rcp 100 final Flashcards
1
Q
terms:
bradycardia
A
slow heart rate under 60
2
Q
tachycardia
A
fast heart rate over 100
3
Q
hypertension
A
high blood pressure over 140
4
Q
hypotension
A
low blood pressure under 90
5
Q
hypervolemia
A
excessive amount of fluid in the body leading to fluid overload
6
Q
hypovolemia
A
low amount of fluids particularly blood volume
7
Q
bradypnea
A
slow breathing rate less than 12 breathes per min
8
Q
apnea
A
Temporary cessation of breathing
9
Q
dypnea
A
difficult of shortness of breath
10
Q
orthopnea
A
shortness of breath that occurs when lying down and improves when sitting
11
Q
trepopnea
A
shortness of breath that occurs when lying on one side but not the other
11
Q
platypnea
A
worsen breathing when sits or stands up,improves when lying down
12
Q
tachypnea
A
rapid breathing
13
Q
cyanosis
A
bluish-purple discoloration of skin & mucous membrane caused by deficiency in oxygen in blood
14
Q
jaundice
A
yellow discoloration of skin,eyes,and mucous membrane caused by build up of bilirubin in blood
15
Q
pallor
A
paleness of the skin, mucous membrane or other tissue, caused by decreased amount of oxygenated hemoglobin in blood
16
Q
anterior
A
front or forward part of the body
17
Q
posterior
A
back or rear of the body
18
Q
distal
A
farther way from the midline
19
Q
proximal
A
closest to the midline
20
Q
lateral
A
on the side
21
Q
supine
A
lying flat on back w/ face and torso upeward
22
Q
prone
A
lying face down w/ chest and stomach facing the ground
23
Q
trendelenburg
A
supine position, w/feet elevated above their head usually 15-30 degree incline
24
reverse trendelenburg
lies in supine position w/head elevated higher than their feet
25
solid state
fixed volume and shape
molecules have shortest distance to travel before collision
strong mutual attractive force b/w atoms
26
liquid state
fixed volume but adapt to shape of container
atoms exhibit less degree of mutual attraction
shape is determined by numerous internal and external forces
27
gaseous state
no fixed volume or shape
weak molecular attraction
expand to fill container
easily compressed
rapid random motion frequent collision
28
conduction
heat moves directly b/w objects that are touching
heat transfer of solids
29
convection
warmer areas of liquid or gas rise to cooler areas
how heat spreads in liquid and gases
30
radiation
transfer of heat through electric magnetic waves
w/out direct contact b/w two substances
31
evaporation
form of vaporation, where heat is taken from the air surrounding the liquid cooling the air
liquid-->gas
32
condensation
opposite of evaporation, gas looses energy to turn back to liquid
gas--->liquid
33
absolute zero
0 K lowest possible temp
no kinetic energy
molecules cease to vibrate no measurable heat
34
conversions
F/C
celcius= (F-32)/1.8
F= (1.8 x C) + 32
35
cohesion
attractive force b/w like molecules
36
adhesion
attractive forces b/w unlike molecules
37
absolute humidity
water vaporation
actual amount of water vapor in gas
varies w/ temp & pressure
measured in mg/L
43.8
38
what does respiratory care include
assessment, treatment, management, diagnostic evaluation, education and care of patients with abnormalities of cardiopulmonary system
39
what is the purpose of the red outlets
outlets connected to backup generators. ALL respiratory equipment&vital equipment should be pluggedin red outlets to ensure they continue working during outage
40
R.A.C.E
Rescue
alarm
contain
extinguish
41
P.A.S.S
Pull
Aim
Squeeze
Sweep
42
is there is a fire in the facility, what should the respiratory therapist do first?
