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NON-SECURED TMC 2
| Question | Answer |
|---|---|
| UMECLIDINIUM/VILANTEROL (anoro ellipta) is a: | DPI requiring rapid inhalation. LABA/ LAMA |
| Pentamidine isethionate (NebuPent) aerosolized side effects: | bronchospasm |
| Surfactant is: ___% protein, and ___% phospholipid: | 7% protein and 85% phospholipid |
| Levalbuterol (Xopenex) is long Rescue or Maintenance? | SABA (rescue) |
| Fluticasone/ Salmeterol (Advair Diskus) is what type of med? | LABA/ ICS |
| Azithromycin (Zithromax) is what type of med? | Antibiotic |
| EXHALED nitric oxide detects: | inflammatory process |
| Dornase Alfa (Pulmozyme) decreases what? and how can it be given? | Decreases the viscosity of sputum. Can be given via VIBRATING MESH neb. |
| Dexmedetomidine (precede) is what kind of med? | Anxiolysis w/out suppressing respiratory drive. |
| What med can be given to patients who are spontaneously breathing that have anxiety? | Dexmedetomidine (precede) |
| Ipratropium (Atrovent) is an _____ to albuterol, if patient is still _______. | Ipratropium (Atrovent) is an ___ADJUNCT__ to albuterol, if patient is still ___WHEEZING____. |
| Salmeterol (severent) is what type of med? | LABA that has a long onset of action. |
| Tiotropium (Spiriva) is what type of med? | LABA |
| Albuterol is what type of med and treats what? | SABA/ treats bronchospasm. *Quick relief not scheduled (PRN) |
| Cisatracurium (Nimbex) relaxes what? | -Non depolarizing skeletal muscle relaxant |
| Morphine is an opioid that acts on ____ and ____ to reduce the feeling of/ emotional response to _____. | Morphine is an opioid that acts on ___RECEPTORS IN BRAIN___ and __SPINAL CORD__ to reduce the feeling of/ emotional response to __PAIN___. |
| Which kind of drug (starts with M) is a Benzodiazepine used as an anxiolytic and amnestetic? | Midazolam HCI (versed) |
| A depolarizing skeletal muscled relaxant w/ rapid onset paralysis: | Succinylcholine chloride (Anectine) * <1 minute after IV admin * Short- Acting (4-6 min) |
| Hypertonic Saline clears: | Mucus |
| Tobramycin (TOBI) is an inhaled ______ and is the standard of care to treat lung infections with these types of patients: ______. | Tobramycin (TOBI) is an inhaled __ANTIBIOTIC____ and is the standard of care to treat lung infections with these types of patients: __CF____. |
| Budesonide is an inhaled steroid used to decrease_____. | inflammation |
| N-acetylcysteine is what kind of med? | mucolytic |
| What do you assess with an OSA patient? | assess their breathing pattern |
| What type of blood gas electrode is used in transcutaneous monitoring? | Stow- Severinghaus |
| Helium analyzer calibrated= | 0% (air contains no helium) |
| When must your blood gas analyzer be calibrated? | at the site before use |
| Advantages of a PICC line? (Positional inserted central catheter); | best for long term IV access, blood sampling |
| Where is the fluid filled transducer positioned? | "Positional Artery catheter transducer" is zeroed to the patient's position: lower than the patient= decrease BP |
| Pressure Support decreases: | WOB |
| NIPPV: best for ____ Patients. | best for COPD patients. |
| Why is NIPPV NOT best for ARDS patients? | Ventilation/ Oxygenation not met. |
