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RTH 190

pulsus alternans pulse alternates between strong and weak -L heart failure
bounding pulse high blood volume -arterial sclerosis
pulsus paradoxus pulse decrease on inhale -COPD
thread pulse low blood volume -hypovalemic
causes for thread pulse 1.shock 2.dehydrated 3.hemorrhage
causes for bounding pulse 1.exercise 2.fever 3.anxiety 4.high BP
adult pulse range 60-100
child pulse range 80-120 70-110
newborn pulse range 90-160
neonate pulse range 120-160
what can cause arterial blood pressure to vary 1.age 2.blood volume 3.exercise 4.worry 5.change position 6.wrong BP cuff size
causes of bradycardia 1.hypothermia 2.heart disorder 3.athletes 4.old age
bradycardia sign of what in only premies hypoxemia
Causes of tachycardia 1.hypoxemia 2.fever 3.blood loss 4.anxiety 5.exercise
how do you check for cerebral perfusion` pupillary reactivity -PERLA
biological indicator for ETO gas bacillus sabtillus
what does the indicator tape say about the equipment that it has gone through the process
ETO mixed with water creates what Ethylene Oxide
PVC plus ETO mixed together create what ethylene chloride
ETO criteria temp- 50 time- 3/4 hr humidity-50% concentration-100%
Autoclaving criteria temp-121 pressure-15 time-15min temp-134 pressure-29.4 time-3min
what does activated gluteraldehyde 1.cell wall is destroyed in 10 hours- sterilization 2.high level disinfection
other name for activated gluteraldhyde cidex
how long does cidex take to disinfect 12 min @ 20 degree celcius
what is the least likely sterilization/disinfectant method to be used steam autoclaving
why is steam auto claving not used on resp equipment it will melt the equipment
how long does ETO have to air out if not put in an aerator 7 days
does pasteurization kill spores no
handwashing can prevent what nosocomial infections
what position helps minimize hypoxemia in CHF patients semi-fowlers
consolidation dull-pneumonia
pleural effusion flat-fluid
pneumothorax hyperresenonce-air
hyper-inflated hyperresenonce
atelectasis dull
protocol if error in medical record 1.draw line through 2.initial
protocol if error in EMR 1.edit 2.correct 3.why change 4.initial
increased WBC means bacteria
decreased WBC means infection
purpose of C&S test sputum for bacteria
culture says what what kind of bacteria
sensitivity says what what antibiotics will work to kill bacteria
pseudomonas secretions 2.thick 3.smells
pulmonary edema pink and froathy
lung cancer red/bloody
bronchiectasis 3 layered 2.yellow 3.frothy
smoker gray
URI yellow thick
chest formation and x-ray for emphysemia pt 1.barrel chest 2.flattened diaphragm 3.hyperinflation 4.increased A-P diameter 5.widened ribs
dysphagia hard swallowing
anorexia no appetite
orthopnea SOB laying
platypnea SOB sitting
dyspnea SOB
bradypnea slow breathing
hypopnea shallow breathing
hyperpnea deep breathing
tachypnea fast breathing
eupnea normal breathing
kussmals deep fast breathing from DKA
Biots irregular breathing with apnea
cheyne-stokes increase depth and rate of breathing with apnea
macroglossia enlarged tongue
normal RR 12-20`
normal NIF 80-100
normal VT 5-8
normal VC 65-75`
normal Ve 5-6
what is the criteria needed to be considered for extubation rr= <25/min NIF=>-20 Vt=>5ml/kg VC=>10ml/kg Ve=<10L/min
formulas for RSBI RR/Vt
complication from extubation stirdor
how do you know if a patients ETT is in the right place 1.CO2 detector 2.bilateral breath sounds 3.bilateral chest movement X-ray
on an x-ray where is the end of the ETT 1.4th rib 2.4th thoracic vertebrae 3.2-3 cm above carina 4.2cm aortic noch
sins of a complete airway obstruction talking 2.accessory muscle use 3.universal sign 4.supraclavular retraction
PISS pin index safety system
why is PISS used to prevent missconnect
where is PISS used E and smaller
what are the pin numbers for PISS for O2 2 and 5
why crack the cylinder to clear debris
how can you check O2 levels in tank read pressure gauge
psi tank formula psi x (.28/3.14)/Lpm
after the tank formula how do you find out how long the tank will last divide by 60
what is a 2 stage regulator 2 stages to reduce psi
how can you tell how many stages a regulator has number of pop off valves
how can a venture FIO2 be high if air entrainment ports are blocked
if a pt can't feel O2 coming out of NC 1.check connections for malfunction 2.put in water to see bubbles
what is oxygen induced hypoventilation 1.O2 kicks out hypoxic drive
2 goals of oxygen therapy 1.decreased WOB 2.decreased cardio work
why give a pt heliox bypass an obstruction because heliox is lighter than O2
flow rate formula for 20/80 heliox lpm x 1.8
flow rate formula for 70=30 heliox lpm x 1.6
what device do you use to deliver heliox nonrebreather
if you remove the oneway valve to the reservior from a nonrebreather it is an partial rebreather
if a patient doesn't like wearing a simple mask, what is a replacement a nasal cannula
how do you cure sangulation carbon dioxidee
how do you deliver carbon dioxide to the patient nonrebreather
can you leave a patient on carbon dioxide for 3 hours no more then 15 min and stay with them the whole time
what should be monitored with a patient on carbon dioxide therapy 1.RR 2.pulse 3.depth of respirations
if a patient is spontaneously breathing and needs 100% FIO2 what device should they be put on nonrebreather
what is a low flow oxygen device one that obly give a portion of patients inspired air and varies with patient effort
what are 2 requirements for a device to be considered high flow 1.provides all of inspired air 2.consistant FIO2 regaurdless of patient effort
4 examples of low flow devices 1.NC 2.nasal catheter 3.simple mask 4.partial rebreather
