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Fundamentals Unit 9
SPC Fundamentals Unit 9 Exam 4
| Question | Answer |
|---|---|
| What are the 3 factors of Evaporation? | 1. Temperature 2. Atmospheric Pressure 3. Surface Area |
| What relationship is "Temperature" as an atmospheric pressure? | Direct |
| What relationship is "Atmospheric Pressure" as an atmospheric pressure? | Inverse |
| What relationship is "Surface Area" as an atmospheric pressure? | Direct |
| Define Absolute Humidity? | The weight of water in a gas sample expressed in mg/L Referred to as content |
| Define Maximum Absolute Humidity? | A fully saturated gas sample. Referred to as 100% water capacity |
| Define Relative Humidity? | Content/Capacity X 100 or Absolute/Max. Absolute x 100 |
| Calculate Normal Values @ "Room Temp" | @25 Degrees C / Max. A.H.=23mg/L / If you measure 10mg/L / Calculate R.H.? Answer 10/23=.43x100=43% |
| Calculate Normal Values @ "Body Temp" | @37 Degrees C / Max. A.H.=44mg/L / % of body humidity is R.H. @37 Degrees C / If you measure 30mg/L / Calculate B.H.? Answer 30/44=.68x100=68% |
| Define Humidity Deficit? | Content below 100% B.H. (Body Humidity) i.e. 44mg/L--If you measure 10mg/L calculate H.D. (Humidity Deficit) Answer 44-10=34mg/L |
| Define Aerosol? | A suspension of solid or liquid particles in a gas. |
| What does M.M.A.D. stand for? | Mean Mass Aerodynamic Diameter |
| What is MMAD? | The distribution of particle diameter around which 50% of the particles are larger and 50% of the particle are smaller. |
| What is the size needed for particles to be visible? | >50 microns in diameter |
| What is the size for microns in the upper airways? | 5-20 Microns |
| What is the size of microns in the lower airways? | 2-5 Microns |
| What is the size of particles in the parenchyma? | 1-3 Microns |
| T/F Parenchyma is the functional part of the lung? | True |
| What are the 3 Physical Properties of Aerosol Deposition? | 1. Inertial Impaction 2. Gravitational Sedimentation 3. Diffusion |
| What are the 3 factors that increase Inertial Impaction? | 1. Turbulent Flow 2. Airway Branching 3. High Inspiratory Flow >30L/M |
| What is the factor that increase Gravitational Sedimentation? | Time- A 10 second breath hold will increase deposition up to 10% |
| What is the factor that increase Diffusion? | Inconclusive |
| Particle size of Inertial Impaction is... | >5 Microns |
| Particle size of Gravitation Sedimentation is... | 1-5 Microns |
| Particle size of Diffusion is... | <3 Microns |
| What is the Patient Factor of Aerosol Deposition? | Ventilatory Pattern |
| What are the 4 variable of Ventilatory Pattern? | 1. High Inspiratory Flow 2. Slow Rate 3. Large Vt (Tidal Volume) 4. Mouth Breathing |
| What are the 5 chain of events with Inadequate Humidification? | 1. Impaired Ciliary Activity 2. Impaired Mucus Flow 3. Retained Secretions 4. Infection 5. Pneumonia |
| What are the 3 Goals of Aerosol Therapy? | 1. Humidify Inspired Gas 2. Deliver Medications 3. Improve Bronchial Hygiene |
| What does it mean to Improve Bronchial Hygiene? | To thin & mobilize secretions and to promote cough and expectoration (cough something up) |
| What are the 3 Hazards of Aerosol Therapy? | 1. Bronchospasm (Asthmatics at risk) 2. Fluid Overload (Infants at risk) 3. Cross Contamination (droplet borne pathogens) |
| What does A.N.S.I. stand for? | American National Standard Institue |
| What are the A.N.S.I standards for Humidifiers? | 1. Minimum Level of A.H. (Absolute Humidity) is 10mg/L 2. Patients w/ bypass of upper airways is 30mg/L |
| What are the 3 types of Humidifiers? | 1. Bubble 2. Passover 3. Heat Moisture Exchanger |
| What is the clinical use and output of a Bubble Humidifier? | Clinical: Pass through a diffuser to create small bubbles, typically used w/ low-flow oxygen devices Output: 15-20mg/L |
| What is the clinical use and output of a Passover Humidifier? | Clinical: A simple reservoir with a wick and membrane, typically used in ventilator circuits. Output: 35-50mg/L |
| What is the clinical use and output of a Heat Moisture Exchange Humidifier? | Clinical: Captures a patients exhaled gas and uses it to warm & humidify the next inspiration. Use with a hydrophobic or hydroscopic condenser, typically used in ventilator circuits Output: 20-30mg/L |
