Respiratory Therapy

Front 1

Alveolar Air Equation

Back 1

( Fio2 x 7 ) - ( PaCO2 + 10) = PAO2

Hint 1

Fio2 : 40%= 280 50%= 350 55%=385 60%=420

Front 2

Chest x ray reveals :

*Lowered flattened diagram

*Increased radioluncency in lung fields

*presence of bullets and blebs

*decrease in peripheral vascular markings

* a narrow mediastinum

Back 2

Severe Emphysema

Hint 2

Obstructive Disorder CBABE

Front 3

Rate is 12 mins and Expiratory Time is 3.25 sec . What is inspiratory time ?

Back 3

I = (60\F)- E = (60\ 12)-3.25= 1.75

Front 4

Pressure Volume Detects

Back 4

Detects Compliance ( slope of curve)

Resistance ( width of curve )

Suspect Over inflation ( beaking appearance )

Front 5

What is this ECG tracing

Back 5

Myocardial infraction

Front 6

Define Hypo ventilating

Back 6

CO2 retainers , Respiratory Acidosis

Increase MV, VT, RR

Increase Rate = decrease E-time

Increase Peak Inspiratory Flow

(Increase Flow = decrease I time and

Increase E time )

Remove tubing to decrease mechanical dead space

PaCO2 increased needing to be lower patient is not ventilating >45 increase the following :

Volume Control :VT

Pressure Control : PIP

HF Jet : driving Pressure

HF Oscillator : Amplitude

BIPAP : IPAP

Front 7

Define Hyperventilating ( blowing off to much)

Back 7

Respiratory Alkalosis

PaCO2 low needing to be raised patient is ventilating <35Lower the following :

Decrease MV, Vt,PIP, RR

Decrease Peak Inspiratory Flow

Add tubing to increase mechanical dead space

Front 8

Difference between FVC and FEV1

Back 8

FVC measures volumes and used to assess the patients ability to cough and deep breath

FEV1 measures flow and used to assess to inhaled bronchodilator

Front 9

Auto Peep defined as positive airways pressure at the end of exhalation caused by an expiratory time that is too short. How can you fix it ?

Back 9

Decrease Inspiratory Time

Increase Flow

Increase expiratory time

Decrease Vt, RR, MV

Front 10

Volume, Pressure and Flow are accuracy verified by

Back 10

Volume = Spirometry 3l syringe

Pressure =Water/ Mercury manometer

Flow = Rotameter (Respirometer)

Front 11

Pharmacology : Prophylactic Asthma Management in 2 years of age only approved ?

Back 11

Montelukast (Singular )

Cromolyn Sodium (Intel )

Mast Cell Stabilizer

Front 12

Pharmacology: What are the top three reversing agents for

Benzodiazepine ?

Opioid ?

Nondepolarizing neuromuscular agents ?

Back 12

Benzodiazepine : Flumazenil (Romazicon)

Opioid or Analgesics : Naloxone (Nardin )

Neuromuscular blocking agents reversal anticholinesterase inhibitors:

Neostigmine ( Prostigmin)

Pyridostigmine ( Mestinon)

Edrophonium (Tensilon)

Front 13

Metabolic Alkalosis Low K+ Interverted T wave ischemia. ..patient on diuretics use a K+ sparing agent ?

Back 13

Amiloride " Midamor" or Ronolactone

Front 14

Metabolic Acidosis High K+

what do you do to lower it ?

Back 14

High doses aerosolized albuterol or

K+ wasting Lasix

Front 15

Inspiratory Hold and Expiratory Hold measure what ?

Back 15

Plateau pressure is measured by Inspiratory Hold

Auto Peep is measured by Expiratory Hold

Front 16

Side effects of Inhaled Nitric Oxide and how to detect it ?

Back 16

Methemoglobinemia and Hemioximetry

Front 17

When should an RRT replace a Tracheostomy Tube ?

Back 17

Suction catheter unable to pass and

Patients Oxygen desaturated

Front 18

Major Component of Surfactant is

Back 18

Phospholipids

Front 19

Mean Airway Pressure will change when ?

Back 19

Inspiratory Time allows increase in VT , RR and PIP ... PEEP is most influence of Mean Airway Pressure that primarily effects oxygenation .

Front 20

Ethylene Oxide is used on equipment like ?