6 examples of a high flow device 1.high flow NC 2.venturi mask 3.trach collar 4.face tent 5.nonrebreather 6.T piece (briggs)
if a patient is breathing fast and shallow what oxygen device would be the best choice 1.venture- high flow that will give the same FIO2 reguradless of patient efforts
what are 4 complications of giving oxygen to patients 1.O2 toxicity 2.O2 hypoventilation 3.retrotenal fibroplasia 4.absorption atalectasis 3.ret
when can oxygen toxicity occure if patient is on oxygen for more then 12-24 hours
when can O2 hypoventilation occur with COPD patients, there hypoxic drive will be messed up and they will stop breathing
who is effected by retrotenal fibroplasia infants if O2 is too high and they become blind
what is absorption atelectasis too much O2 pushes out Nitrogen which holds open alveoli and then they collapse
if a patients nonrebreather mask collapses when they inhale what should be done to correct it increase the flow
if a patients nonrebreather mask collapses when they inhale what is happening to the patient they are not getting enough air
2 ways to increase te output of an aresol nebulizer 1.put a heater on it 2.use a tandum set up
what does a tandum set up do for an aresol neb increases the flow
why put a heater on an aresol setup increases the humidity which is the amount of moisture the air can hold thus giving the patient more aresol
4 ways to keep nosocomial infections down when using aresol devices 1.hand hygiene 2.change equipment 3.use equipment sterile 4.don't tough the inside of sterile equipment
2 devices that can give 100% body humidity to a patient 1.Wick 2.Cascade
100% body humididty 44ml/L 47mmHg
24% 25:1
28% 10:1
30% 8:1
35% 5:1
40% 3:1
45% 2:1
50% 1.7:1
60% 1:1
70% .6:1
total flow rate formula air + O2 x LPM
why heat a nebulizer increases humidity so the amount of aresol delivered goes up=more mist
if water is trapped in the venturi what does it do to the FIO2 increases the FIO2 because it take up the area where air would be entrained, so all patient is getting is the O2
what does the reservior tubing at the end of a T piece do it maintains the FIO2
fluid reserviors are most often contaminated with psuedomonas
why id=s the loop below patient level on a large bore aresol neb to keep condensation following gravity and go down into the water trap to prevent patient aspiration
6 things that can happen to patient tracheobronchial tree when humidity deficit is present 1.tenacious secretions 2.decrease bronchial clearance 3.increase viscosity 4.possible atelectasis 5.possible infection 6.possible increase WBC
disadvantages and side effects of aresol therapy 1.increase bacterial infections 2.increase bronchospasm 3.increase body weight
3 things that can be obtained from an ABG 2.pao2 3.paco2
why is ph important to therapist acid base balance of body, lets us know if something is wrong with the body and find out what it is so we can fix it
why is pao2 important how well is pt oxygenating
why is paco2 important how well pt is ventilating
systol vent. contraction
dystol vent. @ rest
if the cuff is too tight what happens to blood pressure High reading
if the cuff is too big what happens to the BP low reading
total cycle time = 60 divided by RR
I time total cycle time/(I+E)
E time Total cycle time - I time
tracheal shifts with pneumothorax away
tracheal shifts with pleural effusion away
tracheal shifts with atelectasis towards
tracheal shifts with emphysema none because it effects both lungs
tracheal shifts with lung tumors towards
tracheal shifts with pneumonia towards
formula for VD/Vt PaCO2-PeCO2/ PaCO2
formula for Vt Ve/Rates
formula for MAP 2Dystol + 1Systol/3
formula for pack years packs per day x years smoked
formula for total flow rate (air + O2) x Lpm
formula for IBW 50 + (2 x height over 5ft)
formula for alveolar Vt Vt-dead space
formula for average VC 65-75 ml/kg
formula for RSBI RR/Vt
what are the 4 capacities preformed in a PFT 1.vital capacity 2.inspirator capacity 3.functional residual capacity lung copacity
what are the 4 volumes preformed in a PFT 1.inspiratory reserve volume 2.tidal volume 3.expiratory reserve volume 4.residual volume
what is the IRV deepest breath possible on top of Vt
what is Vt normal breath
what is ERV exhale as much as possible
what is RV what is left in your lungs after exhale
formula for TLC Vt + IRV + ERV +RV
formula for FRC ERV + RV
formula for IC VT + IRV
formula for VC VT + IRV + ERV
what is VC maximal exhale after maximal inhale
what conditions can affect puls ox readings 1.acrylic nails 2.dark nail polish 3.poor perfusion 4.methemoglobin 5.carboxyhemoglobin
4 things that can affect a patients PO2 1.age 2.FIO2 3.altitude 4.CO2
advair fluticasone propionat and salmeterol or flovent and salmeterol
abuterol names 1.ventolin 2.proair 3.proventil
vanceril beclomethosone
solumedrol methyylpredisolone
how is methylprednisolone delivered 1.IV 2. oral
when is methylprednisolone delivered via IV acute asthma attack
flunisolide aerobid
xopenex levalbuterol
xopenex dosages .63 and 1.25
duo neb ipitropuim bromide and albuterol or ipitropium bromide and fenoterol
atrovent ipitropium bromide
beta agonists peak early and end early
anticholernergics peak late and last longer
patients ability to follow instructions preforms tasks on command
patients ability to say their name orientation to person
patiens ability to know where they are awareness of location
patients ability to know date and time awareness of time
when do CPR on an infant when their HR is less than 60bpm
Created by: Kataleshire
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