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536 Cards in this Set
- Front
- Back
Canula-Fio2 and Recommended L/min
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FiO2=0.24-0.4
lpm=1-6 |
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Simple mask-Fio2 and Recommended L/min
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FiO2=0.40-0.55
lpm=6-10 |
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Venturi mask-Fio2 and Recommended L/min
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FiO2=delivers a precise FiO2 which remains the same with increase or decrease of flow.
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Non-rebreather-Fio2 and Recommended L/min
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FiO2=0.21-1.0
lpm=all the way up |
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Partial rebreather-Fio2 and Recommended L/min
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FiO2=0.60-0.65
lpm=6-10lpm |
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For every 1lpm increase in the flowmeter with a nasal cannula the therapist can expect to increase the FiO2 by:
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4%
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What is the approximate FIO2 delivered by a canula set @ 3 L/min?
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FIO2 of 32%
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What liter flow should the flowmeter be set to deliver an FIO2 of 40%?
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5 l/min
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What is a rservoir canula?
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Designed to maintain FIO2 at lower levels by using a reservoir.
The flowrate may be reduced w/o affecting the FIO2. |
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Purpose of the transtracheal o2 catheters(TTO2):
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A method of delivering long-term low flow o2 therapy.
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What are the hazards of TTO2 actual insertion procedure?
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Bronchospasm
bleeding abscess pneumothorax airway obstruction subcutaneous emphysema |
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What would you do for a pt. who became sob or has increased wob with a TTO2?
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You would need to flush the catheter because it could be obstructed with secretions.
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What are four O2 administration devices that can deliver humidity and aerosol?
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Aerosol mask
Trach collar Face tent Briggs adapter(T-piece) |
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Briefly describe an oxyhood and what is it used for?
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Clear plastic device of various sizes that completely encompass the head of the infant for the administration of oxygen and high humidity
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What flow range should be used for oxyhood and why?
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Flow Range 7-14 L/min to prevent CO2 buildup and allow controlled FIO2's w/o sealing the infants neck around the hood
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What is the best method for monitoring the FIO2 on an oxyhood?
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Preferred methosd is to analyze O2 continously near the infant's face.
O2 may layer with higher FIO2's in the lower layers |
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What environmental factors are controlled in O2 tents, Croupettes and isolettes?
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O2 concentration
TEMPERATURE(less than room temp) Filtered gas Humidity and aerosol delivery |
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What liter flow should the tents, croupettes and isolettes be run at?
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Run flow at 12-15 L/min to wash out CO2
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Indication and uses of CPAP mask:
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Short term temporary use for pt's with obstructive sleep apnea, CO poisoning, pneumonia, post-op atelectasis, etc.
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What would cause a loss in pressure in CPAP mask?
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Difficulty maintaining a seal(leak) and pt tolerance.
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What would you do if pressure fluctuates during inspiration on a CPAP mask?
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increase the flow
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What type of pts can Nasal CPAP be used with?
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On adults with obstructive sleep apnea
Useful on neonates since they are obligate nose breathers. |
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What happens if the baby is crying while on a nasal cpap?
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Will lose CPAP
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q
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a
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What are the 4 types of PEEP valve assembly and explain each types?
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Answer
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Q
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A
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q
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a
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q
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a
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q
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a
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q
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a
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What is this and name the parts:
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Bubble Humidifier
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Bubble Humidifier Troubleshooting
a. Humidifier efficiency depends on: |
a
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Bubble humidifier troubleshooting
A clogged jet would cause: |
a
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Bubble humidifier troubleshooting
A whistling alarm will occur on a humidifier if: |
a
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Bubble humidifier troubleshooting
When the connecting tube on a bubble humidifier is occluded and no alarm occurs this would be caused by: |
a
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Bubble humidifier troubleshooting
What will happen if the "down tube becomes obstructed? |
no bubbling or alarm will occur.
compensated flowmeter will read zero |
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Proper function of humidifier should be checked by:
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occluding or pinching the connecting tubing and listening for the whistling alarm
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Passover or Blow-by humidifier
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What is this?
|
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Passover or blow-by humidifier
How does evaporation occur? |
Evaporation occurs as air is "passed over" the water container/reservoir.
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Passover or blow-by humidifier
Why should you use heat with this device? |
So it would be more effective in humidifying an artificial airway.
Least effective if not heated |
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Name the device and parts:
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HEAT MOISTURE EXCHANGER (HME)
(ARTIFICIAL NOSE) |
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Briefly describe an HME:
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A
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Where should the HME be place on a ventilatory circuit?
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A
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What should be done if an artificial nose is being used and the pt is receiving aerosol therapy?
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a
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q
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a
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q
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a
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If HME's increase or thicken secretion wahat should you do?
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Change to a heated humidifier.
DO NOT Rinse out. |
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HME's are ideally used for:
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patient transport and short term ventilation.
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Why is cascade humidifier ideally suited for infant oxygen hood humidification?
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A
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How does condensation affect a Cascade heated humidifier?
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a
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What will happen if the cascade heated humidifier runs out of water?
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a
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Cascade heated humidifier
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Name the device
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What is Cascade heated humidifier and what can it do?
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A
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Sounding of the pop-off alarm on a cascade heated humidifier would indicate:
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Occlusion of the attached tubing (not a leak)
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What will decrease the effectiveness of the cascade heated humidifier?
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Removal of the cascade tower
decreased water levels temperature flow |
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How does a wick humidifier work?
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A
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What are handheld nebulizers used for?
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a
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Name several characteristics of a reservoir jet nebulizer:
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A
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q
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a
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Handheld(small volume) nebs are powered by
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a pressurized gas source
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How is a hand held neb administered?
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1-3 second breath hold is important to enhance medication delivery
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Reservoir jet nebs are utilized to:
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nebulize large volumes of fluid
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Characteristics of a jet nebulizer
|
a
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Name the device and parts:
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Reservoir jet nebulizer
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What happens as the FIO2 on a reservoir jet nebulizer is decreased?
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A
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Name the device and parts:
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Reservoir jet nebulizer
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What happens to the density of an aerosol from a reservoir jet neb as the air-dilution control is increased from 40% to 100%
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the density of the mist increases
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What causes the reservoir jet nebs to not mist enough?
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A
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What causes the FIO@ on a reservoir jet neb to increase?
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A
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Aerosol produced in short puffs on a reservoir jet neb indicates:
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The tubing should be drained (condensation has built up) into a receptacle, NOT back into the nebulizer container.
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When a prefilled nebulizer runs low on a reservoir jet neb what should you do?
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Change the unit, DO NOT refill the unit or allow it to run dry.
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An increased rate and depth of breathing on a pt using a reservoir jet neb may indicate:
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Insufficient flow
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On a reservoir jet neb what is the best way to verify adequate flow?
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The best way is to observe the aerosol coming out the end of the tubing during inspiration.
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What is the risk of using a reservoir jet nebulizer?
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Have a higher risk of contamination because particles are produced
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What drug can the SPAG be used with?
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The SPAG is specifically designed to deliver Ribavirin(Virazole) for treating RSV(Bronchiolitis).
Not to be used with any other drug substance. |
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What is the purpose of the drying chamber on the SPAG?
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It functions to dehumidify and reduce the size of the aerosol particles to 1.3 microns.
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What is a major cause of problems associated with ribavirin administration?
