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Fund Final
Fundamentals Final
| Question | Answer |
|---|---|
| Joseph Black | Discovers carbon dioxide |
| Joseph Priestly | Credited with the discovery of oxygen |
| Thomas Beddoes | Uses oxygen to treat various disorders |
| AARC | Promote profession & practice |
| NBRC | Testing & credentialing organization |
| CoArc | Program accreditation organization |
| Service Areas | General Therapeutics, Critical Care, Emergency Care, Diagnostics, Pulmonary Rehabilitation |
| Boyle's Law | Volume of gas varies inversely with its pressure P1V1 = P2V2 |
| Charles' Law | Volume of gas varies directly with changes in its temperature V1/T1 = V2/T2 |
| Gay-Lussac's Law | Pressure exerted by a gas varies directly with its absolute temperature P1/T1 = P2/T2 |
| Combined Gas Law | (P1xV1)/T1 = (P2xV2)/T2 |
| Minute Ventilation calculation | VE = VT x f |
| Alveolar Ventilation calculation | VA = (VT - VD) x f |
| Shunt | Perfusion without ventilation |
| Deadspace | Ventilation without perfusion |
| Oxygen Content equation | (1.34 x Hb x SaO2) + (PaO2 x 0.003) |
| ABG ranges | pH:7.35–7.45, PaCO2(Resp):35 – 45 mmHg, HCO3(BiCarb):22 – 26 mEq/L, Base Excess: -2 to +2 |
| Cylinder Volumes | E = 22cu.ft. / 623L G = 187cu.ft. / 5292L H = 244cu.ft. / 6905L K = 275cu.ft. / 7783L |
| Cylinder Duration equation | (Tank Pressure x Tank Factor) / Flow |
| Tank Factors | E = .28, G = 2.41, H = 3.14 |
| NFPA | Regulates storage & handling of cylinders, as well as central supply gas & piping systems. |
| DOT | Regulates cylinder construction, testing, & transport. |
| CGA | Sets all safety standards (ASSS, DISS, &PISS) |
| FDA | Sets medical gas purity standards. |
| Liquid to Gas conversion | 1cu.ft. liquid O2 = 860cu.ft. gaseous O2 |
| Cubic Feet to Liters conversion | 1cu.ft. gaseous O2 = 28.3L gaseous O2 |
| Refractory Hypoxemia | Low levels of O2 in blood that cannot be corrected with add'l O2. Use PEEP or CPAP. |
| Responsive Hypoxemia | Low levels of O2 in blood that can be corrected w/ add'l O2 - Significant increase in PaO2 w/ increase in FiO2 due to V/Q mismatch or diffusion defect. Use low or high flow O2 device. |
| Manifestations of Hypoxemia | Tachycardia – high heart rate > 100bpm Tachypnea – high rate of breathing > 20L/m Restlessness / confusion (nasty, mean) Pulmonary Hypertension |
| Alveolar Air equation | PAO2 = FiO2(760 – 47) – PaCO2 / 0.8 *If FiO2<60% don't / by 0.8 |
| AARC CPGs for Hypoxemia | Documented: PaO2 < 60mmHg SaO2 < 90% Suspected: Acute M/I Severe trauma |
| High Flow Devices | Will meet pt’s inspiratory flow needs, Air Entrainment Mask < .40, AE Nebs – high flow or < .40 |
| Low Flow Devices | Will not meet pt’s inspiratory flow needs, Nasal / reservoir cannulas, transtracheal O2 catheter, simple, O2 mask, partial & non-rebreather masks, Total Flow Question |
| Polorgraphic Oxygen Analyzer | Components: silver anode, platinum cathode, KCI electrolyte soltn, polypropylene or Teflon membrane battery. Quick response time: <30 sec. |
| Galvonic Fuel Cell Oxygen Analyzer | Components: Lead anode, gold cathode, KOH(potassium hydroxide) or CsOH(cesium hydroxide) electrolyte solution Longer response time: up to 60 sec. |
| HeOx Therapy | Low density gases will decrease turbulence and WOB, helps O2 move better into airways. Tx of: stridor croup, foreign body aspiration, upper airway masses |
| HeOx Gas Densities | Air 1.29g/L & O2 1.43g/L *80/20 He/Ox – 0.43g/L = flow x 1.8 *70/30 He/Ox – 0.55g/L = flow x 1.6 |
| Spectrophotometry | Red & Infrared light absorption on finger or earlobe to calculate HbO2 |
| Photoplethysmography | Light transmission to determine pulse |
| Pulse Oximetry | *Red light is absorbed by deoxyHb *Infrared is absorbed by oxyHb *Low R/IR, ½ = High SpO2, 98% *High R/IR, 2/1 = Low SpO2, 60% |
| Adrenergic meds | Sympathetic, Catecholamines & Non-Catecoholamines, Side effects: tachycardia, tremor, headache, insomnia, nervousness |
| Catecholamines | Rapid onset < 10 min, Short duration < 3hrs Epinephrine: Alpha 1, Beta 1 & 2 Racemic Epinephrine: Neb, Alpha 1, Beta 1 & 2 |
| Non-Catecholamines (4-6hr duration) | *Onset 15 – 20min, Peak 30 min, Metaproterenol – Neb/MDI/Tab, Pirbuterol – MDI, Albuterol – Q4 @ 2.5mg, Neb/MDI/TB/DPI, Levalbuterol – Q6 @ 1.25mg |
