Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
78 Cards in this Set
- Front
- Back
|
What is the point in the respiratory track where inspired gas reaches body temperature, ambient pressure, saturated (BTPS) conditions?
|
isothermic saturation boundry
ISB |
|
|
What is the primary goal of humidity therapy?
|
maintain normal physiologic conditions
|
|
|
Indications for warming inspired gases include all of the following EXCEPT:
A. treating a pt whose airways are reactive to cold B. providing humidification when the upper airway is bypasses C. treating a pt with a low body temp. (hypothermia) D. reducing upper airway inflammation or swelling |
D. reducing upper airway inflammation or swelling
|
|
|
Administration of dry gas at flows exceeding 4L/min can cause which of the following?
I. structural damage II. heat loss III. water loss |
all of them
|
|
|
Inhalation of dry gases can do which of the following?
1. increase viscosity of secretions 2. impair mucociliary motility 3. increase airway irritability |
all of them
|
|
|
Clinical indications for delivering cool humidified gas include which of the following?
1. postextubation edema 2. upper airway inflammation 3. croup 4. epiglottis |
all of them
|
|
|
Factors affecting a humidifier's performance include all of the following EXCEPT:
a. surface area b. temperature c. time of contact d. outlet size |
outlet size
|
|
|
What is the most important factor determining a hudmdifier's performance?
|
temperature
|
|
|
The greater the temp of gas, the________________?
|
more water vapor it can hold
|
|
|
Gas leaving an unheated humidifier at 10 'C and 100% relative humidity (absolute humidity =9.4 mg/L) would provide what relative humidity at body temp?
|
about 20%
|
|
|
What is the simpilest way to increase the humidity output of a humidifier?
|
increase the temp of either the water or the gas
|
|
|
All of the following are true about humidification and contact time EXCEPT:
1. the longer a gas is exposed to water, the greater is the amount of evaporation 2. the rate of gas flow through a humidifier determines contact time 3. low flows decrease and high flows increase relative humidity output 4. bubble humidifier contact time depends on the water column depth |
3. low flows decrease and high flows increase relative humidity output
|
|
|
Simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems?
|
oronasal oxygen delivry
|
|
|
increasing the flow through an unheated bubble humidifier has what effect?
|
decreasing the water vapor content
|
|
|
Why shouldn't you heat the reserviors of a bubble humidifier used with an oronasal oxygen delivry system?
|
condensate will obstruct the delivery tubing
|
|
|
the relief vavle on a bubble humidifier serves what function?
|
it indicates when flow has been interupted
it protects the device from pressure damage |
|
|
To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate ________?
|
pressure relief valves
|
|
|
The typical pressure pop-off incorporated into most bubble humidifiers releases pressure above _____ psig?
|
2 psig
|
|
|
when checking an oxygen delivery system that incorporates a bubble humidifier running at 6 L/min, you occlude the delivery tubing, and the humidifier pressure relief immediatly pops off. What does this indicate?
|
mormal, leak free system
|
|
|
A design that increases surface area and enhances evaporation by incorporating an absorbant material partially submerged in a water resevior that is surrounded by a heating element best describes what type of humidifier?
|
wick
|
|
|
All of the following are TRUE regarding a membrane-type humidifier EXCEPT:
1. water and gas are seperated by a hydrophobic membrane 2. the membrane is permeable to water vapor but not to liquid water 3. as with other passover humidifiers, there is no bubbling action 4. a small layer of liquid water remains on both sides of the membrane |
4. a small layer of liquid water remains on both sides of the membrane
|
|
|
Advantages of passover humidifiers include include all of the following EXCEPT:
a. they add minimal flow resistance to breathing circuits b. they do not require heating to maintain body temp, ambient pressure, saturated (BTPS) conditions c. they do not generate any bacteria-spreading microaerosol d. they can maintain water vapor saturation at high flows |
b. they do not require heating to maintain body temp,
|
|
|
what type of humidifier "traps" the pts body heat and expired water vapor to raise the humidity of inspired gas?
|
heat-moisture exchanger
|
|
|
Heat-moisture exchanger (HMEs) are mainly used to do what?
|
warm and humidify gases delivered to the trachea via ventilator circuits
|
|
|
What are these called?
simple condenser hygroscopic condenser hydrophobic condenser |
Heat-moisture exchangers (HMEs)
|
|
|
All of the following are features of an ideal heat-moisture exchanger (HME) EXCEPT:
a. high compliance b. minimial dead space c. 70% or higher efficiency d. minimal flow resistance |
a. high compliance
|
|
|
All of the following are true of HMEs EXCEPT:
a. moisture output falls at high volumes and rates of breathing b. high inspiratory flows and high FIO2 values can decrease HME efficiency c. in-use HMEs have little effect on flow resistance to breathing d. HMEs reduce bacterial colonization of ventilator circuits |
c. in-use HMEs have little effect on flow resistence too breathing
|
|
|
For which of the following pts would you select a heated humidifier?