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Most problems are associated with crystallization of the drug which causes obstruction in the ET tube or pt circuit.
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What is the significance of increased nebulizer flowmeter readings (greater than 6 L/min)?
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a
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What should be done if the nebulizer flow reads less than 3.6 L/min?
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a
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What should be done if the nebulizer is not misting properly?
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a
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SPAG drying chamber gas flow troubleshooting
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a
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SPAG Operation
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a
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Parts of a SPAG
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Parts of a SPAG
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What does SPAG stand for?
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Small Particle Aerosol Generator
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What types of problems are associated with using a SPAG unit in conjunction with a mechanical ventilator?
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a
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Explain frequency and amplitude in the ultrasonic nebulizer?
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a
|
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If the amplitude of the sound waves in the ultrasonic nebulizer are increased what happens to the aerosol output?
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If the amplitude is increased the aerosol(mist) will increase.
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Ultrasonic nebulizer
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Q
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With what do you clean the transducer on an ultrasonic nebulizer with?
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Acetic acid(vinegar)
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Characteristics of Hydrnamic nebulizers:
|
a
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Hydronamic nebulizer
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Ultrasonic nebulizer
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On a SPAG an improperly seated nebulizer gasket will?
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Allow particles to escape and deposit outside the nebulizer chamber.
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To increase medication delivery to the pt. where should the SPAG be placed on the mechanical ventilator?
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At the pts. wye adapter
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Give an example of a hydronamic nebulizer?
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hydrosphere nebulizer
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Examples of an Ultrasonic nebulizer?
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De Vilbiss
US-I Monaghan Portasonic Fiso Neb Pulmosonic |
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How do you increase the mist on an ultrasonic nebulizer?
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a
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What are the DO NOT's while using an ultrasonic neb?
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A
|
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Newer models of ultrasonic nebs can be used to?
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Nebulize bronchodilators
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What is the primary use of Centrifugal nebulizers/spinning-disc humidifier?
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used primarily as room vaporizers/humidifiers
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It has the highest source of contamination.
Produces spray that should not be directed towards the pts face. |
Centrifugal nebulizers/spinning disc humidifier
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Give an example of a centrifugal neb/spinning disc humidifier?
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Hankscraft or DeVilbiss
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Centrifugal nebulizer/spinning-disc humidifier
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Name of device?
|
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Spinhaler(dry aerosol device)
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Name of device?
|
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MDI-metered dose inhaler
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Name of device?
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What is spinhaler used for?
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used for administering cromolyn sodium powder
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What is a rotahaler used for?
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A device similar to spinhaler, used for administering powdered albuterol.
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When using an MDI when should the pt. inhale?
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a
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What is the advantage of an MDI?
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Advantage is more reproducible administration of drug.
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How does spacers and holding chambers improve the efficacy of MDI?
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a
|
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Why is it important to have pt cooperation?
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a
|
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How would you know if the MDI is working properly?
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Upon squeezing the cartridge, a fine mist should be seen.
|
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Ideal pts. using MDI's should be?
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Able to understand and cooperate.
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Spacers and Holding Chambers
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Name of device?
|
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Spacers can also be used for drug delivery by MDI to:
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intubated and mechanically ventilated pts.
|
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Leaks from spacer will cause?
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loss of volume delivered
|
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Spacers are also ideal for pts:
|
to overcome coordination dificulties.
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Describe the A.S.S.S. safety system connections
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a
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Describe the P.I.S.S. safety system connections
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a
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Describe the D.I.S.S. safety system connections
|
a
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Proper procedure for attaching regulators
|
a
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If tank is leaking what should you do?
|
a
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If the pt states that there is no flow sensed what is the first thing you should instruct the pt to do?
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a
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Duration of flow formula
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a
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Tank factor of an E cylinder?
|
a
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Tank Factor of an H cylinder?
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a
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q
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a
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What is this?
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____cylinder tank?
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What is this?
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E cylinder Tank
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q
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a
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q
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a
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q
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a
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q
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a
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What are the 3 types of bulk oxygen systems used in the hospital?
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1. Cylinder manifolds
2. Fixed cylinders 3. Trailer units |
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Descibe a Cylinder manifold
|
a
|
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Describe fixed cylinders
|
a
|
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Describe trailer units
|
a
|
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Bulk systems are designed to?
|
a
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|
q
|
a
|
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Advantages of Liquid bulk oxygen?
|
a
|
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Describe cylinders
|
a
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What should you warn pts of when refilling their liquid bulk systems?
|
a
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Advantages of Liquid bulk oxygen systems
|
a
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Disadvantages of Liquid bulk oxygen systems
|
a
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Liquid bulk oxygen systems
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What is this?
|
|
What principle does an o2 concentrator utilize?
|
Utilize a "molecular sieve" which removes nitrogen and their gases from room air to concentrate the o2
|
|
What FIO2 is obtained from most oxygen concentrators running at 1-2 L/min?
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94-95% o2 can be provided at 1-2 lpm continously
|
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Why must a backup system be utilized with an o2 concentrator?
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A backup system (tank or liquid) must be used in case of a power failiure
|
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Why must a backup system be utilized with an o2 concentrator?
|
A backup system (tank or liquid) must be used in case of a power failiure
|
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Operation of a reducing valve
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Continued
|
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How can the therapist identify the number of stages in a reducing valve?
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The number of pressure relief devices (pop-offs) corresponds to the number of stages
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Oxygen concentrator
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What is this?
|
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Safety instuctions for o2 concentrators
|
a
|
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Principle of operation of an o2 concentrator
|
a
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O2 concentrators runs on?
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Electricity
|
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What happens if you set the O2 concentrator at higher flows?
|
At higher flows O2 concentratration can fall 85-93%
|
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If the molecular sieve beds are not working on the O2 concentrator what should you do?
|
Analyze the FIO2
Check circuit (breaker/fuse) |
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What is a pre-set reducing valve?
|
a
|
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What is an adjustable reducing valve?
|
a
|
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What is the purpose of a reducing valve?
|
a
|
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What happens if the poppet valve operated by the spring and diaphragm fails on a reducing valve?
|
The excess pressure is relieved trough the pop-off/pressure relief device
|
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Name 2 different types of flowmeters
|
Thorpe tube and bourdon gauge flowmeter
|
|
When a flowmeter is attached to a reducing valve what is it now called?
|
A regulator
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A flowmeter that can be both compensated and uncompensated
|
Thorpe tube
|
|
A flow meter that is only uncompensated?
|
Bourdon gauge flow meter
|
|
Describe the construction of the thorpe tube
|
It involves a tube that has an increasing diameter toward the top and a ball in the tube to denote flow.
|
|
How is the amount of flow going through this upright(thorpe)tube indicated?
|
The amount of flow is indicated by the position of the ball therefore it is considered "position sensitive" and is inaccurate in any other position
|
|
What happens if a restriction is applied at the flowmeters outlet, if the thorpe tube is back pressure compensated?
|
Therefore the flow is accurate
|
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How do you determine if the thorpe tube is back pressure compensated?
|
You check for the placement of the needle valve which should be farther away (distal) from the quick connect device.
or Distal to or after the thorpe tube, quick connect or gas source or Downstream from the thorpe tube or if you plug it into the gas wall outlet the ball or indicator jumps |
|
The thorpe tube is uncompensated for back pressure if?