| Why is NIPPV NOT best for Drug OD-ers? | They are PRONE TO ASPIRATION |
| Benefits of "Lung Recruitment": | Beneficial for High Plateau Pressures & Severe Refractory Hypoxemia |
| Define "PEAK FLOW": | maximum flow during forced exhalation |
| What is used to determine the strength of muscles used for inspiration? | MIP (maximum inspiratory pressure) |
| Describe an increase in a/W resistance: | Increase in the difference between peak a/W pressure & Plat Pressure |
| What does and "Airway exchange catheter" maintain? | maintains a tract while exchanging ETT. |
| IF: -High Cuff pressure needed -Recurrent Aspiration - Abdominal Distention WHAT is needed? | need a Larger ETT |
| If you increase PEEP, _____ will Increase and this will Decrease _______. | If you increase PEEP, __FRC___ will Increase and this will Decrease ____intrapulmonary shunt___. * this will address hypoxemia |
| If your trach patient is using a vent, what kind of tube do they need? | cuffed tracheostomy tube |
| For your trach patient who needs to speak the cuff needs to be ______. | deflated |
| Fish Tail (negative force) on pressure-volume loop: What needs to be adjusted? | Trigger sensitivity adjustment -> Pt has difficulty triggering a breath |
| If you notice a HIGH PRESSURE ALARM with wide changes in pressure: WHAT IS WRONG? | Not enough flow |
| Water in the circuit will cause Dyssonchrony due to: | auto-Triggering |
| the smaller the ETT = the Increase in: | a/W resistance & WOB |
| Hyperinflation on a pressure-volume loop will cause what? What do you need to do? | "Bird Beaking"; Decrease Vt |
| Describe "End Expiratory Hold": | equilibrates pressure in vent circuit and a/W= estimation of alveolar pressure |
| Auto peep confirmation: | End Expiratory hold |
| Auto PEEP can decrease _____ to Increase ______. | Auto PEEP can decrease _RATE__ to Increase __E-Time____. (allowing more time to exhale reduces air trapped in lungs at end exhalation). |
| A "RSI" -> Rapid sequence induction; where BVM is avoided. Can impair ventilation altering geometry of trachea. | Cricoid Pressure |
| Neck hyperflexion/ extension: | opens a/W to optimize positioning for BVM |
| OPA a/W restores ____ and pulls tongue _____ in an _____ patient. | OPA a/W restores _AIRWAY PATENCY___ and pulls tongue __FORWARD___ in an _UNCONSCIOUS ____ patient. |
| With Excessive PEEP; what happens to the PVR? | Increase in PVR (pulmonary vessels are compressed & blood flow is obstructed) |
| Abdominal Thrust is used to assist patients with ______ to more forcefully _____ out secretions. | Abdominal Thrust is used to assist patients with ___DECREASED RESPIRATORY MUSCLE FUNCTION___ to more forcefully _COUGH____ out secretions. |
| What is the type of catheter the enters the left mainstem and costly? | Coude Cath |
| What would you use for short term humidity? | HME |
| what type of catheter can be occluded w/ large amounts of sputum? | whistle tip cath- 14Fr |
| suction trap used in neonatal care? | DeLee trap |
| ALTITUDE on a fixed wing medical transport with an UNPRESSURIZED cabin can cause: | Hypoxemia |
| When Transporting a patient what must be estimated? | duration of oxygen supply |
| What increases as gas cools? | Relative humidity |
| What is needed for long term humidity? | Heated humidifier |
