increase= decrease in particle size)\ 3. number of baffles (the more the smaller the particles

Question 57

what is the appropriate gas flow rate for powering a SVN

Answer 57

6-10 lpm

Question 58

what are the 8 potential complications of aerosol therapy

Answer 58

1. infection 2. bronchial obstruction 3. atelectasis (mucus plugging) 4. overhydration 5. electrolyte changes 6. dyspnea 7. drug concentration effect 8. airway reactivity

Question 59

korotkoff sounds

Answer 59

phase 1: systolic pressure phase 5: silence marks the diastolic pressure

Question 60

what is a heat/moisture exchanger also called

Answer 60

hygroscopic condensor humidifier

Question 61

what is the specifics about a heat/moisture exchanger

Answer 61

passive humidifier that uses paper, wool, foam, treated with hygroscopic salt to increase thermal conductivity (increases temperature and RH%)

Question 62

what is E cylinders safety and escape factor

Answer 62

escape- 0.28 safety- 500 psi

Question 63

what is H-cylinders safety and escape factor

Answer 63

escape- 3.14 safety- 200 psi

Question 64

what is the formula to calculate time remaining in a cylinder

Answer 64

(cylinder psig-safety factor) x escape factor divided by liters

Question 65

indications for aerosol therapy (5)

Answer 65

1. delivery of medications 2. humidification of airways 3. mobilize tracheobronchial secretions 4. upper airway edema 5. sputum induction

Question 66

what are the three clinical situations in which humidity might be required

Answer 66

1. administration of medical gases 2. any artificial airway that bypasses the normal anatomical route for humidification 3. treatment of thick secretions

Question 67

what happens when an air entrainment device has an occlusion

Answer 67

the occlusion causes downstream resistance that builds up backpressure in the system. This will decrease the amount of air entrained and result in an increase in FiO2 delivered but will decrease the total flow delivered to the patient

Question 68

what are the 3 functions of a spacer/holding chamber

Answer 68

1. increase time and provide a holding volume to allow aging of aerosol particles 2. reduction of oropharyngeal drug loss 3. provision of a reservoir holding chamber to remove the need for coordination of actuation and inhalation by the user

Question 69

what do you change to help a patient overcome work of breathing

Answer 69

you change the flow rates

Question 70

what do you change to improve a patients oxygenation

Answer 70

you change the FiO2

Question 71

if a patient is not capable of using a incentive spirometer what should you have them do

Answer 71

you have them do deep breath, cough exercises

Question 72

if there is a picture of big single bubbles what device is this

Answer 72

a simple bubble humidifier

Question 73

if there is a picture of lots of bubble what will this be

Answer 73

a diffuser

Question 74

what does a salter or high flow nasal cannula typically run at

Answer 74

15 lpm

Question 75

if patient cannot use a svn on there own what should you do

Answer 75

have them use Blow by for passive treatment, the aerosol will go through there nose

Question 76

heat and moisture exchangers should only be used

Answer 76

short term

Question 77

HEM

Answer 77

more saturation with water will cause resistance to increase, and coughing can occlude the device

Question 78

everyone who comes into the hospital should get a blood gas done

Answer 78

false

Question 79

what are the oxygen percentages for the Venturi mask

Answer 79

24-50%

Question 80

what will a bourdon gauge show if the device is occluded

Answer 80

the bourdon gauge will not change but the patient will receive lower FiO2s

Question 81

what is the equation for MAP

Answer 81

MAP= systolic + (diastolic x 2) divided by 3