|
The needle valve is closer to the quick connect device
or being proximal to or before the thorpe tube or upstream from the thorpe tube or gas source or if you plug it into the gas wall outlet the ball or indicator DOES NOT jump |
|
Describe the construction of a bourdon gauge flowmeter
|
The bourdon gauge consists of a coiled tube, gear mechanism housing and face plate to measure pressure of flow
|
|
How will the Uncompensated thorpe tube flowmeter read when exposed to back pressure?
|
This tube reads lower than the actual flow in the face of back pressure
|
|
How will the compensated thorpe tube flowmeter read when exposed to back pressure?
|
The flow is accurate
|
|
What type of flowmeter is best used to transport pts with o2?
|
A bourdon gauge flowmeter is commonly used
|
|
Back pressure Compensated Thorpe tube
|
What is this?
|
|
Uncompensated Thorpe tube
|
What is this?
|
|
What happens to the bourdon gauge flowmeter as pressure is applied?
|
a
|
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What happens to the bourdon gauge flowmeter in the face of obstruction at the outlet?
|
a
|
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What happens to the bourdon gauge flowmeter when there is resistance?
|
a
|
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What does the bourdon gauge flowmeter use to determine flowrate?
|
a
|
|
q
|
a
|
|
If a massive leak occurs after removing a flowmeter what should you do?
|
a
|
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What will you do if you notice a continous bubbling in a humidifier with the needle valve closed on a flowmeter?
|
a
|
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All thorpe tubes are calibrated at?
|
50 psi with the source gas
|
|
On all thorpe tube flowmeters this will cause inaccurate readings?
|
Different gases or pressures will cause this
|
|
What should you do if needle does not return to zero on a bourdon gauge?
|
1. indicates worn spring or "spring fatigue"
2. Do not use and replace the gauge |
|
What should you do if the pt becomes dyspneic and thorpe tube reads zero or bourdon gauge reads higher?
|
You should check for an obstruction or kinks in the tubing
|
|
What is the purpose of using a pulsed-Dose O2 delivery system?
|
a
|
|
Bourdon gauge flowmeter
|
What is this?
|
|
Pulse-Dosed O2 delivery System
|
What is this?
|
|
Describe how a pulsed-dosed o2 system works
|
"can be changed to continous flow settings if necessary"
|
|
Why are humidifiers not required on a Pulsed-Dose O2 delivery system?
|
Humidifiers are not required because the system delivers a minimum amount of dry gas
|
|
What type of pt is pulsed-dose o2 systems most often used for?
|
Used most often with homecare pts to reduce the cost and use of o2.
|
|
Can pulsed-dose O2 delivery systems be changed to continous flow if necessary?
|
Yes
|
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What is the purpose of an air/o2 proportioner or blender?
|
a
|
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What is the reed alarm? What would cause it to alarm?
|
a
|
|
What are the components of a blender?
|
a
|
|
To achieve a precise FIO@ on a blender what can be used?
|
A non-rebreather mask
|
|
Where can air compressor device be used?
|
Cab be used in a hospital, out-pt clinic or in the home setting
|
|
Do you need an air cylinder with air compressors?
|
no
|
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What are air compressors used for?
|
Used as an alternative means for providing air to pt without using an air cylinder
|
|
Can air compressors be used to power a hand held nebulizer for a copd pt in the home setting?
|
Yes
|
|
Air-Oxygen Proportioners(blenders)
|
What is this?
|
|
Air compressor
|
What is this?
|
|
On Oxygen Analyzers with any o2 change you should?
|
ALWAYS re analyze!!!
|
|
Other names for Galvanic fuel cell?
|
Teledyne
Biomarine |
|
Describe the galvanic fuel cell
|
Is an O2 analyzer that Creates electron flow as a result of the oxidation/reduction of o2(produces current)
|
|
What does the galvanic fuel cell measure?
|
It measures partial pressure,
displays FIO2 |
|
How is the galvanic fuel cell's accuracy affected?
|
Accuracy can be affected by water on the sensor, "high system pressures" and changes in altitude
|
|
If you are unable to calibrate the galvanic fuel cell, what should you do?
|
If unable to calibrate, change fuel cell
|
|
Describe the principle of operation of the polarographic O2 analyzer
|
Operation is similar to a galvanic fuel cell except for the presence of a "battery" used to polarize the electrodes
|
|
What does the polarographic O2 analyzer measure?
|
"It measures Partial pressure, displays FIO2"
|
|
What is the polarographic O2 analyzer affected by?
|
It is affected by altitude, water, and high pressure
|
|
This type of device is analogous to the clark electrode?
|
Polarographic O2 analyzer
|
|
Other name of Polarographic O2 analyzer?
|
Ohio
|
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If you are unable to calibrate the polarographic O2 analyzer what should you do?
|
Change the battery and check electrolyte level (refill if low)
|
|
What should you do if after setup of a ventilator, blender or venturi system and the O2 analyzer reads higher or lower?
|
Recalibrate analyzer and then recheck equipment
|
|
Galvanic fuel cell O2 analyzer
|
What is this?
|
|
Polarographic O2 analyzer
|
What is this?
|
|
Oral pharyngeal airway
|
What is this?
|
|
Nasal pharyngeal airway
|
What is this?
|
|
Describe the method used to determine the proper size of an oral airway
|
Oral- length should be equal to distance from angle of jaw to tip of chin OR angle of jaw to just pat corner of mouth
|
|
Describe the method used to determine the proper size of a nasal airway
|
a
|
|
Describe the insertion technique for an oral airway
|
a
|
|
Describe the insertion technique for a nasal airway
|
a
|
|
Two types of blades used commonly on adults during intubation?
|
1.Curved/Macintosh
2. Straight/Miller blade |
|
Curved/macintosh blade
|
What is this?
|
|
Straight/Miller blade
|
What is this?
|
|
What is the preferred blade for infant intubation?
|
Straight/Miller blade
|
|
What should be done if the light on the blade does not work?
|
If light does not work:
1. tighten bulb 2. check handle attachment 3. change blades 4. check batteries |
|
A blade used to assist in intubation that fits into vallecula and indirectly raises epiglottis
|
Curved/Macintosh blade
|
|
A blade used to assist in intubation that fits directly under the epiglottis?
|
Straight/Miller blade
|
|
What is the blade size for an adult?
|
Size 3
|
|
What is the blade size for pediatric?
|
Size 2
|
|
What is the blade size for term infant?
|
Size 1
|
|
What is the blade size used on a pre-term infant?
|
size 00
|
|
What is a stylet used for?
|
Used only to aid in oral intubation
|
|
What is the magill forceps used for?
|
Used only to aid in nasal intubation
|
|
It shapes the ET tube for easier insertion?
|
Stylet
|
|
While using a stylet the end is to be recessed at?
|
1 cm above tip of ET tube
|
|
What should you do to the opposite end of the stylet to prevent from advancement?
|
It should be bent or positioned to prevent advancement
|
|
Stylet
|
What is this?
|
|
Magill forceps
|
what is this?
|
|
What is the endotracheal tube size used for an adult patient?
|
Adult (wt in kg/10)=approx. size
Example: 80 kg/10= size 8 tube |
|
What is the endotracheal tube size for a full term infant patient?
|
Size 3 tube
|
|
What is the endotracheal tube size for a pre-term infant patient?
|
Size 2 tube
|
|
A tool to assist in intubation and is inserted in mouth to lift the ETT?
|
Magill forceps
|
|
Endotracheal Tube(ETT)
|
What is this?
|
|
q
|
a
|
|
What is this?
|
a
|
|
What is this?
|
a
|
|
Cuff pressure should not exceed_______? and why?
|
20 mm Hg
In order to allow circulation to the tracheal mucosa |
|
Minimal occluding Volume(MOV)
|
q
|
|
Minimal Leak Technique(MLT)
|
q
|
|
How can cuff presure be measured?
|
and also Minimal occluding volume and Minimal leak technique.
|
|
What do you do when checking cuff pressure with a manometer the cuff pressure registers zero?
|
Check to make sure connections are tight between manometer and pilot baloon
|
|
Cufflator
|
What is this?
|
|
Describe a double-lumen ETT(DLT)/Endobrochial Tube
|
A tube with 2 independent lumina of different lengths and has 2 cuffs.
|
|
Where is the longer lumen inserted and the shorter lumen of the double-lumen ETT placed?
|
The longer lumen is inserted into either the left or right mainstem.
