question

Lung expansion therapy

answer

the most common form of therapy used in high risk patients

question

What are some pulmonary complications that are common serious problems seen in patients who have undergone thoracic and abdominal surgery?

answer

Atelectasis, pneumonia, acute respiratory failure

question

Common Modalities

answer

-Deep breathing/directed cough - incentive spirometry (IS) -Continuous positive airway pressure (CPAP) -Positive Expiratory pressure (PEP) -Intermittent positive airway pressure breathing (IPPB) -To guide the patient into improving pulmonary function by maximizing alveolar function and optimizing airway clearance

question

What is the purpose of lung expansion therapy?

answer

to increase functional residual capacity (FRC)=the volume of air present in the lungs after exhalation -stimulate a deep breath or sigh

question

ACBT

answer

active cycle of breathing therapy

question

PEP

answer

Positive expiratory pressure

question

AD

answer

Autogenic drainage

question

PDPV

answer

Postural drainage, percussion, and vibration

question

CPT

answer

chest physical therapy

question

CPAP

answer

Continuous positive airway pressure

question

EPAP

answer

Expiratory positive airway pressure

question

FET

answer

Forced expiratory technique

question

HFCWC

answer

High frequency chest wall compression

question

HZ

answer

Hertz

question

ICP

answer

Intracranial pressure

question

IPV

answer

Intrapulmonary percussive ventilation

question

MI-E

answer

Mechanicall insufflation-exsufflation

question

Name four phases of the normal cough. Give examples of impairments for each.

answer

1) irritation-anesthesia, CNS depression, narcotics 2) inspiration-pain, neuromuscular dysfunction 3) Compression- laryngeal damage, artificial airway, abdominal weakness, surgery 4) expulsion-airway compression, obstruction, abdominal weakness.

question

Full obstruction or ________ plugging, results in ____________.

answer

Full obstruction or MUCUS plugging, results in ATELECTASIS AND SHUNT

question

Partial obstruction increases _______ of breathing and leads to air ____________.

answer

Partial obstruction increases WORK of breathing and leads to air TRAPPING AND POOR V/Q

question

Name two obstructive lung diseases that result in excessive secretion of mucus and impairment of normal clearance.

answer

CF and Bronchiectasis

question

List four neurologic or musculoskeletal conditions that impair cough.

answer

ALS muscular dystrophy myasthenia gravis poliomyelitis

question

List two absolute and two relative contraindications to turning.

answer

Absolute: Unstable spinal cord injuries Traction of arm abductors Relative: Sever diarrhea Marked agitation

question

How long should you wait to schedule a postural drainage after a patient eats?

answer

1 1/2 -2 hours

question

What is the minimum range of time for effective application of postural drainage therapy?

answer

3-15 minutes

question

Complication: Hypoxemia

answer

Intervention: Administer O2 or raise the FIO2, reposition patient

question

Complication: Increased ICP

answer

Intervention: Stop. Restore patient position. Consult physician

question

Complication: Acute Hypotension

answer

Intervention: Stop. Restore patient position. Consult physician

question

Complication: Pulmonary Bleeding

answer

Intervention: Stop. Restore patient position. Give O2, get physician

question

Complication: Vomiting

answer

Intervention: Stop. Suction, give O2, position, airway, get dr

question

Complication: Bronchospasm

answer

Intervention: Stop. Position, give O2, request bronchodilator

question

Complication: Cardiac Dysrhythmia

answer

Intervention: Stop. Position. Give/increase O2 and contact dr

question

What are the four components of Postural Drainage Therapy?

answer

Turning, postural drainage, percussion, vibration

question

What is splinting?

answer

Supporting the area of incision

question

Describe the three repeated cycles of the ACB technique.

answer

1) breathing control 2) thoracic expansion 3) FET or huff cough

question

During the initial treatment, a PEP device is set to deliver a pressure of 15 cm H2O. The patient complains of dyspnea and can only maintain exhalation for a short period of time. Which of the following should the RT recommend? A) decrease the PEP level to 10 cm H2O B) increase the PEP level to 20 cm H2O C) discontinue the PEP therapy D) Add a bronchodilator to the PEP therapy

answer

A) decrease the PEP level to 10 cm H2O

question

A patient is lying on her left side, one-quarter turn toward her back, with the head of the bed down. What division of the lung is being drained? a) lateral segments of the right lower lobe b) right middle lobe c) left upper lob, lingular segments d) posterior segment of the right upper lobe

answer

b) right middle lobe

question

A patient is receiving postural drainage in the Trendelenburg position. The patient begins to cough uncontrollably. What action should the RT take at this time? a) encourage the patient to use a huff cough b) administer oxygen therapy c) administer a bronchodilator d) raise the head of the bed

answer

d) raise the head of the bed

question

In explaining the therapeutic goal of PEP therapy to a patient, it would be most appropriate to say: a) "This will help prevent pneumonia" b) "This will increase your intrathoracic pressure" c) "This will help you cough more effectively" d) " This will prevent atelectasis"

