Review Flashcards
(268 cards)
1
Q
What is the abbreviation for right upper lobe??
A
RUL
2
Q
What is the abbreviation for “four times a day”?
A
QID
3
Q
What is the abbreviation for left lower lobe?
A
LLL
4
Q
What is the abbreviation for Intramuscular?
A
IM
5
Q
What is the abbreviation for intravenous?
A
IV
6
Q
What is the Abbreviation for liter?
A
L
7
Q
List four phases of the cough mechanism?
A
- Irritation
- Inspiration
- Compression
- Expulsion
8
Q
Define hypoxemia?
A
- A patient that has a PaO2 less than 80
- low oxygen in the blood
9
Q
Define responsive hypoxemia?
A
- Oxygen fixes it
- It is a V/Q mismatch
10
Q
Define refractory hypoxemia?
A
- Arterial hypoxemia
- True Shunt
11
Q
Define hypoxia?
A
- Low oxygen in the tissues
12
Q
List four types of hypoxia and give examples with each?
A
- Histotoxic hypoxia. Example: cyanide
- Anemic hypoxia. Example: carbon monoxide, anemia
- Stagnant hypoxia. Example: shock, vasoconstriction
- Hypoxemic hypoxia. Example: V/Q mismatch
13
Q
Describe oxygen toxicity?
A
- To much oxygen
- After 12-24 hours of high FIO2
14
Q
Describe depression of ventilation as applied to high FIO2 use?
A
- Elevated bicarbonate levels
- Co2 retainers
15
Q
Describe retinopathy of prematurity?
A
- when you give infants a high flow you can make them go blind
- must give me a PaO2 < 80
16
Q
What does CBABE stand for?
A
C- cystic fibrosis B- bronchiectasis A- asthma B- bronchitis E- emphysema
17
Q
Describe absorption atelectasis?
A
- alveolar collapse
- nitrogen washout
18
Q
What is the normal pulse rate?
A
60-100 beats per minute
19
Q
What is tachycardia?
A
A pulse rate over 100 beats per minute
20
Q
What is bradycardia?
A
Is a pulse rate under 60 beats per minute
21
Q
What is normal range for systolic and diastolic blood pressure?
A
Systolic- 90 to 140
Diastolic- 60 to 90
22
Q
What is the average blood pressure reading?
A
120/80 mmHg
23
Q
What is hypertension?
A
Blood pressure that is over 140/90 mmHg
24
Q
What is hypotension?
A
Blood pressure that is under 90/60 mmHg
25
What is Pectus carinatum?
Penguin chest
26
What is Pectus excavation?
Funnel chest
27
What is kyphoscolosis?
Forward and lateral curvature in the spine
28
What is scoliosis?
Spine curvature that is lateral
29
What is kyphosis?
Back curvature that is forward
30
What is apnea?
Extended time with NO breathing
31
What is apneustic breathing?
Prolonged inspiration with extremely short insufficient expiration
32
What is Cheyne-Stokes breathing?
Irregular breathing pattern
Breathing increase and decreases in depth and rate with periods of apnea
Usually happens right before a patient dies
33
What is Biot's?
Irregular breathing with long periods of apnea
34
List the low flow devices
- nasal cannula
- nasal catheter
- transtracheal catheter
- simple mask
- partial rebreathing mask
35
What are retractions?
Sinking in of the skin overlying the chest walls
36
What are the disease that obstruct air flow?
| can't get air out
- emphysema
- asthma
- chronic bronchitis
37
What is the normal range for red blood cell count?
4-6 million/ mm3
38
What is the normal count for hemoglobin?
12-16 g/ dL
39
What is the normal range for white blood cell count?
5,000- 10,000/ mm3
40
What is the normal range for hematocrit?
40-50%
41
What is the normal range for platelets?
150,000- 400,000 /mm3
42
What is the range for forced exploratory flows in small airways?
25-75%
43
What is the abbreviation for arterial blood gas?
ABG
44
What is the abbreviation for "before meals"?
AC
45
What does a CBC stand for?
Complete blood count
46
What is the abbreviation for "activities of daily living" ?
ADL
47
What is the abbreviation for twice a day?
BID
48
What does AP stand for?