shut off the zone valves providing oxygen
43
why may communication be hindered
language barriers, mental impairment, stroke, trauma, age, cultural differences
44
define hypoxia
abnormal condition, O2 available to body cells is inadequate to meet metabolic needs
* low oxygen in tissue
45
define hypoxemia
abnormal deficiency of O2 in arterial blood
lab value 80-100mmHg
*low oxygen in blood
46
what are the clinical objectives for oxygen therapy
1.correct acute hypoxemia
2. decrease symptoms associated w/chronic hypoxemia
3.decrease the workload hypoxemia causes on heart and lungs
47
indications for oxygen therapy
*documented hypoxemia
*acute care situations in which hypoxemia is suspected
*sever trauma
*acute myocardial infarction
*short term therapy or surgical intervention
48
what is the PaO2 for a healthy person
80-100mmHg
49
what is the PaO2 for a COPD person
55-75mmHg
50
what happens when exposed to 100% FiO2
*oxygen toxicity
*pulmonary fibrosis&hypertension
*thickening of alveolar capillary membrane
51
nasal cannula
liter flow: 1-6liters
low flow
FiO2: 24%-44%
humidifier for 4L and above
52
FiO2 levels of nasal cannulas
1L=24%
2L=28%
3L=32%
4L=36%
5L=40%
6L=44%
53
when would you use a bubble humidifier
4L or above
used to add moisture to oxygen, dry oxygen cause irritation of nasal passage
54
calculate minute ventilation formula
MV=RR x TV divide by 1000 to get liters
minute ventilation=respiratory rate x tidal volume
55
partial rebreather
vs
non rebreather
pr- no valve, reservoir
liter flow-10-15L
lowest-10L
CO2 rebreathing
FiO2- 40-70%
non- valve, reservoir
liter flow-15L above
lowest- 10L
CO2 rebreathing
FiO2- 60-80%
56
Magic Box calculation formula
(100 - FiO2%) / (FiO2%-20)= ratio
(ratio + 1) x liter flow= total flow
ex FiO2 is 40% and flow set is 8L
100-40=60 40-20= 20
60/20= 3L
3 + 1= 4
4 X 8= 32
57
evidence of documented hypoxemia
PaO2<60mmHg or SaO2<90% breathing room air
PaO2 or SaO2 below range for specific clinical situation
58
simple mask
reservior
Liter flow 6-10L
FiO2= 35-50%
lowest liter flow= 6L
CO2 rebreathing
59
high flow system differ from low flow
high flow- meeds or exceeds peak inspiratory flow, fixed FiO2, 60L/min
low flow-O2 concentration 22-45%,low cost, easy application, disposable
60
what is laboratory gas and which gases are in the category
equipment calibration and diagnostic testing
ex. nitrogen, carbon dioxide
61
what is therapeutic gas and which gas is in this category?
relieve symptoms, improve oxygenation
ex. oxygen
62
what is anesthetic gas and which gas is in this catergory
combined w/oxygen to provide anesthesia during surgery
ex. nitrous oxide
63
which production of oxygen is used in the hospital
fractional distillation
64
what composition make up air
21% O2
1% trace gas
78% nitrogen
65
heliox calculations
80/20= 1.8 70/30= 1.6
1.8 x flow. 1.6 x flow
ex 80/20 mixture at 10L/min
1.8 x 10= 18L/min
66
cylinder colors
O2=green
Air= yellow
CO2=grey
He=brown
N2O=blue
Heliox= brown and green
NO=teal and white
67
what is the purpose of the relief valve
*gas release if too much heat
*prevent tank pressure from becoming too high
68
calculations to find out how long a tank will last
e tank= .28
h tank= 3.14
(PSI x Factor)/ flow= (ans)/60 mins=(ans)
(hr)on left / right x 60
ex.
1800 psi E cyclinder at 4LPM
(1800 x .28)/4= 126/60= 2.1. 2hr .1x60= 6
2 hr and 6 mins
69
nitric oxide uses
*used for infants w/ hypoxic respiratory failure
70
what is the bodys natural humidification device
nose
71
what is ISB
Isothermic saturation boundary
72
what outside factors can cause a shift in ISB?
*breathing in cold dry air
*upper airway by pass (trach, endo tube)
*minute ventilation is higher than normal
73
indications for humidification
*dry medical gases
*bypass upper airway
*treating bronchospasm caused by cold air
74
clinical signs of inadequate airway humidification
*atelectasis
*dry nonproductive cough
*infection
*increased airway resistance
*increased WOB
*patient complaint of substeral pain & airway bypass
*thick, dehydrated secretions
75
what is the difference b/w active and passive humidifiers
active: adding heat or water or both to device patient interface
passive: recycling exhaled heat & humidity from patient
76
what is an active humidifier
adding heat or water or both to device patient interface
types: bubble, passover, nebulizers of bland aerosol & vapor
77
bubble humidifiers ( what will happen if exceed 4L w/out the bubble)
*dry gas damage
*heat loss
* water loss
*structural damage
*airway irritation
*increased mucus
*ciliary motility reduction
*increased secretion viscosity
78
passover humidifiers: what is the advantage over bubble
*maintains saturation at high flow rates
* adds little or no flow resistance
* do not generate any aerosols
3 types: simple, wick, membrane
79
what is passive humidification
HME
recycles captured exhaled heat & moisture
"artifical nose"
80
when do we use the HME?
how does it work?