| What is Nebulization? | Production of an aerosol w/ narrow range of particles vis the use of baffles. |
| What are baffles? | Spheres or plates against which the aerosol is impacted in order to decrease particle "MMAD" |
| What are the 2 categories of nebulizers? | Pneumatic & Electric |
| What are the 5 Pneumatic Nebulizers? | 1. Jet 2. SVN (Small Volume Nebulizer) 3. LVN (Large Volume Nebulizer) 4. MDI (Metered Dose Inhaler) 5. DPI (Dry Powdered Inhaler) |
| What are the 2 Electric Nebulizers? | 1. Ultrasonic 2. Mesh |
| Jet Nebulizers are also known as? | Air-entrainment Nebulizers |
| What's the clinical goal of Jet Nebulizers? | Humidify Inspired Gas |
| What's the Output of Jet Nebulizers? | 25-35mg/L cold 35-55mg/L heated |
| What's the clinical goal of SVN (Small Volume Nebulizers)? | Deliver Medication |
| What are the 4 factors affecting SVN (Small Volume Nebulizers)? | 1. Baffles-decrease the MMAD 2. Neb. Positioning- tilting stops output 3. Fill Volume- Drug delivered 4. Reservoirs- Drug delivered |
| What are the 3 gas source factors of SVN (Small Volume Nebulizers)? | 1. Compressor Pressure- output and particle size 2. Flow- output and particle size 3. Gas Density- Heliox decreases output |
| What are the 2 types of LVN (Large Volume Nebulizers)? | 1. SPAG (Small Particle Aerosol Generator) 2. Heart/Hope Nebulizer |
| What does SPAG stand for? | Small Particle Aerosol Generator |
| What is the clinical goal of the LVN SPAG? | Deliver Ribavirin |
| What is the clinical goal of the LVN Heart Nebulizer? | Continuous Bronchodilator Therapy |
| What does MDI stand for? | Metered Dose Inhaler |
| What are MDI's? | Pressurized canisters w/ drug, propellant, and dispersing agent. |
| T/F Propellants CFC will become HFA? | True |
| T/F Dispersing agents are called Surfactants? | True |
| What is the clinical goal of MDI's? | Deliver Medication |
| What are the two MDI factors? | 1. Flow-Triggered MDI 2. Spacers & Holding Chambers |
| What does DPI stand for? | Dry Powder Inhaler |
| What is a DPI? | A breath-actuated MDI that creates the aerosol as the patient draws air through a finely milled drug powder. |
| What is the clinical goal of DPI's? | Deliver Medication |
| Patient must have what to use a DPI? | High Inspiratory Flow >40L/M |
| Who should NOT use a DPI? | Infants <5y/o & S.O.B adults |
| High humidity causes what with use of DPI? | Clumping of Powder |
| What is a Ultrasonic Nebulizer? | Use of a Piezoelectric Crystal Transducer to generate aerosol. |
| What the clinical goal of Ultrasonic Nebulizers? | Thin & Mobilize Secretions |
| What is the output of Ultrasonic Nebs? | As much as 500mg/L |
| What are MESH Nebulizers? | Pass liquid through an aperture or plate to create an aerosol. |
| What are two types of MESH Nebs? | Passive & Active |
| What is the clinical goal of the MESH Nebs? | Deliver Medication |
| Catecholamines and Non-Catecholamines are classified as what? | Adrenergics |
| What is Catecholamines? | When the Benzene Ring is rapidly metabolized by COMT (Catechol-O-methyl transferase) in the gut |
| What is Non-Catecholamines? | When the Benzene Ring has been altered blocking COMT (Catechol-O-methyl transferase) |
| What is the onset for Catecholamines? | <10min |
| What is the duration for Catecholamines? | <3hrs |
| T/F Catecholamines are effective PO (by mouth)? | False |
| What are the 4 Catecholamine medications, delivery, and actions? | 1. Epinephrine (Adrenaline) -SC (Subcutaneous)- Alpha 1&2, Beta 1&2 2. Recemic Epinephrine (Vaponefrin)-Neb-Alpha 1&2, Beta 1&2 3. Isoprotererenol (Isuprel)-Neb & MDI-Beta 1&2 4. Isoetherine (Bronkosol)-Neb/MDI-Beta 2 |
| What is the duration of Non-Catecholamines? | Up to 12hrs |
| What action are all Non-Catecholamines? | Beta 2 Agonists |
| T/F Non-Catecholamines are effective PO (by mouth)? | True |
| What are the 4 SHORT DURATION Non-Catecholamines medications and delivery? | 1. Metaproternol (Alupent)-MDI/Neb/tablet 2. Pirbuterol (Maxair)-MDI 3. Albuterol (Proventil/Ventolin)-Neb/MDI/DPI/tablet 4. Levalbuterol (Xopenex)-Neb & MDI |
