| Question | Answer |
| what three areas need to be communicated to members of the health care team? | patient status, new orders, adverse reactions |
| briefly explain the coordinating patient care | scheduling treatments, avoiding conflicts, sequencing therapy, making schedule known to other practitioners |
| list three goals of oxygen therapy | relieve hypoxia- pneumonia, V/Q mismatch; decrease WOB- asthma, COPD; decrease work of heart- MI, pulmonary edema |
| how does hypoxemia effect the circulatory system? | peripheral vasodilation, pulmonary vasoconstriction, tachycardia |
| at what FiO2 does the therapist become concerned with the development of O2 toxicity? | >60% for 12-24 hours |
| list the signs and symptoms of O2 toxicity | nausea and vomiting, substernal chest pain and tightness, thachpnea, decreased compliance and surfactant, pulmonary edema |
| identify three major hazards of O2 therapy | decreased RR and Vt, increased PaO2 increased PCO2 and decreased pH, lethargic sleepy confused |
| what is hyperbaric oxygen therapy? | means of increasing PO2 by increasing the barometric pressure |
| list three diseases treated with hyperbaric therapy | CO poisoning, tissue transplant/grafting, decompression sickness |
| name six gram negative microorgansims that commonly produce respiratory diseases. | pseudomaons, haemophilus influenza, serratia marcescens, e. coli, proteus, klebsiella |
| name four common gram positive cocci that are respiratory pathogens | staph., strep., diplococcus, pneumococcus |
| what is the classification of candida albicans? | fungi |
| what is the classification of streptococcus? | gram positive |
| what is the classification of pseudomonas? | gram negative |
| what is the classification of mycobacterium tuberculosis? | acid fast bacilli |
| what is the classification of adeno virus? | viruses |
| what is the classification of histoplasma capsulatum? | fungi |
| what is the classification of klebsiella? | gram negative |
| what is the classification of staphylococcus? | gram positive |
| what is the classification of proteus? | gram negative |
| what is the classification of E. Coli? | gram negative |
| what are nosocomial infections? | infectious organsim recieved by medical personnel |
| what is the most common piece of respiratory therapy equipment that will be a source of bacteria and the microorgansim commonly found? | water containing equipment, pseudomans and serratia |
| list two microorganisms causing pneumonia in which the patient should be placed in complete isolation. | staph. and group A strep |
| describe protective isolation and name a patient who would benefit from this type of isolation. | strict isolation--burn, transplant, cancer and HIV/AIDS |
| describe COPD | characterized by dyspnea on exertion with significant hypercapnea |
| Assessment of COPD | expiratory wheeze, barrel chest, hyperlucency, increased A-P diameter, decreased flow (FEV1) |
| Treatment of COPD | aerosol therapy, low flow O2, meds- bronchodilaotrs, rehab therapy |
| Etiology of croup and epiglottitis | parainfluenza and hemophily influenza |
| upper respiratory infection? croup and epiglottitis | croup-yes, epiglottitis-no |
| incidence of croup and epiglottitis | croup-winter, epiglottitis-varies |
| age for croup and epiglottitis | croup- <3 yrs, epiglottitis- 3-7 yrs |
| admission criteria for croup and epiglottitis | croup- stridor at rest, epiglottitis- drooling and extended neck |
| treatment for croup | cool mist tent, dexamethasone (steroid), racemic epi aerosol |
| treatment for epiglottitis | intubation, IV antibiotics (ampicillin) |
| X-ray of croup | subglottic edema, steeple or pencil sign |
| x-ray of epiglottitis | supraglottic edema, thumb or nail print sign, obliterated vellecula |
| description of sleep apnea | cessation of breathing during sleep |
| assessment of sleep apnea | obesity/overweight = obstructive. decreased nasal flow, decreased respiratory effort = central sleep apnea. decreased nasal flow, increased effort = occlusive |
| treatment of sleep apnea | CPAP, trach, weight loss, respiratory stimulants |
| description of TB | caused by acid-fast, rod-shaped bacteria, spread by inhalation |
| assessment of TB | night sweats, weight loss, dry cough, two positive tests, x-ray shows consolidation |