| Advantages of a PULSE-DOSE-OXYGEN CONSERVING DEVICE? | oxygen delivered during inspiration and no waste occurs |
| Downfall of Liquid Oxygen system: | expensive & requires regular refills |
| Downfall of E-Cylinders: | require regular replacement & supply can be depleted |
| Benefits of Oxygen concentrator: | cost effective, doesn't require refills/ replacements |
| Suction Pressure for CHILD: | -80 to -100 mmHg |
| PBW formula: | male= 50 kg + .9kg (cm height -152) female= 45.5 kg + .9kg (cm height -152) |
| Physiologic Dead Space= | arterial PCO2 and expired PCO2. Bohr equation: {Vd/vt =(PaCO2 - PeCO2)/ PaCO2} |
| P(A-a)O2 mmHg Formula: | PaO2 = FiO2 (Pb -47) - PaCO2/ R |
| What is an adverse reaction of Fiberoptic Brochoscopy: | a/W obstruction |
| What is this called: stimulation of vagal receptors in the tracheobronchial tree causes a rapid slowing of the HR? | Vagal stimulation |
| Capnography "SHARK FIN" | obstruction lung disease shows impaired expiratory air flow w/ a rounded ascending phase that never reaches plateau |
| DNI patients can utilize: | NPPV |
| If a neonate requires an increase in O2 what should you recommnend? | an X-RAY |
| What is a physical condition program? | 6MWT |
| ABG: Respiratory Alkolosis | Decrease Vt |
| Titrating O2 during Exercise: | if Desat (give more O2; 2L - 3L NC) |
| An order must still be placed even if: | the MD notates changes in the care plan |
| Brain death classifications: | PaCO2 > 60 mmHg, increase paCO2 of 20 mmHg/ greater from baseline with no respiratory movement |
| Orthopnea: | Supine distress= CHF patients-> High Fowler's position |
| an OPA a/W is needed when: | the tongue causes obstruction of a/W -this moves the tongue off posterior wall. |
| crossmatch of blood type: | completed with blood loss event |
| What is a value that a CBC provides that is used to calculate O2 delivery? | Hemoglobin |
| CDC airborne precautions: | air purifying or N95 mask |
| CDC droplet isolation precaution for transport in hospital: | patient don surgical mask |
| CDC guidelines when managing disaster is to prioritize : | patients showing of acute respiratory distress. |
| Home CPAP cleaning: | dishwashing soap |
| Urine output: | .5 mL/kg/hr |
| Capnography: Increase & slant in CO2: | emphysema due to prolonged expiration & air trapping |
| a PNUEMOTACHMETER mesaures: | flow |
| a SPIROMETER accuracy is measured with a: | 3 LITER SYRINGE |
| Pre-Op to assess respiratory: | spirometry |
| Chest Tube-> PNEUMOTHORAX location: | 2nd- 3rd intercostal space in mid-clavicular line |
| Chest Tube -> HEMOTHORAX location: | 5th intercostal space at mid-axillary line |
| From the Pulmonary artery catheter; what is the best method to evaluate tissue oxygenation? | mixed Venous analysis |
| retinopathy of prematurity (ROP) cause by: | TOO much O2, always be titrating with neonates |
| Bacterial PNA= | FEVER, Productive Cough, Purulent sputum |
| Describe a CHF patient: | SOB & nonproductive cough |
| cough for a patient with Viral respiratory tract infection: | nonproductive |
| Describe a patient with Allergic Rhinitis: | runny nose, congestion. No fever or sputum production. |
| What does PEP therapy increase: | increases FRC -acts as PEEP/CPAP by exhaling through resistance |