Anterior- posterior
49
What is the abbreviation for beats per minute?
BPM
50
What is the abbreviation for chest physical therapy?
CPT
51
What's the abbreviation for hemoglobin?
HgB
52
What is the abbreviation for at bedtime?
HS
53
What does Hx stand for?
History
54
What is the forced expiratory flows for large airways?
200-1200
55
What does FEV1 stand for?
Forced expiratory volume time
56
What does SVC stand for?
Slow vital capacity
57
What does FVC stand for?
Forced vital capacity
58
What is the equation to convert Celsius to fahrenheit?
( 1.8 * Celsius) + 32
59
What's the equation to convert Fahrenheit to Celsius?
(Fahrenheit - 32)/1.8
60
What is the peak expiratory flows Forman and women?
Men- 10 L/sec or 600 L/min
| Women- 7.5 L/sec or 450 L/ min
61
What are the diseases that restrictive to volume?
| can't get air in
- scoliosis
- obesity
- Gillian-barre syndrome
62
What is the normal chemistry panel for sodium?
135-145 mEq/l
63
What is the normal basic chemistry panel for potassium?
3.5 - 5 mEq/l
64
What is the normal for a basic chemistry panel on chloride?
85-100 mEq/l
65
What is the normal basic chemistry panel for bicarbonate?
22-26 mEq/L
66
What is normal basic chemistry panel for BUN ( blood urea nitrogen)?
7-20 mg/dL
67
What is the normal basic chemistry panel for creatinine?
0.7-1.3 mg/ dL
68
What is the definition for veracity?
Binding agreement that the provider of care and the patient will tell the truth
69
What is the definition of nonmaleficence?
"do no harm"
| Obligation to prevent harm where it is possible
70
What is the definition of beneficence?
Obligation to provide helpful treatment
71
What is the definition of autonomy?
Personal rights to decide your own course of action
72
What is the purpose of the slow flow rate during inhalation of the SMI maneuver?
To slowly open up the lungs and the alveoli, it fully allows the air to pop them open and get through
73
What is the purpose of the breath hold maneuver during IS therapy?
To open up the alveoli and let O2 absorb
| Which is alveoli recruitment
74
Characteristics of RBC (red blood cells)?
- normal 4-6 million/mm3
| - supplies O2 to the blood
75
What is polycythemia?
RBC that are greater than 6 million
76
What is anemia?
RBC that are less than 4 million
77
List the characteristics of hemoglobin (Hgb)?
- protein in RBC
- helps maintain acid-base balance
- decrease hemoglobin can be anemia
Normal hemoglobin is 12-16 g/dL
78
What does WOB stand for?
Work of breathing
79
What is abbreviation for three times a day?
TID
80
What does SOB stand for?
Shortness of breath
81
There are 5 general approaches to bronchial hygiene.
| List three of them?
1. CPT aka postural drainage therapy
2. Coughing and related expulsion techniques
3. Positive airway pressure airway adjuncts
82
What does RLL stand for?
Right lower lobe
83
What is the abbreviation of postero-anterior?
PA
84
What is the Abbreviation for rule out?
RO
85
What does PRN stand for?
As required
86
What is the abbreviation for every night?
QPM
87
What is the abbreviation for every morning?
QAM
88
What does PO stand for?
Orally
89
What is the abbreviation for every hour?
QH
90
What is the abbreviation for every day?
QD
91
What is the abbreviation for nasogastric?
NG
92
What does NPO stand for?
Nothing by mouth
93
What does magnet resonance imaging?
MRI
94
What is the abbreviation for milliequivalent?
mEq
95
Left upper lobe what is the abbreviation?
LUL
96
What is the abbreviation for lateral?
LAT
97
What does Dx stand for?
Diagnosis
98
What does DC stand for?
Discontinue
99
What is the abbreviation for chest x-ray?
CxR
100
What is the abbreviation for chief complaint?
CC
101
What does RML stand for?
Right middle lobe
102
What will happen to inspiratory time on IPPB when pressure is increased?
Increases
103
What will happen to delivered volume on IPPB when pressure is decreased?
Decreases
104
List three types of air compressors?