The shorter lumen is placed in the trachea above the carina. |
|
On a double-lumen ETT what can each lumen do?
|
Each lumen can ventilate each lung seperately or they can be connected via wye and share a ventilation source
|
|
How many cuffs does a double-lumen ETT have and what can each cuff do?
|
The tube has 2 cuffs.
One cuff is a low pressure/high volume cuff And the other cuff is Smaller and a high pressure/low volume cuff(R or L mainstem bronchus tube) |
|
How do you confirm proper/correct placement of a double-lumen ETT?
|
The bronchial cuff has a radiopaque line.
|
|
What are the indication for a double lumen ETT(DLT)?
|
a
|
|
Standard tracheostomy tube-Shiley Trach Tube
|
q
|
|
What is the purpose of a fenestrated trach tube?
|
Used for weaning and temporary mechanical ventilation with inner cannula.
Used for phonation(speaking) |
|
Describe a fenestrated trach tube
|
Has opening in outer canula above the cuff
|
|
What is a fenestrated trach tube not used for?
|
Not used for code or emergencies
|
|
When plugging the tube of a fenestrated trach tube what should you do?
|
Be sure to deflate the cuff
Remove the inner cannula and then plug the tracheostomy tube. |
|
What is tracheal button used for?
|
a
|
|
Double-Lumen Endotracheal tube(DLT)/Endobronchial
|
What is this?
|
|
Shiley trach tube/Standard tracheostomy tube
|
What is this?
|
|
Fenestrated tube
|
What is this?
|
|
Tracheal Button
|
What is this?
|
|
Jackson Trach tube
|
q
|
|
Kamen-Wilkinson Foam/Bivona Cuff
|
q
|
|
Jackson Trach Tube
|
What is this?
|
|
Kamen-Wilkinson Foam/Bivona Cuff
|
What is this?
|
|
Name the recommended vacuum ranges for suctioning the:
1. adult- 2. child- 3. infant- |
a
|
|
What happens when the collection bottle gets full?
|
a
|
|
How would you adjust the vacuum range?
|
Adjust with tubing occluded
|
|
What are vacuum regulators used for?
|
It is used to adjust vacuum
|
|
Vacuum system/suctioning equipment
|
What is this?
|
|
What is the purpose of the coude tip suction catheter?
|
The coude tip catheter is angled to help suction the left mainstem bronchus
|
|
Closed system suction catheter
|
q
|
|
What is the ideal length of a suction catheter?
|
20-22 inches
|
|
Suction catheters are sized in?
|
French units
|
|
French unit refers to?
|
Circumference
|
|
The external diameter of the suction catheter should ideally be?
|
It should be no greater than 1/2 the inside diameter(ID) of endotracheal or trach tube
|
|
What is the method of determining the proper sized suction catheter for a given airway or tube?
|
a
|
|
Closed system suction catheter
|
What is this?
|
|
What device is used to suction the mouth and throat?
|
An Oral suction device such as a Yankauer and a tonsil suction device along with using aseptic technique(flush to clear)
|
|
What device is used to collect a sputum specimen?
|
Lukens trap/sterile suction trap
|
|
Where is the lukens trap/sterile suction trap placed?
|
It is placed in an upright position between the suction catheter and the suction tubing
|
|
On a lukens trap/sterile suction trap with what do you flush the catheter with?
|
Flush the catheter with sterile water or isotonic saline(not bacterostatic or hypertonic saline)
*Use saline for CYTOLOGY* |
|
Trubleshooting for Vacuum systems/Suctioning equipments
|
4. check all connections
|
|
Coude tip catheter
|
What is this?
|
|
Yankauer-oral suction device
|
What is this?
|
|
Lukens trap/Sterile suction trap
|
What is this?
|
|
An ideal suction catheter should have?
|
Must have a beveled tip with at least 2 openings to decrease tracheal damage and a thumb support to provide intermittent suctioning
|
|
Each catheter tip are designed to?
|
Reduce trauma to the mucosa
|
|
How do you test for leaks on a resuscitation bag(self-inflating)?
|
Test leaks by occluding bag and turn-off pressure pop-off
|
|
Resuscitation bag(self-inflating) ideal stroke volume for:
1. Adult- 2. Infant- |
1. Adult-800 mL avg. (1000-1800 max)
2. Infant-200 mL |
|
Safety features of ideal resuscitation bag(self-inflating)
|
a
|
|
Describe the features of the resuscitation bag design
|
a. Well fitting
b. shapeable c. transparent |
|
What is the function of a reservoir?
|
a. to give 95-100% concentrations (at 15 LPM)
b. Quick attachment/non-bulky |
|
What should you do if the resuscitation bag fills rapidly and collapses easily on minimal pressure?
|
You should check for absent inlet valve or if inlet valve is stuck open
|
|
What should you do if resuscitation bag becomes difficult to compress and pt compliance is normal?
|
The pt's valve may be stuck you should open or close it.
|
|
On a resuscitation bag this may cause valves to jam?
|
Excessively high flows
Use 15 L/min or low range of flush |
|
Usually when there is a problem with a resuscitation bag what should you do?
|
You do not attempt to fix it, use another form of ventilation
|
|
Resuscitation bags are used for?
|
Used for short term, emergency, transport, or back-up ventilation
|
|
What are the advantages of mouth-to-valve mask ventilation?
|
a
|
|
Resuscitation bag(self-inflating)
|
What is this?
|
|
Mouth-to-valve mask ventilation
|
What is this?
|
|
Description of a Mouth-to valve mask ventilation
|
Head tilt is applied, mask is placed on the face of the patient(an oropharyngeal airway may be inserted if needed)
|
|
What is the ideal criteria for oxygen powered resuscitation devices(pneumatically powered resuscitation device/demand valves)?
|
A
|
|
What is this device?
|
Pneumatically powered resuscitation device/demand valves
Oxygen powered resuscitation device |
|
What are the limitations of pneumatic resuscitation devices?
|
A
|
|
What are the different kinds of Pressure-Cycled Ventilators?
|
1. Bird Mark 7
2. Bennett PR-II Respirator 3. AP 4 and AP 5 Ventilators |
|
What are the classifications of a Bird Mark 7?
|
A
|
|
What is this ventilator and name the parts.
|
Bird Mark 7
|
|
The numbers on the Flow Rate Control on a Bird Mark 7 are for?
|
Reference
|
|
Turning the flow rate control on a bird mark 7 to a higher number causes a___(A)___flow into the mainstream breathing circuit and nebulizer which __(B)______ the I-time?