| treatment of TB | respiratory isolation, drugs- isoniazid |
| description of pneumonia | infectious bacteria or virus enters the lungs via inhalation or aspiration |
| assessment of pneumonia | chills, fever, purulent sputum, WBC count-increase = bacteria decrease = virus, consolidation on x-ray |
| treatment for pneumonia | bronchial hygein, antibiotics, mechanical ventilation if PCO2 >45 and PO2 is <60 |
| description of pleural effusion | fluid in the pleural space |
| assessment of pleural effusion | dyspnea, decreased breath sounds, tracheal shift away from affected side |
| treatment of pleural effusion | thoracentesis and antibiotics |
| description of ARDS | acute respiratory distress syndrome. series of reactions leading to inflammation, resulting in decreased lung compliance and shunting |
| assessment of ARDS | respiratory distress with tachypnea and cyanosis, refactory hypoxemia, increased A-a gradient, decreased FRC, shunting and respiratory failure |
| etiology of myasthenia gravis and gullain barre syndrome | MG- auto-immune response, GBS- delayed reaction to viral infection |
| upper respiratory infection? myasthenia gravis and gullain barre syndrome | MG-no, GBS-yes |
| paralysis? myasthenia gravis and gullain barre syndrome | MG- descending, BGS-ascending |
| treatment of myasthenia gravis | intubation/vent - short term, neostigmine |
| treatment of guillain barre syndrome | steroids, antibiotics, vent/trach - long term, plasmapheresis |
| what are the three area where pulmonary rehab can be utliized? | patient in the hospital, outpatient rehab clinics, home care |
| what are two objectives of pulmonary rehab? | alleviate or control as many medical symptoms of respiratory impairment as possible; teach and train the patient how to maximize their ability to carry out the activities of daily living. |
| what are the ten basic components of a rehab program? | patient selection, patient evaluation, determine short and long-term goals, CPT, exersize conditioning, respiratory therapy, patient and family education, general health care, assessment of patient progress, follow-up |
| what are the eight long-term benegits/goals of pulmonary rehab? | improve tolerance for dyspnea, improve ability to active daily living, increase physical capacity or increased efficiency of skeletal muscles, reduced resting heart rate, improve sputum clearance, improved diaphragmatic breathing, improve appetite |
| describe the technique of pursed-lip breathing | position patient, inhale slowly through nostrils lips closed, pucker at end of inhalation, exhalation should be passive |
| describe the technique of diaphragmatic breathing | muscle relaxation (shoulder, upper chest), conditioning (abdomina, lower chest muscles), combined with pursed-lip technique, abdomen rises on inspiration |
| describe cough control techniques | sitting upright or slightly leaning forward, relaxation between efforts, volume building, multiple cough-single exhalation, serial cough, huff coughing-for COPD patients, splinting |
| describe the type of diet a COPD patient should eat | several small meals, inreases protein and fat-low carbs, fluids |
| how should a COPD patient monitor his fluids at home? | check urine color, weight gain, increased thick secretions |
| what types of therapy can be given in the home? | all procedures used for in- and out-patient with some modifications |
| what four precautions should be taken to assure patient safety in the home? | teach proper use of O2 equipment, teach proper uses of medication and side effects, provide easy access to all necessary item and remove obstructions, train patient and families to recognize problems and emergencies |
| how would you instruct a patient to clean their equipment in their home? | wash with mild detergent, rinse with water, soak in distilled vinegar for 20 minutes, rinse and air dry |
| what types of O2 conservation devices are used in the home? | demand valve cannula, reservoir cannula, transtracheal catheter |
| what are the four criteria used to determine if a patient will benefit from O2 in the home? | PO2<55 on room air, exersize limitation that is responsive to O2 therapy, ear or finger oximetry is suggested, polycythemia |
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Created by:
grumpeme
on 2008-10-01