1. pt receiving O2 through a bypasses upper airway 2. pt receiving long-term mechanical ventilation 3. pt receiving O2 through an oronasal mask |
1. pt receiving O2 through a bypasses upper airway
2. pt receiving long-term mechanical ventilation |
|
|
These are necessary features in selecting a __________?
water level readily visible over-temp protection auditory and visual alarms minimal temp overshoot |
all of them
|
|
|
What are some potential problems with manually refilled geated humidifier resivoirs?
1.cross-comtamination and infection 2.variable compliance or delivered volume 3. delivery of dry and/or hot gases |
all of them
|
|
|
The following are contraindications for heat-moisture exchangers EXCEPT:
a. presence of thick, copious, or bloody secretions b. presence of large leak around artificial airway c. when a pt is suffering from hyperpyrexia d. when a pts minute ventilation exceeds 10 L/min |
c. when a pt is suffering from hyperpyrexia
|
|
|
A patient receiving ventilatory support is being provided with humidification using a heat-moisture exchanger. A DR orders a bronchodilator drug administered through a metered-dose inhaler (MDI) via the ventilator circuit. What must be performed to ensure delivery of the drug to the patient?
|
The HME must be removed from the circuit during MDI use
|
|
|
A pt has been supported by a mech vent using a HME for the last 3 days. Suctioning reveals an increase in the amount and tenacity of secretions. What action is indicatied?
|
switch the patient to a large volume heated humidifier
|
|
|
Which of the following is FALSE about heated humidifier condensate?
a. it can block or obstruct the delivery circuit b. it must be treated as contaminated waste c. it requires that circuits be drained frequently d. it poses minimal infection risk |
d. it poses minimal infection risk
|
|
|
Which of the following are acceptable means to help minimize the problems caused by condensation in heated humidifier circuits?
1. installing water traps in the circuit 2. using a heated wire circuit 3. setting heater temp to 25-28'C |
1. installing water traps in the circuit
2. using a heated wire circuit |
|
|
When using water traps to help minimize the problems caused by condensation in a heated humidifier ventilator circuit, where would you place the traps?
|
in both the expiratory and inspiratory limbs, at low points in the circuit
|
|
|
All the following are TRUE when heated wire circuits are used with heated humidifiers EXCEPT:
a. the humidifier operates at a higher temp b. there is less condensate and a reduced need for drainage c. cost savings (less water and staff time) are realized d. there is less infection risk for both the patient and caregivers |
a. the humidifier operates at a higher temp
|
|
|
Which of the following pts would you recommend bland aerosol therapy administration?
1. pt with upper airway edema 2. pt with a bypassed upper airway 3. pt who must provide a sputum specimen |
all of them
|
|
|
which of the following pts would you NOT recommend bland aerosol therapy administration?
1. pt with a history of airway hyperresponsiveness 2. pt with a bypasses upper airway 3. pt with active bronchoconstriction |
1. pt with a history of airway hyperresponsiveness
3. pt with active bronchoconstriction |
|
|
All of the following indicates a potential need for administration of a water or isotonic saline aerosol EXCEPT:
a.stridor or brassy, crouplike cough b. evidence of increased volume of secretions c. hoarseness after extubation d. patient discomfort after bronchoscopy |
b. evidence if increased volume of secretions
|
|
|
The particle size produced by an unltrasonic nebulizer depends mainly on _______?
|
signal frequency
|
|
|
A Dr orders bland water aerosol administration to a patient with an intact upper airway. Which of the following airway appliances could you use to meet this goal?
1. simple O2 mask 2. face tent 3. T-Tube 4. aerosol mask |
face tent and aerosol mask
|
|
|
A Dr orders bland water aerosol administration to a patient with a tracheostomy. Which of the following airway devices could you use to meet this goal?
1. tracheostomy mask 2. face tent 3. T-tube 4. aerosol mask |
tracheostomy mask and T-Tube
|
|
|
For what should sputum collected by aerosol therapy induction be inspected?
1. color 2. volume 3. odor 4. consistency |
all of them
|
|
|
The risk of overhydration with continuous delivery of bland water aerosols is greatest among which patient group?
1. pt with fluid or electrolyte imbalances 2. pts with fever and infection 3. infants and small children |
1. pts with fluid or electrolyte imbalances
3. infants and small children |
|
|
A pt receiving nasal o2 at 3L/Min complains of nasal dryness and irritation. what could be done to make this patient more comfortable?
|
adding a humidifier to the delivery system
|
|
|
_________ is a suspension of liquid or solid particles in a gas?
|
aerosol
|
|
|
What is the retention of aerosol particles resulting from contact with the respiratory tract mucosa called?
|
deposition
|
|
|
what do the following factors affect:
1. size of the particles 2. shape and motion of the particles 3. physical characteristics of the airways |
pulmonary deposition of an aerosol
|
|
|
What is the primary mechanism for deposition of large, high-mass particles (greater than 5 um) in the respiratory tract?
|
inertial impaction
|
|
|
The following will increase aerosol deposition by _______ _________?