A. Greater or Lesser? B. Increases or decreases? |
A. Greater Flow
B. Decreases I-time |
|
What will occur if the flow rate control is turned to a lower number?
|
It causes a lesser flow into the mainstream breathing circuit and nebulizer and the I-Time increases.
|
|
To adjust the I/E ratio on a Bird Mark 7 what controls should you use?
|
The Flow rate control
|
|
To increase the E-Time on a Bird Mark 7 what should you do?
|
Increase the flow by adjusting the flow rate adjustment dial (flow rate control)
|
|
If you want to increase the I-Time on a Bird Mark 7 what should you do?
|
Decrease the flow by adjusting the flow rate adjustment dial (flow rate control)
|
|
Peak flow on a Bird Mark 7 when air-mix is on?
|
0-80 liters/min
|
|
Peak flow on a Bird Mark 7 when the air-mix is off?
|
0-50 liters/min
|
|
If the manometer needle rises, then falls, then again rises on a bird mark 7 what should you do?
|
Need to increase the flow
|
|
If you want a 100% source gas setting on a bird mark 7 ventilator what should you do?
|
Turn the Air-Mix off
|
|
What happens to the air mix plunger when the air mix is off?
|
The air mix plunger is pushed in which causes it to cover the outlet leading to the venturi
|
|
As a result of turning off the air mix control on a bird mark 7 what is reduced?
|
Flow rates are reduced as a result of not using the venturi(0-50 l/min)
|
|
When changing to 100% source gas setting(air-mix off) on a bird mark 7 what must you always do?
|
You must increase the flow setting
|
|
On a bird mark 7 this setting will give 40%-80% O2 concentration?
|
Air-Mix on
|
|
What happens to the air mix plunger when the air mix is on?
|
The air mix plunger is out allowing gas flow to go to the venturi
|
|
On a bird mark 7 variable concentrations are achieved when air mix is on because?
|
The gas from the venturi rebounds into the ambient chamber which increases the FIO2 in this chamber. Thus the next breath will be a higher FIO2 because of the entrainment of the increased % of O2 in the ambient chamber
|
|
It is an adjustable control to limit ventilating pressure on a bird mark 7?
|
Pressure adjustment lever(pressure control)
|
|
How is the pressure control regulated on bird mark 7?
|
It is regulated by the closeness of the magnet to the plate
|
|
By adjusting the pressure limit on a bird mark 7 what is changed?
|
Volume
|
|
Pressure limit on a bird mark 7?
|
Near 60 cmH2O
|
|
This will prevent normal cycling to exhalation in a bird mark 7?
|
Leaks in the circuit
|
|
This would prematurely end inspiration on a bird mark 7?
|
Obstuction or coughing
|
|
Patient effort control on a bird mark 7 is also known as?
|
Sensitivity
|
|
This is an adjustable control for cycling the ventilator on a bird mark 7?
|
Sensitivity(pt effort control)
|
|
The sensitivity control on a bird mark 7 is adjusted to allow the ventilator to cycle at approximately how many cmH2O?
|
-1.0 to 2.0 cmH2O
|
|
What will happen if the respirator(bird mark 7) is set too sensitive?
|
Self-cycling will occur
|
|
What does a higher number setting on a bird mark 7 sensitivity control indicate?
|
It indicates increased pt. effort (decreased sensitivity 2.0 cmH20)
|
|
What does a lower number setting on a bird mark 7 sensitivity control indicate?
|
It indicates decreased pt. effort (increased sensitivity -1.0 cmH20)
|
|
What is this?
|
IPPB Circuit
|
|
Classifications of a Bennett PR-II Respirator?
|
A
|
|
Adjustment of this control causes a flow to the top of the bennett valve?
|
Sensitivity control
|
|
The greater the flow of gas to the top of the bennett valve means?
|
Less negative pressure is needed to cycle the respirator
|
|
A variable sized orifice that limits the flow of gas from the ventilator( Bennett PR-II Respirator)to approximately 15 L/min?
|
Peak Flow
|
|
Peak flow on a Bennett PR-II Respirator does not create flow but it...?
|
It Limits the flow
|
|
How many nebulizer controls does a Bennett PR-II respirator have?
|
It has 2 controls for nebulization, one is for inspiratory and the other is for expiratory.
|
|
The nebulizer on a Bennett PR-II respirator operates on how much % source gas?
|
Normally 100% O2
|
|
If pop off or hiss during tx. on a Bennett PR-II respirator occurs what should you do?
|
Recommend decreasing flow to the nebulizer
|
|
This control provides flow to the Bennett valve that compensates for leaks and can also be used when problems arise with mask treatments.
|
Terminal flow
|
|
What does terminal flow on a Bennett PR-II respirator decrease and why?
|
Terminal flow decreases FIO2 because this control utilizes a venturi
|
|
What do you do to turn on air dilution on a Benett PR-II Respirator and how much O2 is delivered?
|
Air Dilution Control is pushed in 40%-80% O2 is delivered and FIO2 changes in the same manner as the Bird Mark 7
|
|
What do you do to turn off air dilution on a Benett PR-II Respirator and how much O2 is delivered?
|
Air Dilution Control is pulled out and 100% source gas is delivered
|
|
On a Benett PR-II Respirator adjustment of this control causes automatic cycling (assist-control mode)?
|
Rate control
|
|
What is the set I/E ratio on a Benett PR-II Respirator?
|
1:1.5
|
|
What is the available rate on a Benett PR-II Respirator?
|
0-70 bpm
|
|
On a Benett PR-II Respirator this control is operated along with the rate control to change exhalation time?
|
Expiratory time control
|
|
On a Benett PR-II Respirator this control increases exhalation time?
|
Expiratory time control
|
|
On a Benett PR-II Respirator this control allows variable pressure of 0-50 cmH20 to be achieved and influences delivered volume?
|
Pressure control
|
|
What are the types of manometers on a Benett PR-II Respirator?
|
1. System pressure gauge
2. Control pressure gauge |
|
On a Benett PR-II Respirator this measures the pressure above the bennett valve (preset cycling pressure)?
|
System pressure gauge manometer
|
|
On a Benett PR-II Respirator this measures the pressure at the mouth?
|
Control pressure gauge manometer
|
|
On a Benett PR-II Respirator this valve will rotate to the off position when a terminal flow of 1 liter per minute is reached?
|
Bennett Valve
|
|
On a Benett PR-II Respirator this allows the respirator to be flow limited/sensitive?
|
Bennett Valve
|
|
What is this and name the parts?
|
Bennett PR-II Respirator
|
|
Classifications of a AP-4 and AP-5 Ventilators?
|
a. positive pressure
b. electrically powered c. compressor driven d. patient cycled (assist mode only) e. flow limited f. pressure limited |
|
On an AP-4 and AP-5 Ventilator this control is adjustable from 0-30 cmH20 and influences delivered volume?
|
Pressure Control
|
|
On an AP-4 and AP-5 Ventilator this control is adjustable and provides continous flow to provide aerosol?
|
Nebulizer control
|
|
On an AP-4 and AP-5 Ventilator this controls power to unit?
|
On/Off switch
|
|
What is the terminal flow On an AP-4 and AP-5 Ventilator?
