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wwallace RT test 1

wwall RT 2 Test 1

QuestionAnswer
What is a SPAG nebulizer designed to admin Ribavirn
What nebulizer should RTT where mask gloves gown and goggles when delivering meds with SPAG
What is a USN ultrasonic nebulizer
What is the particle size of a USN fine
How does USN work radio frequency generator produces high frequency vibrations across piezoelectric transducer or crystal, breaks up meds, frequency determines particles size, amplitude determines volume
Best nebulizer of choice for pt with thick retained secretions USN
How does RTT control the volume on a USN amplitude, can go as high as 6 l/m (2x higher than other nebs)
Hazards of USN over hydration, bronchospasm, sudden mobilization of secretions, electrical shock, water in tube from condensation, nosocomial infections, drug dosing changes caused by reconcentrations in nebulizer as treatment continues
Why must RTT be concerned about condensation in the tubing during neb treatment accidental pt lavage, water in tube caused decreased flow and increased FIO2
What kind of mask is most often used with a SPAG tent or hood
You are delivering humidity to pt at 30 percent but when you analyze it, it reads 60 percent, what is the problem condensation in the tube increases FIO2
What is a Passover humidifier non heated low humidity appox 25 percent body humidity
What is a bubble humidifier the most common non heated humidifier, body humidity of 35 to 40 percent, usually for nasal canulla
What is a diffuser humidifier high output aerosol neb often used with CPAP, heated, uses evaporation to produce high humidity at high flow (misty ox)
What is the cascade humidifier heated humidifier most often used with vent pt, water passes over a grid, capable of deliver 100 percent humidity at high flows
What is a wick or concha humidifier heated humidifier, water passes over wick made of paper, cloth or sponge, produces humidity close to 100 percent, best for artificial airway for pt on vent
What is an HME heat moisture exchange, device placed between pt and wye on vent circuit, body humidity is collected and then used to humidify next insp, ideally 70-90 humidity is produced
How often do we change out the humidifier circuit to prevent pseudomonas every 24 hours
Therapeutic range for aerosol meds is .5 to 3 microns
What is an HHN hand held nebulizer aka SVN
What is the volume of an SVN less than 30 ml
What is the particle size of an SVN 1.5 to 7 microns
Respigard II SVN is used for what tamadine or pentamidine medication for treating C Pneumonia in AIDS pts
AeroEclipse is what breath actuated nebulizer used in many hospitals today, saves meds and gives shorter treatment
MDI’s are more effective with what spacer and good pt education
DPI is what dry powder inhaler
What is the downside of DPI pt must have a strong enough inspiratory flow to get meds
What is the upside to DPI’s do not take the same pt coordination as MDI
What is the purpose of large volume nebs provide continuous aerosol therapy, refill every 4 to 8 hours depending on flow and heat
Allegiance health LVN air entrainment prefilled neb for cool or heat 21 to 100 percent
Misty ox hi-fi neb air entrainment 60-90 percent on flows of 42 to 77 L/M
Misty ox gas injection neb or GIN 21 to 100 percent at rates over 100 L/M not an air entrainment device, used with CPAP, requires 2 gas sources if greater that 75percent
Heart neb used if giving continuous aerosolized meds like albuterol for status asthmaticus, 240 ml reservoir
What is humidity water in a gaseous states
What are the advantages of MDI convenient, inexpensive, portable, no drug prep, hard to contaminate
What are the disadvantages of MDI pt coordination and activation, increased pharyngeal deposits, abuse, no high doses, not all meds available, CFC’s
What are the advantages of SVN less pt coordination, high doses, even and continuous, no CFC
What are the disadvantages of svn’s expensive, wasteful, drug prep, contamination, not all drugs available press source required, long treatment time
Hazards of aerosols are wheezing and bronchospasm esp with copd, broncoconstriction with artificial airway, infection, overhydration, pt discomfort, rtt exposure, edema
Contraindications of aerosol are Bronchoconstriction, history of airway hyperresponsive
Indications of aerosol are upper airway edema (cool), LTB, subglottic edema, post extubation edema, post op mgmt of upper airway, sputum specimen or mobilize secretions
Body humidity is 44 mg/L always, regardless of body temp or outside temp
Actual humidity RH x capacity
Aerosol is what liquid particles suspended in gas
Bland aerosol therapy is what sterile hypo, hyper or normal saline in aerosol
What is the primary purpose of humidity therapy humidify dry medical gases to overcome humidity deficit when upper airway is bypassed
What is the secondary purpose of humidity therapy heated to manage hypothermia or treat bronchospasm from cold air
How do you tell if a non heated humidifier has a leak all have pop off at 2 psi, kink the hose if pop off does NOT sound, you have a leak
Where do you monitor temp of humidity insp side at wye
Passover humidifiers are wick-air flows over wick, membrane-gas passes through hydrophobic membrane, USN-prezo electronic crystal
Contraindications of HME thick copious secretions, less than 70 VT, less than 32 body temp, great than 10 min vent
Hazards of HME under hydration, mucus plugging, increased WOB, hypoventilation from increased dead space, ineffective pop off, hypothermia
Contraindications for heated humidifiers there are none
Hazards of heated humidifiers high flow at disconnect will spray contaminated condensation, under hydration, mucus plugging, inc WOB, wrong FIO2 from condensation in tubing, hypothermia, burns, lavage
Relative humidity is actual humidity divided by capacity
Indications for humidity are all vent patients with endotrach or tracheostomy, primary – pt receiving dry gas, upper airway bypassed, secondary – mgmt of hypothermia and bronchospasm from cold air
Which nebulizer administers particles with sizes 0.5-3.0 microns and allows for the greatest deposition of aerosol? Ultrasonic nebulizers
Created by: williamwallace