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wwallace RT test 1
wwall RT 2 Test 1
| Question | Answer |
|---|---|
| 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
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