| Non-Catecholamines (Up to 12hr duration) | Formoterol – Onset 3 min, Peak 30 – 60, DPI, Salmeterol – Onset 15 – 20, MDI/DPI, Arformoterole Tartrate – Onset 15 min, Neb |
| Anticholinergics | Onset 15 min, duration 4 – 6 hrs, Ipratropium Bromide (Atrovent) – MDI/Neb, Q6 - 8, Tiotropoim Bromide (Spiriva) – DPI, QDay, *Side effects – increased heart rate & blood pressure, decreased secretions |
| Asthma Maintenance Drugs | Mast Cell Stabilizers & Leukotriene Receptor Agonists |
| Mast Cell Stabilizers | Intal & Tilade (Not avail. In US) |
| Leukotriene Receptor Agonists | Accolate, Zyflo, Singulair – all 3 are mtce drugs |
| Proteolytic Agent | Pulmozyme (dornase alpha) – neb, 0.1% solution, commonly used with CF pts, can’t be mixed. *Side effects: pharyngitis, laryngitis, conjunctivitis |
| Henry's Gas Law | Directly proportional to partial pressure |
| Graham's Gas Law | Inverseley proportional to the square root of the gases GMW |
| 3 Major Cartilages | Epiglottis, Thyroid, Crycoid |
| Glottis | The space between the vocal cords |
| Trachea | 16-20 C Shaped cartilages, bifurcates at the carina into the R & L mainstem bronchi |
| Bronchi order | Mainstem, Lobar, Segmental, Sub-Segmental |
| Bronchioles | Thousands, terminal bronchioles are the last of the conducting airways. |
| Pleurae | Parietal: membrane that lines the ribcage, diaphragm, & mediastinum. Visceral: membrane that surrounds the lungs. |
| Diaphragm | Major muscle of inspiration, R & L, innervated by phrenic nerve |
| Inspiratory Accessory Muscles | Neck, shoulders |
| Expiratory Accessory Muscles | Stomach |
| Pericardium | Fibrous, Parietal, Visceral (from outer most to inner most) |
| Heart Layers | Epi-, Myo-, Endo- (from outer most to inner most) |
| Apnea | Not Breathing |
| Dyspnea | Short of Breath |
| Eupnea | Normal Breathing |
| Hyperventilation | Blowing off CO2 < 35 |
| Hypoventilation | CO2 level > 45 |
| Orthopnea | Ability to breathe only while sitting up |
| Hyperpnea | Tidal volume > 10L/m |
| Hypopnea | Tidal volume < 5L/m |
| Bradypnea | Rate < 10L/m |
| Tachypnea | Rate > 20L/m |
| Causes of Respiratory ACIDOSIS | Anesthesia, sedatives, narcotics Poliomyelitis, Myasthenia Gravis, Guillain-Barre Syndrome Sever obesity, COPD |
| Causes of Respiratory ALKALOSIS | Anxiety, fever, stimulant drugs, pain, hypobarism(high altitude) Acute asthma, Pulmonary Vascular Disease |
| Causes of Metabolic ACIDOSIS | Loss of BiCarb, Diarrhea, renal tubular acidosis, chloride administration, Diabetic ketoacidosis, alcoholic ketoacidosis, lactic acidosis, Drug or chemical induced = salicylate intoxication |
| Causes of Metabolic ALKALOSIS | Admin/Ingestion of BiCarb, hypochloremia, diuretic therapy, Severe vomiting, nasogastric suction, corticosteroids |
| Humidifiers | Bubble, Passover, HME |
| Nebulizers | Pneumatic: Jet,SVN,LVN,DPI,MDI. Electric: Ultrasonic,Mesh |
| Autoclaving | Uses steam under pressure. Rubber & plastic are easily damaged. Thermal indicators – temperature exposure. Biological indicators – sterilization |
| Ionizing Radiation | x-rays/gamma rays. Limited use due to high cost, & the creation of toxic bi-products, long exposure time 48-72hrs |
| Disinfection | Destroys the vegetative form of pathogens but NOT spores |
| Low Level Disinfection | Will not kill resistant microorganisms |
| Acetic Acid | Basically vinegar & water, used in homes to clean SVNS & tubes |
| Quaternary ammonium compounds | Used to clean ventilators |
| Intermediate Level Disinfection | Kill all vegetative bacteria & fungi, but not certain viruses |
| Ethyl & Isopropyl Alcohol | Good surface disinfectants |
| Phenolics | Limited use surface disinfectants |
| Iodophors | Used primarily as an antiseptic agent (skin/tissue application – think IODINE) |
| High Level Disinfection | Kills ALL vegetative microorganisms |
| Glutaraldehyde | True sterilizing agent – kills SPORES w/ 3hr exposure time. Most widely use HIGH LEVEL disinfectant in Respiratory. Used w/ ventilator tubing, bronchoscopes, airways, & resuscitation bags. |
| Hydrogen peroxide | Popular wound antiseptic, 6hr exposure time. |
| Sodium hypochlorite (bleach) | Excellent surface disinfectant |
| Peracetic Acid | w/ buffers is an excellent sporicidal agent |
| Ethylene Oxide | Good for heat sensitive equipment. Chemical indicators – ETO exposure. Bio indicators – sterilization |
Created by:
vgflgirl
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