|
3 lpm
|
|
What is the maximum flow rate On an AP-4 and AP-5 Ventilator?
|
90 lpm non-adjustable
|
|
This type of pressure-cycled ventilator can provide room air unless O2 is adapted to the pt. circuit as a bleed in which is recommended for copd's?
|
AP-4 and AP-5 Ventilator
|
|
On pressure-cycled ventilators show how each of the following control changes will effect the FIO2 (When air-mix is "ON" and the ventilator is powered by 100% O2).
|
A
|
|
On Pressure-cycled ventilators show how each of the following control changes will effect the volume delivered.
|
A
|
|
On a Pressure-cycled ventilator show how each of the following control changes will effect the inspiratory time and I:E ratio.
|
A
|
|
On a pressure-cycled ventilator show the changes in delivered volume with changes in compliance and airway resistance.
|
A
|
|
AP-4 and AP-5 Ventilator
|
What is this?
|
|
On a pressure-cycled ventilator(bird mark 7, Bennett PR-II, AP-4 AP-5) what are the problems when there is a loss of pressure?
|
1. a leak
2. Not enough flow |
|
On a pressure-cycled ventilator(bird mark 7, Bennett PR-II, AP-4 AP-5) what are the problems when there is excessive pressure?
|
1. Obstruction
2. Too much flow |
|
On a pressure-cycled ventilator(bird mark 7, Bennett PR-II, AP-4 AP-5) what should you do when ventilator fails to cycle into inspiration?
|
1. Adjust sensitivity
2. Tight seal around mouthpiece |
|
On a pressure-cycled ventilator(bird mark 7, Bennett PR-II, AP-4 AP-5) what is the problem when the ventilator fail to cycle off?
|
A leak!!!
due to: mouthpiece/mask seal cuff leaking fenestrated trach tube open loose equipment connection |
|
On a pressure-cycled ventilator(bird mark 7, Bennett PR-II, AP-4 AP-5) what is the problem when pressure does not rise normally?
|
Not enough flow
|
|
What would cause the spirometer bellows rise during inspiration and decreased system pressure on the Bennett MA-1 ventilator?
|
An expiratory valve malfunction or
A disconnected expiratory valve line |
|
What are the classifications of a Bennett MA-1 Ventilator?
|
VOLUME-CYCLED
flow limited time triggered pt. triggered |
|
When adjusting PEEP On a Bennett MA-1 Ventilator what must you also adjust?
|
Must adjust sensitivity
|
|
What happens when cascade runs dry on the Bennett MA-1 Ventilator?
|
It will automayically shut off
|
|
If the spirometer bellows is not rising and alarm sounds on every inspiration On a Bennett MA-1 ventilator what should you do?
|
DO NOT TRY TO FIND OR FIX THE PROBLEM OR OBSTRUCTION!!!
Disconnect patient from ventilator and manually ventilate |
|
TRUE OR FALSE
All volume cycled ventilators can be used equally well on most patients. There are only a few differences between them. |
TRUE
|
|
On a volume cycled ventilator how frequent should you change the ventilator tubing circuits and why?
|
should be changed on a regular basis to prevent nosocomial infections
|
|
When changing the ventilator circuits in a patient On a volume cycled ventilator how long should the patient be off the ventilator?
|
For the shortest possible amount of time
|
|
While changing the ventilator circuits On a volume cycled ventilator what will be necessary while the new circuit is attached and tested by another person?
|
Manual ventilation with a resuscitation bag on the patient.
|
|
What should you do while changing ventilator circuits on a patient on a volume cycled ventilator to prevent iatrogenic hypoxemia?
|
Pre and post oxygenate with 100% O2
"Iatrogenic" (preventable, you caused it) |
|
What are Microprocessor Ventilators used with?
|
Used with volume cycled flow limited ventilation or
pressure limited time cycled(pressure control) ventilation |
|
What are the advantages of microprocessor ventilators?
|
Reliable and inexpensive signal processing transmission
|
|
What can be easily monitored on the microprocessor ventilator?
|
Ventilator rate
mean airway pressure(MAP) peak and plateau pressures volumes compliance etc. |
|
Give an example of a microprocessor ventilator?
|
Bennett 7200
Hamilton Veolar Bourns Bear 1000 |
|
What additional modes of ventilation can a microprocessor ventilator deliver?
|
Can provide pressure control ventilation(PCV) and
Pressure support ventilation (PSV) |
|
Bennett MA-1 Ventilator
|
What is this?
|
|
Volume-cycled ventilator circuit
|
What is this?
|
|
Microprocessor Ventilator
Bennett 7200 Hamilton Veolar Bourns bear 1000 |
What is this?
|
|
Measures barometric pressures?
|
Mercury barometer
|
|
If barometer contains water how can you properly read it?
|
Read from the bottom of the meniscus
|
|
Where is the needle indicator in a mercury barometer set and how can you properly read it?
|
Is set flush with mercury allowing the mercury in the column to rise or fall.
Read from the top of the meniscus |
|
It is less precise than a mercury instrument and is used in blood pressure cuffs and in ventilators to record pressures?
|
Aneroid barometer
|
|
It is a device used to convert one form of energy into another form?
|
Pressure transducer
|
|
In what types of patient monitoring equipment are pressure transducers used?
|
Commonly used in hemodynamic monitoring to convert pressures (analog signal) into electrical signals (digital signals) that can display pressures or waveform graphics.
|
|
What is the most common type of pressure transducer?
|
A strain-gauge transducer
|
|
Mercury barometer
|
What is the name of this device?
|
|
Aneroid barometer
|
What is the name of this device?
|
|
What are the two things can an oximeter measure non-invasively?
|
1. Oxygen saturation (SaO2 or SpO2)
2. Pulse |
|
Is the most appropriate noninvasive technique for continous monitoring of O2 sat(SaO2 or SpO2) and pulse.
|
Finger Pulse oximeters
|
|
What are the things that can affect/limit the accuracy of finger pulse oximeters?
|
Accuracy affected by:
Perfusion-shock and hypotension and conditions that interfere with the Light transmission- Fingernail polish erythema bright ambient lights etc. |
|
How does the finger pulse oximeter function?
|
Probe attaches to finger and transmits light pulses through the capillary beds.
|
|
While using a finger pulse oximeter you observe that there is a sudden fall in readings without a change in patients condition. What should you do?
|
There is a malfunction of the probe!
Change or reattach the probe. |
|
What results are accurate while using a finger pulse oximeter in a patient with good perfusion and saturation of 70% or higher?
|
SaO2 results are accurate
|
|
What are finger pulse oximeters recommended for?
|
Recommended for monitoring in:
Sleep apnea and for; resting and excercise desaturation |
|
What will finger pulse oximeter read if carbon monoxide poisoning is present?
|
Finger pulse oximeters will read higher saturations
|
|
What is a co-oximeter used to diagnose?
|
Used to diagnose carbon monoxide poisoning (>20% COHb)
|
|
What is the normal COHb?
|
1-3%
|
|
What is the normal COHb for smokers?
|
5-10%
|
|
What is the normal COHb for heavy smokers?
|
10-15%
|
|
What is the BEST way to evaluate oxygenation in a CO poisoning patient?
|
Use a Co-oximeter
|
|
Difference between ear and finger pulse oximeter and co-oximeter?
|
Works the same way as ear and finger pulse oximeters EXCEPT that a blood sample and more wavelength of light are used instead of a probe attached to the skin.
|
|
What does the co-oximeter more accurately measures?
|
It more accurately measures:
COHb O2Hb and; other non-functional Hb(MetHb-methemoglobin). |
|
It is an invasive and non-continous measurement of COHb, O2Hb, non-functional Hb (MetHb-methemoglobin)
|
Co-oximeter
|
|
What should you do if a clot develops in the cuvette on a co-oximeter?
|
Attempt to clear it with a cleaning solution.