- piston compressor
- diaphragm
- centrifugal
105
What are the two methods of production of oxygen?
- Fractional Distillation
| - Physical Separation
106
List a disease process in which nitric oxide/oxygen would be beneficial in treating pulmonary hypertension?
Pulmonary vasoconstriction
107
What is the duration of flow for an "E" cylinder containing 1700 psig of compressed gas powering a nasal cannula at 3 LPM?
1700 x 0.28/ 3 = 158.6/60
| = 2 hours and 36 minutes
108
List and explain relative contraindications for IPPB therapy?
- BLEB burst alveoli
- TE Fistula
- Hemodynamic instability
- Active Hemoptysis
109
Why on IPPB should medication be nebulized on exhalation?
Gives medication time to build up to and be ready for next inspiration
110
If inspiratory time is excessively long what control needs to be adjusted?
Flow
111
Define passive atelectasis?
Can not take a deep breath, small tidal volumes
| Happens in patients that are bed ridden or abdominal surgery
112
Define reabsorption atelectasis?
Gas absorption in the tissues
113
List three clinical signs of atelectasis?
- decrease expansion
- increased fremitus
- hyporesonant sounds
- accessory muscle usage
- diminished, bronchial, and crackle sounds
114
List three hazards of IS therapy?
- hyperventilation with respiratory alkalosis
- fatigue
- barotrauma
115
What is hypercapnia?
Increased carbon dioxide levels
116
Describe SMI maneuver?
- nice slow deep breath followed by a breath hold
117
What does SMI stand for?
Sustained maximal inspiration
118
If a patient was achieving 1500 mL and his predicted IC was 4800. What is his percent of predicted?
1500/4800=31%
119
What type of ventilator delivers IPPB treatment?
Pressure ventilator
120
What will happen on IPPB when delivered FIO2 the terminal flow is in use?
Decreases
121
If the machine cycles off prematurely what controls need to be adjusted?
Flow
122
If the machine shows large negative swings. What controls need to adjusted?
Sensitivity
123
List four therapeutic out comes for IPPB?
1. Subjective response from the patient
2. Clear breath sounds
3. Improved chest x-ray
4. Improve oxygenation
124
List one absolute contraindications for IPPB therapy?
Untreated pneumothorax
125
What color is designated for a cylinder containing helium?
Brown
126
List three contraindications for IS therapy?
1. When a patient will not cooperate
2. If the patient is not responsive to IS therapy
3. Can not do 1/3 of their IC
127
List and explain four indications for IPPB therapy?
1. Decrease WOB
2. Will not cooperate with IS therapy
3. Decrease pulmonary edema
4. Can not meet 1/3 of IC
128
How will a bourdon gauge flow meter read in the presence of down stream resistance?
Operates in any position
129
What is the duration of flow for liquid oxygen cylinder that weighs 2.0 lbs powering a simple mask at 6 LPM?
2.0 x 860/ 2.5= 688/6
| = 1 hour 54 minutes
130
List two common CXR changes on a patient with atelectasis?
- increased opacity
| - volume loss
131
What is the purpose of cracking the cylinder?
Rid the cylinder of debris before putting on the regulator
132
List two ways to identify a thorp tube as compensated?
- are labeled "calibrated at 50 psi"
- when needle valve is closed, float will jump when connected to the wall
- needle valve position is distal to the tube
133
List the types of high flow systems
- non rebreathing mask
- air entrainment mask
- blending systems
- tents
- hoods
- incubators
134
Qualifications for high flow systems?
- Vt= 700 mL
- RR= > 25
- irregular ventilatory pattern
135
Helios therapy
FIO2= 20/80
FIO2= 30/70
- if 20/80 multiply flow by 1.8
| - if 30/70 multiply flow by 1.6
136
A patient is receiving Helios 80/20 via a non rebreather at 9 LPM.
What flow is the patient actually receiving?
1.8 x 9 LPM= 16.2 LPM
137
What is the normal PaO2 range for a COPD patient that suffers from chronic hypercapnia?
60-65%
138
What is the approximate FIO2 of a 3 LPM nasal cannula?
4 x 3 + 20= 32
139
Explain how delivering an IPPB treatment might cause depression of ventilation?