- variable or irregular passages - turbulent gas flow |
inertial impaction
|
|
|
where do most aerosol particles in the 5-10 um range deposit?
|
upper airways
|
|
|
Where do most aerosol particles in the 1-5 um range deposit?
|
central airways
|
|
|
A __ second breath hold can increase aerosol deposition as much as __% and increase the ratio of aerosol deposited in lung parenchyma to central airways by fourfold?
|
10 second; 10%
|
|
|
What is the primary fate of aerosol particles that are between 1 and 0.5 um?
|
most are cleared during exhalation
|
|
|
Where do most aerosol particles that are less than 3 um deposit?
|
alveoli
|
|
|
A dr wants to deliver a therapuetic aerosol to the upper airway (nose,larynx,trachea). To help ensure maximum deposition in this area, you would select an aerosol generator with an MMAD in what range?
|
5 to 50 um
|
|
|
A dr wants to deliver a theraputic aerosol to the central and lower airways. To help ensure maximum deposition in this area, you would select and aerosol generator with an MMAD in what range?
|
2 to 5 um
|
|
|
A dr wants to deliver a therapeutic aerosol to the lung parenchyma (alveolar region). To help ensure maximum deposition in this area, you would select and aerosol generator with an MMAD in what range?
|
less than 1 um
|
|
|
What is the primary hazard of aerosol drug therapy?
|
untoward drug reactions
|
|
|
Drug aerosol delivery systems include all of the following EXCEPT:
a. dry powder inhalers b. small-volume jet nebs c. metered-dose inhalers d. spinning disk nebs |
d. spinning disk nebs
|
|
|
what does most of the spray generated by the majority of MDI's consist of?
|
propellant
|
|
|
When using a MDI without a holding chamber or a spacer, the patients should be instructed to fire the device at what point?
|
immediately after beginning a slow inspiration
|
|
|
Before inspiration and actuation of a MDI, the patient should exhale to what?
|
functional residual capacity
|
|
|
T/F:
To ensure delivery of the proper drug dosage with a MDI, should you warm the canister to hand or body temp and shake vigorously? |
True
|
|
|
The following are beneficial affects of using a holding chamber with a _____?
Reduction in oropharyngeal aerosol deposition decrease in need for hand-breath coordination |
MDI
|
|
|
After actuating a MDI with a holding chamber, what should the patient be instructed to do?
|
continue to breath through the device for three breaths
|
|
|
Which of the following devices would you select to deliver an aerosolized bronchodilator to a young child?
a. MDI and spacer b. MDI, holding chamber, and mask c. MDI and holding chamber d. dry powder inhaler |
b. MDI, holding chamber, and mask
|
|
|
Advantages of the DPI drug delivery systems include all of the following EXCEPT:
a. low relative cost b. no propellants required c. no hand-breath coordination d. unaffected by humidity |
d. unaffected by humidity
|
|
|
Which of the following would be correct instrucions for a patient being taught proper use of a dry powder inhaler?
1. place mouth piece 4 cm from mouth 2. exhale slowly to FRC 3. inhale slowly (less than 30 L/min) 4. repeat until dose is used up |
2. exhale slowly to FRC
4. repeat until dose is used up |
|
|
Which groups are NOT recommended to use DPIs?
|
infants and children under 5
patients with an acute bromchospastic episode |
|
|
In mouth breathing adult patients, which of the following factors is crucial in determining whether to use a mask or mouthpiece for aerosol drug delivery with a small-volume jet nebulizer?
a, clinician experience b.drug concentration c. patient preference and comfort d. brand of small-volume jet nebulizer |
c. patient preference and comfort
|
|
|
Normally, when using a 50-psi flowmeter to drive a small-volume jet nebulizer, what should you set the flow?
|
6-8 L/min
|
|
|
To decrease the VDS of a small-volume jet nebulizer during drug administration, what should you do?
|
continue the treatment until the nebulizer begins to sputter
|
|
|
To minimize a patients infection risk between drug treatments with a small-volume jet nebulizer (SVN) what should you do?
|
rinse the SVN with sterile water, air dry
|
|
|
Which of the following aerosol drug delivery devices would you recommend against using with a toddler or small child?
1. MDI 2. SVN 3. DPI 4. MDI, holding chamber, and mask |
MDI and SVN
|
|
|
Possible complications associated with the selection of an aerosol drug delivery device include all of the following EXCEPT:
a. underdosing or overdosing because of improper technique b. overhydration or fluid imbalances c. adverse effects of the specific drug agent d. enviornmental contamination or caregiver exposure |
b. overhydration or fluid imbalances
|
|
|
What does this describe:
Give 4 puffs spaced 1-2 minutes apart; repeat up to 12 puffs with continued improvement. The best dose provides maximum subjective relief and the highest peak expiratory flow rate (PEFR) without side effects? |
The proper dose response assessment of an MDI bronchodilator
|