| _____ and _____ effect the O2 concentration delivered in a Self- inflating manual resuscitator. | __FLOW___ and __RESEVOIR___ effect the O2 concentration delivered in a Self- inflating manual resuscitator. |
| If your NRB deflates what do you do? | Increase the flow |
| What can be the result of an arterial puncture not receiving pressure applied? | hematoma (large extravascular blood accumulation) |
| GB= ventilatory impairment; How do you measure? | bedside; VC bedside measurement (serial) |
| What is the result of increasing PEEP? | Hypotension (increases intrathoracic pressure, decreases venous return, decreases preload). |
| A VORTEX sensor spirometer measures: | Flow w/ Time |
| A Bronchoscopy with BAL is a microbiologic analysis obtained and helps differentiate between _______ associated with _______overload or LVF, and ________ associated with _______. | A Bronchoscopy with BAL is a microbiologic analysis obtained and helps differentiate between __HYDROSTATIC PULMONARY EDEMA_____ associated with __FLUID_____ overload or LVF, and ___NON-HYDROSTATIC PULMONARY EDEMA_____ associated with ___ARDS____. |
| IF YOUR PATIENT IS HYPOVOLEMIC WHAT HEMODYNAMIC VALUE WILL BE DECREASED? | CVP |
| A "PCWP" OVER 18 INCATES_______ AND WHAT DO YOU GIVE? | CHF; GIVE O2, PEEP, LASIX, INOTROPIC AGENTS |
| REVIEW TOTAL FLOW CALCULATION-> | |
| ELECTROLYTES WILL BE DECREASED WITH THIS MED: | DIURETICS |
| PEAKED "T-WAVES" IS A RESULT OF TAKING THIS MED: | POTASSIUM |
| LOW POTASSIUM CAUSES: | ALKALOSIS |
| IF YOUR PATIENT IS ON "BETA-BLOCKERS" WHAT MED CAN YOU GIVE FOR BRONCHODILATION? | |
| IF THE AMBU BAG HAS NO RESISTANCE, WHAT SHOULD YOU DO? | REPLACE THE BAG |
| NEVER GIVE MUCOMYST | |
| WHAT MEDS CAN BE GIVEN FOR PAIN? | ANAGELSICS: REDUCE THE SENSATION OF PAIN; RESPIRATORY DEPRESSENT ANESTHETICS: REDUCE THE PERCEPTION OF PAIN |
| ANALGESICS: | |
| ANESTHETICS: | |
| PARALYTICS: | |
| INOTROPIC AGENTS: | |
| DIURETICS: | |
| SMOKERS WILL NORMALLY HAVE HIGH _____. | CO2 |
| CO2 IN NORMAL PATIENTS, SMOKERS, & CO POISONING: | N: <2% S: 4-7% CO: >10% |
| MEDS FOR PATIENTS WITH ASTHMA: !IN ORDER! | FIRST: SABA SECOND: STEROIDS THEN: LABA |
| MEDS FOR PATIENTS WITH COPD: !IN ORDER! | FIRST: SABA SECOND: LABA anticholinergics THEN: STEROIDS |
| WHAT IS A VIBRATING MESH NEB & WHEN IS IT USED? | |
| KNOW PFT CHART: | |
| FEV1/FVC <705 =: | OBSTRUCTIVE DISEASE. USE FEV1 TO DECIDE THE STAGE (SAME AS PaO2 Hypoxemia chart) |
| NORMAL FEV1/FVC & LOW TLC=: | RESTRICTIVE |
| SECRETIONS IN LAYERS: | BRONCHIECTASIS |
| MG/GB WITH LOW "VC", WHAT SHOULD YOU DO? | "MIP" MESAURMENT |
| FiO2 FOR A COPD PATIENT ON VENTILATOR: | 40-60% UNLESS-> CARDIAC ARREST/UNSTABLE (HYPOTENSIVE) =100% |
| PLEURODESIS: | |
| INITIAL/ VENT SETTINGS; WHICH SHOULD BE LOOKED AT FIRST? | FIO2 |
| ett POSITION confirmation= | CXR |
| ett PLACEMENT confirmation: | End Tidal |
| AN UNDEREXPOSED XRAY WILL APPEAR: | WHITER |
| IF YOUR PATIENT IS STILL HYPOXIC ON FiO2 OF 60%. WHAT SHOULD YOU DO NEXT? | GIVE PEEP |
| BRAIN DEATH WITH APNEA TEST: | TEMP CHECK |
| PATIENTS WHO REQUIRE A HIGH Ve: | -EXCESSIVE CALORIC INTAKE (METABOLIC) -INCREASED DEAD SPACE VENTILATION (P.E.) -FEBRILE PATIENT (HYPERVENTILATE) |
| MOST HUMIDITY GIVEN WITH: | HEATED WICK |
| WHAT WOULD YOU USE TO CLEAN A STOMA: | NORMAL SALINE |
Created by:
tumi6472
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