IPPB if a person has COPD it can cause their PaO2 to go above 65 which can knock out their hypoxia drive and cause depression of ventilation
140
Calculate IBW (in kg) for a 5 ft 8 inches female patient?
105 + 5 (68-60)/ 2.2
105 + 5(8)/2.2
= 66 kg
141
What is the range for moderate hypoxemia?
40-59
142
IPPB
| The trigger- what turns the machine on?
Pressure- patient sips in the machine no more than 2 cm H2O should pull back
143
Qualifications for a low flow system?
Vt= 300 mL to 700 mL
RR= < 25 ( less than)
Regular ventilatory pattern
Variable FIO2
144
IPPB
| Cycle- inspiration to end and expiration to begin?
Pressure cycled expiration
145
What does the "+" indicate when stamped on the shoulder of a cylinder?
That the cylinder can be filled 10% over the pressure stamped on the cylinder
146
What are the equations for IBW for male and female?
Male- 106 + 6(ht in the inches -60)/2.2
| Female- 105+5( ht I. Inches-60)/2.2
147
What is the equation to get tidal volume?
Ve/ f= Vt
148
What is a normal PaO2?
80-100 mmHg
149
What is mild hypoxemia?
60-79 mmHg
150
What is moderate hypoxemia?
40-59 mmHg
151
What is severe hypoxemia?
Less than 40 mmHg
152
What is the equation for the duration of flow on a liquid cylinder?
Liquid O2 weight x 860/ 2.2 lbs/L= answer
| Answer/LPM
153
Gas cylinders are filled at what temperature?
70 degrees fahrenheit
154
What is normal pH?
7.35-7.45
155
What is normal CO2?
35-45
156
What is normal HCO3?
22-26 mEq
157
How is liquid cylinders filled?
Density
158
How many cubic feet of gas are in one liter?
28.3 cubic feet
159
Cylinder sizes!
```
D= 0.16 L / Psig
E= 0.28 L/ Psig
M= 1.36 L/ Psig
G= 2.41 L/ Psig
H&K= 3.14 L/ Psig
```
160
What is the equation for minute ventilation?
Vt x f= Ve
161
What does the star mean on a cylinder?
Retest in 10 years for hydrostatic testing
162
Patient is in full trendeleburg laying on left side with arm over head. What is being drained?
Right lateral segment
163
Explain how an IPPB treatment may impair venous return?
Constrict superior and inferior vena cava which causes low blood volume to the right side of the heart, which causes low blood volume to the pulmonary capillary bed and low blood volume to the left side of the heart which causes low cardiac output and low blood pressure
164
List 5 clinical manifestations/physiologic mechanisms of hypoxemia?
1. Cardiopulmonary hypertension
2. Lactic acid
3. Polycethemia- increased RBC
4. Tachypnea
5. Cyanosis
165
What is blood urea nitrogen?
Key marker for kidney function greater than 20 should look at the creatinine levels
If both are high then you are looking at kidney failure
166
Characteristics of platelet count?
- helps blood clot
- thrombocytopenia- low platelet count less than 150,000 mm3
- thrombocytosis- high platelet count greater than 400,000 mm3
167
Characteristics of hematocrit? (Hct)
Ratio volume to whole blood
| Normal : 40-50%
168
What is the characteristics of white blood cells? (WBC)
WBC: known as leukocytes
- helps fight infection
- its differential
- leukopenia- less then 5,000 mm3 WBC
- leukocytosis- increase greater than 10,000 mm3 WBC
169
List four disease states where bronchial hygiene may be helpful?
1. Bronchiectasis
2. Cystic fibrosis
3. Chronic bronchitis
4. Airway dyslectic syndrome
170
Explain how dependent positioning aides in oxygenation?
Patient is turned so that the good lung is dependent or in the down position which oxygenation will improve because gravity directs more blood to the well ventilated alveoli
171
If you place a patient prone with a pillow under the abdomen and bed flat, what segment is being drained?
Superior segments
172
When should vibrations be performed?
Vibrations should be performed on exhalation only after the patient has taken a deep breath
173
List two approaches to oscillations?
1. External application
| 2. Airway application
174
Describe the huff cough?