*use for patients on mechanical ventilation
* capture the heat and moisture from air a patient exhales than using to humidify air they inhale
81
explain dead space? what can cause it
* portion of breathing that doesnt participate in gas exchange (nose, mouth down to terminal bronchioles)
* alveoli that do not participate in gas exchange
82
how much dead space does HME cause
30-90 ml
83
what are the temperatures you can set a heated humidifier to? what can happen if temp is to low or high?
33C- 37C,
prevents complication like drying of the mucosa
84
indications of bland aerosol therapy
*upper airway edema
* croup
*subglottic edema
*post extubation edema
*post operative management of upper airway
*bypassed airway
*need of sputum specimen
85
hazards/complications for bland aeresol therapy
*wheezing/bronchospasm
*infection
*over hydration
*patient discomfort
* caregiver exposure to airborne contagions by sputum/coughing
86
what type of patients can benefit from cool aerosol therapy
*upper airway edema/swelling
*bypassed upper airway
*sputum induction
87
what is the purpose of mist tents/hoods
used to treat children w/croup
*promotes vasoconstriction
*reduces edema
*diminishes upper away obstruction
88
what are some hazards of mist tents/hoods
*heat retention
*CO2 build up (high flow of fresh gas to washout CO2 and heat)
89
hazard of aerosol therapy
*infection
*airway reactivity
*pulmonary&systemic effects
*drug concentration changes
*eye irritation
*exposure to second hand aerosol drugs
90
the four functions that are critical for life
1. ventilation- moving air in&out of lungs
2.oxygenation-oxygen into the blood
3.circulation-moving the blood through the body
4.perfusion-oxygen into the tissue
91
Pack years
1 pack= 20 cigs
fomula:
pk yr= # of pack/day X # years
ex. 45 cig for 10 year
45/20= 2.25 x 10yrs= 22.5 pack years
92
levels of consciousness
*ALERT/RESPONSIVE: normal
*LETHARGIC/SOMNOLENT: sleepy
*CONFUSED/STUPORUS: responds inappropriately
*SEMI COMATOSE: respond to painful stimuli
*OBTUNDED: drowsy state& aspiration risk
*COMA: do not respond to painful stimuli
93
sputum colors and what it tells about patient
*CLEAR- normal
*MUCOID(GREY)-chronic bronchitis
*YELLOW-presence of wbc, bacterial infection
*GREEN- stagnant sputum: gram negative bacteria
* BROWN/DARK- old blood, anaerobic lung infection
*BRIGHT/PINK-hemoptysis
*PINK FROTHY-pulmonary edema
94
pleuritic
vs
nonpleuritic chest pain
pleuritic: located laterally or posteriorly,
-sharp increase w/ deep breathing
nonpleuritic: located in the center of chest& may radiate shoulder or arm, it is not affected by breathing
- angia, gerd, chest wall pain, espohageal spaspm
95
hypothermia common causes
prolonged exposure to cold
less likely: head injury, stroke, decreased thyroid act infection
96
most common cause of lower extremity swelling
heart failure
97
what causes an abnormal increase in AP diameter (barrel chest) what type if patient does this happen to?
Patients w/ emphysema, COPD
chronic lung problems
hyper-inflated lungs
98
explain tracheal deviation
Normal: trachea midline
shift toward pathology:
*atelectasis
*diaphragmatic paralysis
shift away from pathology
*plural effusion
*pnemothorax
*neck or thyroid tumors
99
what do retractions indicate in a patient?
severe increase of WOB
Inward sining of the chest wall during inspirtation
100
wheezes. how do we fix it?
albuterol
*consistent w/airway obstruction
*monophonic- one airway affected
* polyphonic- many airways are involved
101
crackles
course: suction or humidification/ PT coughs
*airflow move secretion or fluid in airways
Fine: lasixs diuretic
*sudden opening of small airways in lung deep breathing
*heard w/pulmonary fibrosis & atelectasis
102
specific cause of cyanosis
main cause of and what is peripheral cyanosis?