answer

c) "This will help you cough more effectively"

question

A COPD patient with left lower lobe infiltrates is unable to tolerate a head down position for postural drainage. What action would you recommend? a) perform the drainage with the head of the bed raised b) do not perform the therapy until 2 hours after the last meal c) administer a bronchodilator prior to the postural drainage d) Notify the physician and suggest a different secretion management technique

answer

d) Notify the physician and suggest a different secretion management technique

question

Active patient participation is an important part of which of the following procedures? 1. postural drainage 2. directed cough techniques 3. airway suctioning 4. positive expiratory pressure (PEP) a) 1 and 2 b) 2 and 4 c) 1 and 3 d) 3 and 4

answer

b) 2 and 4 2. directed cough techniques 4. positive expiratory pressure (PEP)

question

An RT is preparing a patient with bronchiectasis for discharge. Which of the following techniques would be most appropriate for self administered therapy in the home? a) IPPB b) flutter c) suctioning d) percussion and postural drainage

answer

b) flutter

question

Dyspnea

answer

labored breathing

question

Tachypnea

answer

Fast breathing pattern, greater than 20 breaths per minute

question

hyperpnea

answer

deep breathing

question

Biot's

answer

irregular pattern with irregular periods of apnea

question

bradypnea

answer

slow breathing pattern, less than 12 breaths per minute

question

Diminished breath sounds

answer

barely audible sounds

question

vesicular breath sounds

answer

soft breezy sounds

question

crackles

answer

fine popping sounds

question

wheezes

answer

musical sounds

question

Hypoventilation is best detected by a(n): a) pulse oximetry monitor b) apnea monitor c) end-tidal carbon dioxide monitor d) peak expiratory flow monitoring

answer

c) end-tidal carbon dioxide monitor

question

Areas of hyperinflation in the lung cause a _______ percussion note. a) dull b) hyper-resonant c) resonant d) flat

answer

b) hyper-resonant

question

What is "diaphragmatic excursion"? a) movement of the diaphragm with disease b) movement of the diaphragm with breathing c) herniation of the diaphragm d) paradoxical breathing indicating fatigue

answer

b) movement of the diaphragm with breathing

question

Which of the following directly affect CO2 production? 1. age 2. alveolar ventilation 3. metabolism 4. water vapor pressure 5. body pH a) 2,3, and 4 b) 2 and 3 only c) 1, 2, 3 d) all of the above

answer

c) 1, 2, 3 1. age 2. alveolar ventilation 3. metabolism

question

Normal end tidal CO2 is _____. a) 1-5 more than PaCO2 b) 1-5 less than PaCO2 c) 95 % d) 35-45 mmHg

answer

b) 1-5 less than PaCO2

question

True or False The flat plateau of the ETCO2 waveform is alveolar gas.

answer

TRUE

question

True or False An elevated end tidal CO2 with a good plateau is caused by hyperventilation.

answer

TRUE

question

True or False Ambient light will alter the end tidal CO2

answer

TRUE

question

True or False Respiratory acidosis is caused by hyperventilation

answer

FALSE

question

Which of the following are considered therapeutic gases? 1. O2 2. O2-NO mixture 3. O2-He mixture 4.N2O a) 1 and 2 b) 2 and 4 c) 3 and 4 d) 1,2, and 3

answer

d) 1,2, and 3 1. O2 2. O2-NO mixture 3. O2-He mixture

question

Which of the following statements regarding O2 is false? a) it is only slightly soluble in water b) it is odorless and transparent c) it is flammable d) it is heavier than air

answer

c) it is flammable

question

What is the US Food and Drug Administration (FDA) purity standard for O2? a) 21 % b) 90% c) 95% d) 99%

answer

d) 99%

question

Which of the following statements about CO2 is false? a) it does not support animal life b) it is a flammable gas c) it is odorless and colorless d) it is heavier than air

answer

b) it is a flammable gas

question

What key property of He makes it useful as a therapeutic gas? a) low solubility b) chemical inertness c) low cost d) low density

answer

d) low density

question

Which of the following gases is used to treat conditions causing hypoxic respiratory failure? a) N2O b) He c) NO d) cyclopropane

answer

c)NO

question

Department of Transportation (DOT) regulations require gas cylinders to be hydrostatically tested for leaks and expansion how often? a) every 1-2 years b) every 3-5 years c) every 6-8 years d) every 5-10 years

answer

d) every 5-10 years

question

According to the US department of commerce, a gas cylinder that is color coded blue should contain which of the following? a) air b) He c) N2O d) O2

answer

c) N2O

question

In clinical practice, how is a positive identification made of the contents of a medical gas cylinder? a) noting the color of the cylinder b) inspecting the cylinder threads c) reading the cylinder label d) collecting and analyzing a gas sample

answer

c) reading the cylinder label

question

What cylinder factor is used to compute the duration of flow for a 244 cu/ft (H/K) O2 or air cylinder? A)0.16 B)0.28 C)3.14 D)2.41

answer

C)3.14

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