| What is the time frame of short duration Non-Catecholamines? | <8hrs |
| What is the time frame of long duration Non-Catecholamines? | 12hrs |
| What are the 3 LONG DURATION Non-Catecholamines medications and delivery? | 1. Formoterol (Foradil)- DPI 2. Salmeterol (Servent)-MDI & DPI 3. Arformoterol Tartrate (Brovana)-Neb |
| What are the side-effects of Adrenergics? | Tachycardia/Tremors/Headaches/Insomnia/Nervousness |
| What is the onset of Anticholinergics Medications? | Rapid onset <5min |
| What is the duration of Anticholinergics? | Long 4-24hrs |
| What are the 2 medication and delivery of Anticholinergics? | 1. Ipratropium Bromide (Atrovent)-MDI & Neb 2. Tiotropium Bromide (Spiriva)-DPI |
| What are the side-effects of Anticholinergics? | Increase Heart Rate/Increase Blood Pressure/Decrease Secretions |
| What are Mediator Antagonist used for? | Used to treat Asthma |
| 5 Medications used to treat Asthma? | 1. Intal 2. Tilade 3. Accolate 4. Zyflo 5. Singulaire |
| The 5 medications used to treat asthma are maintenance or rescue drugs? | Maintenance Drugs |
| What are Mast Cells? | Mast Cells contain Histamine & other inflammatory mediators |
| What are the two Mast Cell stabilizers and their delivery method? | 1. Intal-MDI/Neb/DPI 2. Tilade-MDI |
| LRA stands for? | Leukotriene Receptor Antagonist |
| Leukotriene receptor stimulation causes what? | bronchoconstriction/mucus secretion/release of inflammatory cells |
| LRA's is what? | Drugs that either block leukotriene actions or inhibit the formation of leukotrienes. |
| What are the 3 LRA Medications and Delivery? | 1. Accolate-tablet 2. Zyflo-tablet 3. Singulaire-tablet |
| Glucocorticoid Steroids are maintenance or rescue drug? | Maintenance Drugs |
| What does Glucocorticoid Steroids do? | Inhibit Anibody Formation/Inhibit Histamine Formation/Non-specific Anti-Inflammatory/Used to treat asthma |
| What steroid medication is administered through tablet only? | Prednisone (Deltasone) |
| What 4 steroid medications are administered through MDI only? | 1. Belcomethasone (Beclovent) 2. Triamcinolone Acetonide (Azmacort) 3. Flunisolide (Aerobid) 4. Ciclesonide (Alvesco) |
| What steroid medication is administered through DPI only? | Mometasone (Asmanex) |
| What 2 steroid medications are administered through DPI & MDI? | 1. Budesonide (Pulmicort) 2. Fluticasone Propionate (Flovent) |
| What are the 3 Combination steroids and delivery methods? | 1. Serevent + Flovent = Advair-MDI & DPI 2. Foradil + Pulmicort = Symbicort-MDI 3. Atrovent + Proventil = Combivent-MDI |
| MDI Steroid Side-Effect | Oropharyngeal fungal infection |
| Systemic Steroid Side-Effects | Osteoporosis/Immunosuppression/Peptic Ulcers |
| Cushingnoid Steroid Side-Effects | Truncal Obesity (buffalo hump/moon face) & Hirsutism (Increase hair growth/muscle wasting) |
| What are the 3 wetting agents? | 1. Hypotonic Saline (thin secretions) 2. Isotonic Saline (thin secretions) 3. Hypertonic Saline (will cough sputum) |
| What is a mucolytic agent? | An amino acid preparation that disrupts disulfide bonds in mucus and thus reduces viscosity of thick secretions. |
| What medication is a Mucolytic? | Acetylcycteine (Mucomyst)-Neb- 10 to 20% solution |
| What are side-effects of Mucolytic? | Bronchospasm (must pretreat with bronchodilator) (Great risk in asthmatics) Nausea/Bronchorrhea/Rhinorrhea |
| What is a proteolytic agent? | A clone of pancreatic Dnase enzyme which digest DNA in secrestions. Used in treating cystic fibrosis patients. |
| What medication is a Proteolytic? | Dornsa Alpha (Pulmozyme)-Neb- 0.1% solution |
| What are side-effects of Proteolytic? | Pharyngitis/Laryngitis/Conjunctivitis |
| What is the Max Absolute Humidity for Body Temperature? | 44mg/L @37 Degrees C |
| What is the Max Absolute Humidity for Room Temerature? | 23mg/L @25 Degrees C |
| List the 8 Steroid Medication | 1. Prednisone (Deltasone) 2. Belcomethasone (Beclovent) 3. Triamcinolone (Azmacort) 4. Flunisolide (Aerobid) 5. Fluticasone Propionate (Flovent) 6. Budesonide (Pulmicort) 7. Ciclesonide (Alvesco) 8. Mometasone (Asmanex) |
Created by:
Langhout1418
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