Back 20

Bird Mark VII

Flow Meter

Non-disposable resuscitation bags

Front 21

Best method Effectiveness of Equipment Sterilization ?

Back 21

Biological Indicator

Front 22

Alkaline Glutaraldehyde "Cidex" is used on what equipment?

Back 22

Reusable plastic

Mouthpieces

Tubing

Nebulizer

Humidifiers

Fiber optic Bronchoscope

Front 23

Patient breathing at a rate of 25 with a minute volume of 10 L/min. What is the patients tidal volume?

Back 23

Vt=10÷25=0.4 L or 400L

Front 24

Patient chest- xray shows Hyperlucent between visceral and plural spaces. Indicates?

Back 24

Pneumothorax

Front 25

PEP therapy improves expectoration for

Back 25

Cystic Fibrosis and Pneumonia Patients

Front 26

To transport a patient with a Flow Meter that is NOT effected by gravity, an RRT would use ?

Back 26

Bourbon Gauge Flow Meter

Front 27

PEFR measures the

Back 27

Obstructive Airway

Front 28

The best way to check the accuracy of a water seal spirometry is to use a

Back 28

Wright Respirometer

Front 29

A physiological goal of CPAP in a atelectasis is to increase

Back 29

Functional residual capacity

Front 30

Chest Tubes

Suction Control Bottle

What is Normal, Leak and excessive bubbling and what to do ?

Back 30

*Normal bubbling is gentle bubbling

*Leak or Obstruction is No Bubbling/ not enough water ... increase suction pressure and check water level

*Excessive Bubbling and decrease suction pressure at wall source

Front 31

Air to Oxygen Entrainment ratios :

Fio2 of 28% , 32% 36 % 40% ?

Magic Box for Air to Oxygen ratio

( if forget )

Back 31

Front 32

P/F ratio less than 200 indicates shunting and the need for ...

Back 32

PEEP and CPAP

Front 33

A patient with chest xray shows left lower lobe pneumonia is ordered for CPT with postural drainage . What would best be patient position?

Back 33

Trendelenburg Prone

Front 34

High Frequency Oscillation Ventilation...

What are the indications and how do you control PaCO2 and PaO2 and what is the range frequency ?

Back 34

Indications : PIP greater than 50cm

Air Leak Syndrome:

1. Bronchopleural Fistula

2. Pulmonary Interstitial Emphysema

3. Pneumothorax

Primary PaCO2 Amplitude then Frequency in hertz

PaO2 Mean Airway Pressure 3-45 cmH20

3-15 Hertz range but 180 to 900in

Front 35

Confirm metabolic involvement by assessing the Base Excess (BE), with values of ...?

Back 35

Values Greater than +2 indicating metabolic Alkalosis and

Values Less than -2 indicating metabolic Acidosis

Front 36

The Severity of Hypothermia are ...?

Back 36

Mild : PaO2 60 -70 torr

Moderate : PaO2 40-59 torr

Severe : PaO2 < 40 torr

Front 37

Bland Aerosol Therapy is indicated to treat upper Airway edema , laryngotracheobronchitis and subglottic and postextubation edema . What else can it be used for ?

Back 37

*Help overcome a humidity deficit in patients

*Patients at risk for retained secretions

*Used for sputum induction procedures

Front 38

The depolarizing agent such as Succinylcholine (Anectine) have a short duration of action. Used for ?

Back 38

Short term paralysis during intubation

Front 39

The nondepolarizing agents produce prolonged paralysis and are used for controlled mechanical ventilation that are?

Back 39

Pancuronium Pavulon

Vecuronium Norcuron

Cisatracurium (Nimbex)

Front 40

Patient demonstrate gastric distress , suctioning of gastric content from the trachea and loss of tidal volume. Symptoms indicate ?

Back 40

Tracheoesophageal

Front 41

Increase PEEP may cause decreased venous return , which will decrease both ?

Back 41

Cardiac Output and Urinary Output

Front 42

If a patient on 10 cm PEEP and 75 % O2 has a PaO2 of 175 torr , the concern and solution is ?

Back 42

The high FIO2 is most concern ( O2 toxcity)

FIO2 should be lowered

Front 43

If a patient is on 18 cm PEEP and 45% oxygen has a PaO2 of 150 torr , the concern would and solution ?

Back 43

The high PEEP level is of the most concern ( barotrauma ) and should be lowered.