low oxygen,
bluish discolor found in hands, fingers toes due to lack of oxygen. Poor circulation
103
breath sounds/pitch/intensity/location
vesicular
bronchial
bronchovesicular
Vesicular: low/soft/ plural lungs
bronichial: high/loud/over trachea
bronchovesicular: moderate/moderate/upper half of sternum
104
explain the following breathing pattern:
Apnea
no respirations
emergency situtation
105
explain the following breathing pattern: agonal
intermittent prolonged gasps
patient is not breathing adequately cardiac arrest
106
explain the following breathing pattern:Kussmaul
increased rate & depth, fast/deep
diabetic crisis
metabolic acidosis
diabetics
107
explain the following breathing pattern: cheyne-stokes
respiratory rate & tidal volume increase in intensity then decrease into apnea for several seconds
neurological problem
108
explain the following breathing pattern: biot
chaotic breathing w/ irregularity in rate & tidal volume which becomes agonal breathing
astma
109
heart sounds
S1. closure of the mitral valve & tricuspid valves
ventricular contraction
S2. closure of the pulmonary & aortic valves
ventricular relax
110
what causes murmurs
* back flow of blood through an incompetent valve
*forward flow of blood through a narrowed valve
*rapid blood flow through a normal valve
111
percusion notes:
emphysema
atelectasis
pleural effusion
pneumothorax
pneumonia
emplysema: hyperresonance
atelectasis: dull or flat, decrease resonance
pleural effusion: decrease resonance dull or flat
pneumothorax: increase resonance, tympanic,hyper
Pneumonia: decrease resonance, dull or flat
112
atelectasis
condition where part or all of the lung collapses,causing alveoli to lose air
113
atrophy
wasting away or reduction in size of organ or tissue, often due to disuse, disease, or aging
114
diaphoresis
excessive sweating due to a secondary cause: infection, medication, hyperthroidism
115
dysrhythmias
abnormal heart rhythm: too fast to slow irregular rhythm
116
febrile
having a fever
117
hematemesis
vomiting of blood
118
fetid
strong unpleasant smell often associated w. decay or putrefaction
119
hemoptysis
coughing up blood or bloody mucus from respiratory tract
120
hyperthermia
body temperature raising ABOVE normal
121
hypothermia
life threatening condition where body temperature drops below 95 F
122
phlegm
thick mucus secreted in the respiratory passages, occurring in the lungs and throat passage
123
pneumothorax
air or gas in the cavity b/w lung and chest wall, causing collapse of lung
124
purulent
containing or producing pus
125
signs
objective observable indications of a disease, or condition such as rash, fever, swelling that can be detected by healthcare professional through test : fever, swelling, etc
126
sputum
mucus that is coughed up from the lungs "phlegm mucus"
127
symptoms
subjective experiences that a patient feels :pain, nausea, fatigue
128
syncope
fainting or passing out
129
DNR
Do not resuscitate
130
DNI
Do not intubate
131
Normal heart rate
60-100
132
normal range of respiratory rate
12-20
133
normal range of blood pressure
120/80
systolic:120
diastolic: 80
134
normal ranges for PH
7.35-7.45
135
normal ranges for CO2
35-45
136
normal ranges for PaO2
80-100 normal person
55-75 COPD
137
normal ranges for HCO3
22-26
138
ABG
Arterial
blood
gases
139
abnormal ranges for PH
PH> 7.40= basic
PH<7.40= acidic
140
abnormal ranges for PaCO2
PaCO2>40=hypercapnia=acidosis
PaCO2<40=hypocapnia=alkalosis
141
abnormal ranges for PaO2
PaO2> 100= hyperoxemia
60-79= Mild hypoxemia
40-59=moderate hypoxemia
PaO2<40= severe hypoxemia
142
PH relationships
INVERSE relationship b/w PaCO2 and PH
1.increase PaCO2= decrease PH= respiratory acidosis
2.decrease PaCO2=increase PH= respiratory alkalotic
DIRECT relationship b/w HCO3 and PH
1. increase HCO3=increase PH= metabolic alkalotic
2.decrease HCO3=decrease PH= metabolic acidosis
