Fundamentals Packet Iii And Quiz – Flashcards

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Lung expansion therapy
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the most common form of therapy used in high risk patients
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What are some pulmonary complications that are common serious problems seen in patients who have undergone thoracic and abdominal surgery?
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Atelectasis, pneumonia, acute respiratory failure
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Common Modalities
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-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
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What is the purpose of lung expansion therapy?
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to increase functional residual capacity (FRC)=the volume of air present in the lungs after exhalation -stimulate a deep breath or sigh
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ACBT
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active cycle of breathing therapy
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PEP
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Positive expiratory pressure
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AD
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Autogenic drainage
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PDPV
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Postural drainage, percussion, and vibration
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CPT
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chest physical therapy
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CPAP
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Continuous positive airway pressure
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EPAP
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Expiratory positive airway pressure
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FET
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Forced expiratory technique
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HFCWC
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High frequency chest wall compression
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HZ
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Hertz
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ICP
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Intracranial pressure
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IPV
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Intrapulmonary percussive ventilation
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MI-E
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Mechanicall insufflation-exsufflation
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Name four phases of the normal cough. Give examples of impairments for each.
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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.
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Full obstruction or ________ plugging, results in ____________.
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Full obstruction or MUCUS plugging, results in ATELECTASIS AND SHUNT
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Partial obstruction increases _______ of breathing and leads to air ____________.
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Partial obstruction increases WORK of breathing and leads to air TRAPPING AND POOR V/Q
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Name two obstructive lung diseases that result in excessive secretion of mucus and impairment of normal clearance.
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CF and Bronchiectasis
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List four neurologic or musculoskeletal conditions that impair cough.
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ALS muscular dystrophy myasthenia gravis poliomyelitis
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List two absolute and two relative contraindications to turning.
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Absolute: Unstable spinal cord injuries Traction of arm abductors Relative: Sever diarrhea Marked agitation
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How long should you wait to schedule a postural drainage after a patient eats?
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1 1/2 -2 hours
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What is the minimum range of time for effective application of postural drainage therapy?
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3-15 minutes
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Complication: Hypoxemia
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Intervention: Administer O2 or raise the FIO2, reposition patient
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Complication: Increased ICP
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Intervention: Stop. Restore patient position. Consult physician
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Complication: Acute Hypotension
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Intervention: Stop. Restore patient position. Consult physician
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Complication: Pulmonary Bleeding
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Intervention: Stop. Restore patient position. Give O2, get physician
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Complication: Vomiting
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Intervention: Stop. Suction, give O2, position, airway, get dr
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Complication: Bronchospasm
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Intervention: Stop. Position, give O2, request bronchodilator
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Complication: Cardiac Dysrhythmia
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Intervention: Stop. Position. Give/increase O2 and contact dr
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What are the four components of Postural Drainage Therapy?
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Turning, postural drainage, percussion, vibration
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What is splinting?
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Supporting the area of incision
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Describe the three repeated cycles of the ACB technique.
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1) breathing control 2) thoracic expansion 3) FET or huff cough
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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
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A) decrease the PEP level to 10 cm H2O
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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
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b) right middle lobe
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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
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d) raise the head of the bed
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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"
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c) "This will help you cough more effectively"
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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
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d) Notify the physician and suggest a different secretion management technique
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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
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b) 2 and 4 2. directed cough techniques 4. positive expiratory pressure (PEP)
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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
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b) flutter
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Dyspnea
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labored breathing
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Tachypnea
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Fast breathing pattern, greater than 20 breaths per minute
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hyperpnea
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deep breathing
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Biot's
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irregular pattern with irregular periods of apnea
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bradypnea
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slow breathing pattern, less than 12 breaths per minute
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Diminished breath sounds
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barely audible sounds
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vesicular breath sounds
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soft breezy sounds
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crackles
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fine popping sounds
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wheezes
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musical sounds
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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
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c) end-tidal carbon dioxide monitor
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Areas of hyperinflation in the lung cause a _______ percussion note. a) dull b) hyper-resonant c) resonant d) flat
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b) hyper-resonant
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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
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b) movement of the diaphragm with breathing
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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
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c) 1, 2, 3 1. age 2. alveolar ventilation 3. metabolism
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Normal end tidal CO2 is _____. a) 1-5 more than PaCO2 b) 1-5 less than PaCO2 c) 95 % d) 35-45 mmHg
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b) 1-5 less than PaCO2
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True or False The flat plateau of the ETCO2 waveform is alveolar gas.
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TRUE
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True or False An elevated end tidal CO2 with a good plateau is caused by hyperventilation.
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TRUE
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True or False Ambient light will alter the end tidal CO2
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TRUE
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True or False Respiratory acidosis is caused by hyperventilation
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FALSE
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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
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d) 1,2, and 3 1. O2 2. O2-NO mixture 3. O2-He mixture
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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
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c) it is flammable
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What is the US Food and Drug Administration (FDA) purity standard for O2? a) 21 % b) 90% c) 95% d) 99%
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d) 99%
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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
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b) it is a flammable gas
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What key property of He makes it useful as a therapeutic gas? a) low solubility b) chemical inertness c) low cost d) low density
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d) low density
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Which of the following gases is used to treat conditions causing hypoxic respiratory failure? a) N2O b) He c) NO d) cyclopropane
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c)NO
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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
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d) every 5-10 years
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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
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c) N2O
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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
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c) reading the cylinder label
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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
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C)3.14
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