Replace the cuvete if the clot will not clear. |
|
An arterial blood gas machine displays an O2 sat of 95%; co-oximetry results reveal a COHb of 25% and O2Hb of 75%. How would you explain the differences in O2 Sat and which results are more accurate?
|
The O2 sat results from an abg machine are CALCULATED not MEASURED.
The co-oximeter results are more accurate since the COHb and O2 sat are directly MEASURED. The difference in the O2 sat is due to an elevated COHb from CO poisoning. Thus the patient should be started on O2 therapy at 100% O2 via a non-rebreather mask. |
|
Describe Transcutaneous PO2 and PCO2 measurement.
|
1. Adaptation to the clark and severinghaus electrodes that:
2. Allows continous, non-invasive PO2 and PCO2 measurement by polarographic electrodes placed on the skin instead of a single measurement with a blood sample. |
|
On a Transcutaneous PO2 and PCO2 measurement what temperature is recommended to heat the skin to and why?
|
Heating the skin around the electrode to 43-45 degrees celcius improves the capillary blood flow (perfusion) and enhances gas movement through the skin
|
|
On a Transcutaneous PO2 and PCO2 measurement.What values correlate well with blood gas analyzer values as long as perfusion is adequate?
|
Transcutaneous values
|
|
On a Transcutaneous PO2 and PCO2 measurement. What conditions will affect accuracy?
|
Accuracy decreases with:
1. increased skin thickness 2. anemia And conditions of decreased perfusion: 3. shock 4. burns 5. vascular disease 6. cardiac defects |
|
On Transcutaneous PO2 and PCO2 measurement where should the electrode be placed?
|
Placement of the electrode is best over flat areas with good perfusion.
Normally on the: Chest, just beneath the center of the right or left clavicle. |
|
On a Transcutaneous PO2 and PCO2 measurement.How often should the electrode site be changed?
|
The electrode site should be changed every 4 hours.
|
|
On a Transcutaneous PO2 and PCO2 measurement. What should you do if erythema occurs?
|
If redness or blistering occurs(erythema) the electrode is moved to a new site more often.
|
|
How is callibration done on a Transcutaneous PO2 and PCO2 measurement?
|
Callibration is done on room air(150 torr at sea level)and with a zeroing solution.
|
|
On a Transcutaneous PO2 and PCO2 measurement. What should you do if you cannot callibrate it?
|
If cannot callibrate:
1. check for torn membrane 2. check for poor connections |
|
On a Transcutaneous PO2 and PCO2 measurement. What will happen if you have an air leak?
|
Air leaks will increase TcPO2 to read higher than the PO2
|
|
Another term for CO2 monitoring?
|
Capnography
|
|
What does capnography measure and how is this accomplished?
|
It measures carbon dioxide content using infrared absorption and once the capnograph is set up, an arterial blood gas is drawn to correlate the values.
|
|
On a capnograph how will the PetCO2 read in relationship to the arterial PCO2?
|
Normally the PetCO2 will read lower than the arterial PCO2.
PaCO2=40 torr PetCO2=30 torr |
|
On a capnograph where should the sensor be placed?
|
Sensor should be placed proximal to the patients airway connection, (at the ET Tube).
|
|
What would an increase in the capnograph PECO2 indicate?
|
An INCREASE in the capnograph (PECO2 or PetCO2%)would indicate a DECREASE IN VENTILATION.(Ventilatory Failure)
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What would a decrease in the capnograph PECO2 indicate?
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A DECREASE in the capnograph would indicate an INCREASE IN VENTILATION or a DECREASED PERFUSION(DEADSPACE DISEASE; pulmonary embolism, hypovolemia)
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On a capnograph what should you do if there is a reading of "zero" or "low"?
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Reconnect patient to ventilator
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On a capnograph what does a low PetCO2 reading indicate immediately following intubation?
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This would indicate that the ET tube is in the esophagus
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On a capnograph what should happen to the PetCO2 during CPR?
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The PetCO2 should increase
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On a capnograph what are exhaled CO2 detection devices used for?
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Are used to detect esophageal intubation
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These devices are designed to produce a color change with the PRESENCE OF EXHALED CO2 and has the ability to produce appropriate color changes for a wide range of PCO2s and respiratory patterns?
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Nonelectronic portable disposable exhaled CO2 detection devices
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On an exhaled CO2 detection device a purple color would indicate?
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POOR
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On an exhaled CO2 detection device a yellow color would indicate?
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NORMAL
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On an exhaled CO2 detection device on what type of patient's would you get a false reading? What else can cause false readings aside from pt?
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Can get false readings in patient's who have been down (w/o CPR) for a period of time.
Moisture and secretions can cause false readings and obstruct the sample tube. |
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Exhaled CO2 detection devices may also be used to?
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May be used to confirm tracheal intubation
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This device measures maximum pressures; and are more accurate than vital capacity measurements in neuromuscular disease patients?
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MIP/MEP Device (Manometer)
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What is Maximum Inspiratory Pressures (MIP) used for?
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Used to monitor and assess the READINESS TO WEAN in ventilator patients.
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What does Maximum Inspiratory Pressures assess?
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1. Readiness to wean in ventilator patients
2. Assesses the DEGREE OF RESPIRATORY MUSCLE IMPAIRMENT in Guillan-Barre' and Myasthenia Gravis |
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Procedure on how to use a MIP device (manometer).
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1. have pt. exhale to residual volume(RV);
2. Then have pt. breathe in as quickly and as hard as possible for 15-20 seconds; 3. Take measurement on manometer and repeat maneuver and measurements 3 times. |
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On an MIP manometer what does a measurement of <-20 cmH20 pressure indicate?
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It indicates inspiratory muscle weakness
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This device is helpful in evaluating a patient's ability to maintain an airway and clear secretions (their ability to cough effectively).
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Maximum Expiratory Pressure (MEP)
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Procedure on how to use a MEP.
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1. Patient inhales to total lung capacity (TLC);
2. Then have patient blast out air as quickly and as hard as possible; 3. Take measurement on manometer and repeat maneuver and measurements 3 times. |
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Trancutaneous PO2 and PCO2 measurement device
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What is this device?
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What does this capnograph indicate?
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No plateau=Airway obstruction
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Normal PetCO2
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Interpret this capnograph reading.
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MIP/MEP device (manometer)
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What is this device?
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When should total flow and o2% calculations need to be stimated?
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These calculations may need to be estimated when:
1. A pt's inspiratory peak flow exceeds the output of the delivery device. 2. Blenders are unavailable for achieving specific FIO2's |
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What is the Normal peak flow range?
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It is approximately 40-60 L/min.
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Air/O2 ratio formula
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100-FIO2
___________ FIO2-21 *If FIO2 is less than 35% use 21% if >35% use 20% |
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Air O2 ratio for 40% setting?