Consists of one or two forced expirations of middle to low lung volumes without closure of the glottis have patient huff during expiration
175
If a patient has a temperature of 94 depress fahrenheit, what will happen to the PaO2 when you run it through an analyzer at 98.6 degrees Fahrenheit?
PaO2 and PCO2 will increase
176
What are the objectives for oxygen therapy?
1. Correct documented or suspected acute hypoxemia
2. Decrease symptoms of chronic hypoxemia
3. Decrease cardiopulmonary workload
177
Semi fowler is?
When patients head is 30-45 degrees
178
Fowlers position is?
When the patients head is 80-90 degrees
179
List the sites for an arterial gas puncture?
- radial
- brachial
- femoral
180
List two complications of P and PD?
- increased ICP
| - Acute hypotension
181
Which artery is released during modified Allen's test?
Ulnar
182
List two types of oximetry?
1. Co- oximetry
| 2. Pulse oximetry
183
What is capnometry?
Measures CO2 at the patients airwa
184
Patient is in semi fowlers pillow under knees which portion is being drained?
Anterior upper segments
185
Patient is slightly bent forward splinting a pillow which segments are being drained?
Posterior apical segments
186
Patient is in full trendeleburg prone position. What is being drained
Posterior segments
187
Patient in supine position bed flat which segment is being drained?
Anterior segments
188
Patient is in modified trendeleburg laying on right side 1/4 back what is being drained?
Left lingular
189
Patient is in modified trendeleburg laying on left side rotated 1/4 back what is being drained?
Right middle lobe
190
What does 3AA mean on a cylinder?
Heat treated steel
191
What does 3A mean on a cylinder?
Non heat treated steel
192
What does 3 AL mean on a cylinder?
Aluminum
193
Duration of flow equation for a gas cylinder?
Pressure in cylinder x cylinder factor / flow
194
Explain why a high flow system has a fixed FIO2?
High flow must meet or exceed the patients inspiratory flow
195
Patient is laying on stomach (prone position) with pillow under hips, bed flat what is being drained?
Superior segments
196
Patient is in full trendeleburg laying on right side put left arm over head. What is being drained?
Left lateral segments
197
Name the hypoxia in which hypoxemia may not be present?
Hidtotoxic hypoxia
198
List 2 of the 3 indications for oxygen therapy?
- acute hypoxia
| - increase cardiopulmonary workload
199
The sensitivity on IPPB?
The closer it's the harder it is for the patient to pull
200
What is the pressure manometer on IPPB?
Tells how much the person is sucking in
201
IPPB
| Limit: what the machine doesn't go over during inspiration?
The pressure it is set at
202
IPPB
Air mix control: FIO2 pushed in is 100%
What isn't pulled out?
FIO2 40-80%
203
List / of the 3 qualifications for a low flow system?
Must be 300 mL to 700 mL
| RR <25
204
List 4 places that a potential leak could occur on IPPB machine?
```
Patient
Machine
Neb cup
Circuit
Mouth
Nose
Connection points
```
205
What is the Alveolar air equation ?
(Bp-H2O)FIO2-CO2(1.25)
| Normals: (760-47).21-40(1.25)
206
What is the total O2 content (CaO2) equation?
(1.34)(Hgb)(SAO2) + (.003)(PaO2)
207
What is the Henderson-hasselbauch equation?
6.1 + log (HCO3/PCO2 x .03)
208
V/ Q ratio is the ventilation to perfusion ratio
| What is the normal?
Normal is .8
If it is increased- dead space
If decreased- shunt
209
What is hydrolysis?
CO2+ H2O= H2CO3= H + HCO3
| This happens at the lungs, cerebral spinal fluid, and kidneys
210
What is cardiac output equation?
Stroke volume x heart rate
211
What is normal cardiac output?
4-8 liters per minute
212
What is normal stroke volume?
40-80mL
213
What is hypocapnea?
Presence of lower thn normal amounts of CO2
214
What is hypercapnia?
Abnormal presence of excess amounts of CO2
215
What is hypokelemia?
Inadequate amount of potassium
216
What is hyperkelemia?
Greater then normal amounts of potassium
217
What is hyponatremia?
Less than normal sodium amounts
218
What is hypernatremia?