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100-40=60 3
______ _ 40-20 =20 1 3:1 * 3 liters of room air entrained for every 1 liter of O2 or sorce gas* |
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Total flow formula
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Total flow= Flowmeter setting x Factor
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Total Flow factor formula
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Total flow Factor= Air +O2
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What would the total flow delivered to a pt. be when a venti-mask is set at 5 L/min and the dilution control is set at 28%?
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1. Air/O2 entrainment ratio for 28%
100-28=72 10 ________ _ 28-21 =7 1 10:1 2) Total Flow factor(air+O2) 10:1=10+1=11 3) Total Flow Flowmeter setting X Total flow factor 5 L/min X 11= "55 L/min.total flow" |
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Air to O2 entrainment & Total flow Factor Table
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A
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Flow rate adjustment formula
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O2 flow=Total Flow/Factor
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A pt. requires a total flow of 45 L/min. What flowrate would be best if the aerosol dilution is set to deliver 40% O2?
a. 5 L/min b. 8 L/min c. 10 L/min d. 12 L/min |
Total flow= 45 L/min
Total flow factor=? Flow rate=? 1. 100-40=60 3 ______ __ _ 40-20 20 1 3:1=3+1=4 2. Flow rate= 45/4=11.25 L/min answer= D |
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Air-O2 entrainment ratio for 28%?
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100-28/28-21=72/7=10/1=10:1
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Air-O2 entrainment ratio for 35%?
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100-35/35-20=65/15=4.3/1=4.3:1
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Air-O2 entrainment ratio for 40%?
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100-40/40-20=60/20=3/1=3:1
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Air-O2 entrainment ratio for 60%?
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100-60/60-20=40/40=1/1=1:1
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Air-O2 entrainment ratio for 100%?
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100-100/100-20=0/80=0/1=0:1
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Calculate the total flow from a venti-mask when the air dilution control is 40% and the liter flow is 7 L/min.
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Total flow=?
Total flow factor= 100-40/40-20=60/20=3/1=3:1=4 Total Flow = FM X FF = 7 L/min X 4 = 28 L/min |
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Calculate the total flow from a venti-mask when the air-dilution control is set at 28% and the liter flow is 9 L/min?
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Total flow=?
Flowmeter= 9 L/min Total flow factor= 100-28/28-21=72/7=10/1=10:1=11 Total Flow = FR X FF = 9 L/min X 11 = 99 L/min |
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It provides a continous visual image of the electrical activity of the heart on a screen?
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Oscilloscope
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It is an instrument used for recording the electrical activity of the heart?
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Electrocardiograph
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It is a portable version of an electrocardiograph that is worn for a 24 hour period to detect cardiac arrhytmias?
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Holter monitor
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An Oscilloscope
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What is this device?
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An electrocardiograph
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What is this device?
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The process of destroying vegetative pathogenic organisms?
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Disinfection
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Terminology meaning lack of any life or living organism?
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Sterile
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It is a Growing microorganisms?
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Vegetative organisms
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These are disease producing organisms?
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Pathogenic organisms
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It means the introduction of disease causing microorganisms?
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Contamination/contaminated
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It means growth is inhibited?
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Static
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It means microorganisms are killed?
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Cidal
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It is a resistant form of certain species of bacteria?
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Spore
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What should be done to all equipment prior to the disinfection process?
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All equipment should be adequately cleaned by removing organic soil and disassembled prior to the disinfection process
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What are the physical methods of disinfection and sterilization?
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1. Steam under presure(steam autoclave)
2. Pasteurization 3. Incineration 4. Irradiation |
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What are the conditions for sterilization for steam autoclave? Give Temp, PSI, and Time.
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Temp=121 degrees C
PSI =15 PSI Time=15 min |
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What are the items that should not be used on steam autoclave?
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It is not used for:
1. Plastics or; 2. Other heat sensitive items |
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When using steam autoclave the items must be wrapped in?
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Wrapped in penetrable packaging
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On a steam autoclave. What must be evacuated and allowed to penetrate all parts of the load?
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All air must be evacuated and steam must be allowed.
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What are the types of monitors used to assure that the conditions for sterilization have been met?
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1. Heat sensitive tapes and/or;
2. Biological indicators |
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It is a DISINFECTION PROCESS using moderate temperatures to kill vegetative organisms?
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Pasteurization
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What are the steps when doing pasteurization?
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1. Items are first washed
2. Items are completely submerged in a hot water bath at "63-70 degrees C for 30 min" 3. Items must then be completely dried 4. Assemble and Package. |
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It is the best method of treating contaminated disposable items and supplies?
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Incineration
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Gamma rays are used to sterilize pre-packaged equipment?
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Irradiation
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Irradiation with gamma rays cannot and should not be re-sterilized by?
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Ethylene oxide
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What are the chemical methods of disinfection and sterilization?
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1. ETO-Ethylene Oxide Sterilization
2. Cidex-Alkaline glutaraldehyde 3. Sonacide- Acid Glutaraldehyde 4. Alcohol 5. Soaps and Detergents |
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What are the factors influencing the ETO process?
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1. Temperature of the chamber
2. Concentration of ETO (800-100 mg/L 3. 50% relative humidity enhances the effectiveness of ETO 4. Exposure Time 5. Aeration Time |
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A method that sterilizes equipment by alkylation of enzyme?
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ETO-Ethylene Oxide
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While using ETO sterilization these are necessary to verify that the conditions for sterility have been met?
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Biological Indicators(ATTEST)
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What types of equipment are recommended for ETO processing?
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1. Bird Mark 7
2. Electric incentive spirometer device 3. Non-disposable resuscitation bag ---removed from a HIV pt's room--- |
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It can perform DISINFECTION or STERILIZATION process and is an appropriate method for reusable plastics (mouthpiece, tubing, aerosols, etc.)and also an appropriate method for BRONCHOSCOPES.
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Cidex- Alkaline Glutaraldehyde
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What is the pH of Cidex?
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7.5 - 8.5
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Cidex is bactericidal in?
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10 minutes
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Cidex is tuberculocidal in?
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10-20 minutes
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Cidex is sporicidal in?
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10 hours (to sterilize)
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After each soaking of equipment in Cidex what must be done?
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Equipment must be rinsed, dried and packaged after each soaking
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How long is Cidex fully potent once it has been activated?
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Cidex once activated will be fully potent for 14 days
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True or false
Sonacide- acid glutaraldehyde is also a disinfection/sterilization process? |
TRUE
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What is the pH of Sonacide?
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2.5 - 3.5
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Sonacide is Batericidal in?
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10 minutes
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Sonacide is tuberculocidal in?
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20 minutes
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Sonacide is sporicidal in?
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1 hour
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What should be done after exposure of equipment to Sonacide?
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Equipment must be rinsed, dried and packaged after exposure to sonacide
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How long is sonacide fully potent once it has been activated?
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Sonacide remains fully potent for 28 days
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A chemical method that can only do disinfection process?
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Alcohol
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Alcohol is used in what concentrations?
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Ethyl and isopropyl alcohol are more effective in concentrations of 70-90% solutions.
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Are alcohol wipes sporicidal? What are they?
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Alcohol wipes are not sporicidal although they are bactericidal and fungicidal
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What are Soaps and detergents used for?
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Used as cleaners not antimicrobial agents
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These are surfactants which will reduce surface tension?
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Agents
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