Greater thN normal sodium amounts
219
What is the set PSI for oxygen in the hospital?
50 PSI
220
What is the pin index for oxygen?
2:5
221
What is the pin index for air?
1:5
222
What is PPHN?
Persistent pulmonary hypertension of newborns
223
What is ASSS?
American standard safety system
Specifications adopted in the U.S. and Canada for threaded high-pressure connections between compressed gas cylinders and their attachments
224
What does DISS stand for?
Diameter indexed safety system
Specifications established to prevent accidental interchange of low pressure (<200psig) medical gas connectors.
To conne t equipment to low pressure gas source
225
What does PISS stand for?
Pin indexed safety system
| Yoke type connection for small cylinders
226
What is Orthopnea?
Labored breathing in the reclining position
227
What is playtpnea?
Difficulty breathing in the standing position
228
What is oscillations?
Back and forth motion, vibration or effects of mechanical or electrical vibrations
229
What is pulses paradoxus?
Abnormal decrease in pulse pressure with each inspiratory effor
230
What is pulsus alternans?
Alternating between strong and weak heartbeats
231
What is a regulator?
Controls pressure and flow
232
What is the airways resistance equation?
Pressure/flow in seconds
233
Normal blood volume?
5 liters
234
What is total lung capacity?
6 L or 6000mL
235
What is vital capacity?
4.8 L or 4800 mL
236
What is reserve volume?
1.2 L or 1200mL
237
What is your inspiratory capacity?
3.6 L or 3600 mL
238
What is functional reserve capacity?
2.4 L or 2400 mL
239
What is inspiratory reserve volume?
3.1 L or 3100 mL
240
What is tidal volume?
.5 L or 500 mL
241
What is expiratory reserve volume?
1.2 L or 1200 mL
242
What is a nosocomial infection?
Developed from being in the hospital
243
What do you wear in droplet precaution?
Mask, gown, and gloves
244
What do you wear in airborne infection isolation?
N-95 mask, negative pressure room, door stays closed, 6-12 air changes per hour helps toreove particles suspended in the air
245
What are normal breath sounds?
Tracheal, vesicular, and bronchovesicular
246
What are adventitious breath sounds?
Strider, wheezes, fine crackles, and coarse crackles
247
What does monophonic mean?
A single note or one obstructed airway
248
What does polyphonic mean?
Multi- notes or multi obstructed airways
249
What is internal respiration?
Gas exchange between systemic capillaries
250
What is external respirations?
Gas exchange at the ( A-C membrane)
251
What is surface tension?
Force exerted by like molecules at a liquids surface
252
What is La Place's Law?
Stronger the surface tension the more force required to tear the surface
253
What is Paschal's Law?
Regardless of shape, size or height of cylinder when pressure is applied it is applied equally in all directions when a liquid is out under pressure
254
What is Archimedes Law?
The weight of an object is less than the buoyancy of force of the water
255
What is Boyles Law?
Temperature constant volume varies inversely with pressure
256
What is Charles law?
Pressure constant volume varies directly with temperature
257
What is Gay-Lussac's Law?
Volume constant pressure varies directly with temperature
258
To give Heliox therapy what mask do you use?
Non- rebreather
259
What is the characteristics of a nasal cannula?
1-6 LPM
Flows over 4 LPM require humidity
Delivers FIO2 of 24-45%
260
What are characteristics of simple mask?
- 5 to 10 LPM @ least 5 to clear CO2
| - delivers FIO2 is 40-50%
261
What are the characteristics of a partial rebreather?
- 6 to 10 LPM
| - delivers FIO2 of 60-65%
262
What are the characteristics of air entrainment masks?
- 4 to 12 LPM
| - delivers an FIO2 24-50%
263
What are the characteristics of hoods?
7-14 LPM
| Over 14 makes too much noise
264
What are characteristics of incubators?
Delivers FIO2 of less than 40% because they are opened frequently
265
What if chest pain is pleuritic, where is it happening?
In the lungs
266
What if chest pain is non- pleuritic, where is it happening?
Not in the lungs usually in the heart
267
Coarse crackles?
Can be cleared with a cough
268
Where do you hear fine crackles?
In the alveoli
