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If you hear a low pressure alarm, what do you look for? Leak
On an Arterial BP waveform on on Inspiration the systolic BP is 120 and expiration is 135; this is described as: Pulsus Paradoxus
If the HR during an SBT is increasing than you should what? Return to previous settings
Use a ______ for blood samples to establish an _______ shunt. (central) catheter; intrapulmonary
What is the main goal for a patient who has CF? Mucous mobilization is the goal
5 indications to give fluid: nausea, vomiting, tachycardia, bradypnea, hypotensive
If your baby has Q3H eating orders & there are Q4H CPT orders; when would you give the treatment? give 1 Hr after feedings
There is a sudden loss of consciousness in your patient; what is the RT's main goal? and how would you do it? Secure a/W patency, head tilt/ chin lift
If your Pt has SpO2 82% w/ increased WOB and the family wants CMV but they are DNR/DNI: what would you recommend? NPPV
When monitoring ETCO2 and there is a fall of 10 in over 24H; what is a reason why? Increased RR * Increased RR = decrease ETCO2 and vice versa
Central Sleep Apnea Tx: BiPAP
Narcotic induced hyperventilation reversal (DRUG) ______: Narcan
If your patient is mechanically ventilated / intubated and is Anxious, and biting on tube what DRUG would you recommend? Propofol
A pt with chronic bronchitis is congested and presents with a non-productive cough; what would you add to their tx? Add PEP therapy
ECG lead "V4" placed? left mid clavicular line
NRB reservoir bag collapses on inspiration what do you do? Increase Flow
Threshold resistor to exhalation valve: Replace flow resistor
If you have an asthmatic pt on a vent and they are given a bronchodilator. How would you know if it is effective? you will see a decrease in PIP's
while suctioning in-line and your patient becomes tachycardic; what should you always do prior to suctioning? Increase FiO2
What type of IV is used for Levophed? Central venous (CVP catheter)
normal CUFF pressure: 20-25 mmHg 25-35 cmH2O
ETT depth: Oral/Lips: Nares: Oral/Lips: 21-25 cmH2O Nares: 26-29 cmH2O
If you notice that you are frequently suctioning a patient who is on a ventilator what can you add? add closed circuit sxn catheter
Unequal breath sounds are clinical findings of: Pneumo
SXN pressure for an adult? 120; (-120)
If your pt is receiving a 70/30 helix mixture, without SOB & tachycardic: what do you recommend? titrating to 80/20 mixture * this is less O2
Loss of O2 can sound which alarms to go off_____ & the ventilator will alarm for: O2 zone alarm; Low O2 alarm
This score ____ determines the neonates gestational age: Ballard
"I can't breathe when I Lay down" is what kind of dyspnea? Orthopnea
Smoke Inhalation. Give ______: 100% O2 -NRB
You need to change the trach tube; you must first: deflate the cuff
Disadvantage of portable liquid oxygen system: EXPENSIVE; runs out quickly??
Uses for Lidocaine during bronchoscopy: anesthetic; give if pt coughs during procedure
In an unpressurized aircraft with an intubated patient; what is critical to monitor during transport? a patients PULSE OXIMETER; SpO2
for an Intubated patient who presents with trachea midline, decreased expansion of the left chest, and left BS diminished: what should you FIRST assess? ETT position
a hypothermic trach pt needs ______ % of humidification which is relative to ______ degrees. 100%; 37
Describe the NORMAL function of a Chest Tube drainage system: if there is an increase in PIP this indicates: H2O levels fluctuate with breathing; obstruction
how to properly use a DPI: inhale forcefully, exhale normally. EC
how to properly use a MDI: slow deep breath, exhale normal, WAIT 1 minute in between
VOCP: importance from most to least: Ventilation, Oxygenation, Circulation, Perfusion
V-Fib with No pulse: Defib
This diagnostic test of the chest can identify a pnuemo: diagnostic chest percussion
Resonance = air; hyperresonance =_____ increased amount of air
A patient is Young, and presents w/ an acute onset of Left chest pain, SOB with Equal BS, tachycardia, and Desaturation. This would indicate: Pulmonary Embolism
why is an ABG best at the radial artery? collateral blood flow present
HFOV initial frequency for a neonate: 10 Hertz
A CXR would confirm the placement of a ________ catheter placement. Subclavian
Your patient is unresponsive to verbal stimuli but passes the SBT; what do you do next? EXTUBATE * NBRC WILL EXTUBATE THE PATIENT; THEY COULD BE RESPONSIVE TO SXNING BUT NOT VERBAL & THAT'S OKAY FOR NBRC!!!
Frequency of quality control for blood gas analyzer: CLIA standards (8 hours)
Recommendations to position your patient who has Right LL atelectasis to improve oxygenation: Left Lateral decubitus (this is a POSITION)
Airplane Scenario! Patient will present with : Pulmonary embolus *Change in barometric pressures causes change in intrathoracic pressure
Which humidifier is effective in achieving absolute humidity? Heated Passover humidifier
A healthy Ejection Fraction: ____% (<50-_____%) 60% (<50-75%) *less than this think cardiac issues
Apnea ALARM Time test set @ __ to __ seconds: 20-30 seconds
For VAP protocol you recommend this type of lavage: mini-BAL lavage
Flail chest would present with _______ movement of the left chest: Asymmetric
For a COPD pt; what are some goals of pulmonary rehab? improve exercise tolerance
After intubation the EtCO@ detector turns ________ and gives _____% EtCO2. yellow; 5% EtCO2
If your pt presents with severe bronchospasm you would give _______. Albuterol
VD/VT formula= ______ - PeCo2/ _______ PaCO2-PeCO2/PaCO2
How would you diagnose Chronic Bronchitis: monitor daily expectorated sputum
If your patient has muscle weakness and fails weaning you would run this LAB test: electrolytes test
How would you clean a SVN (at home): detergent
a 6MWT is based upon: SpO2 (desats)
If you ADD mechanical deadspace what will change and will NOT change? Ve will NOT change; PaCO2 will increase
A tube inserted falsely into the LUMEN can cause: subcutaneous around neck/face POST TRACH
How would you instruct your patient to breath during a DPI tx? rapid inspiration, blow maximal inspiration volume, end inspiration hold
you would need this medical personnel for a patient with a language barrier? medical interpreter
A thoracentesis is recommended for _______. Pleural effusion "air up; midclavicular, fluid down; midaxillary "
your patient is unconscious with a neck injury and you need to improve manual ventilation; you would recommend this a/W: OPA; oropharyngeal airway insert
You would notice presence of Auto-Peep on this waveform: Flow
you notice the sternocleidomastoid & anterior scalene muscles being used: this indicates: increased WOB
Your patient has a trach and there is noticeable vibration through chest on inspiration & expiration. What should you do? suction the patient
There is a decreased MAP and Increased urine output; this would indicate and increased cardiac ______ CI cardiac index (ASKKKKKKK)
Devices for infant INO: HFNC, HFOV, vent.
a CXR asymmetrically spaced around sternum= rotated patient
If you increase the inspiratory flow, what will then decrease? I-Time
A patient on PCV and the vent fails to cycle to expiration; this = leak in circuit (circuit leak)
in a Flow inflating bag, the bag doesn't fill during exhalation= total flow
you notice BUBBLES (in the chest tube) at the END of INSPIRATION; this indicates a _____ leak. Pleural leak
Persistent Vomitting can cause ______. Alkalosis
Use a PRESSURE MANOMETER with _____ patients. Respiratory muscle strength/ neuro patients.
You would REPLACE ELECTROLODES and RECALIBRATE if the value of ABG analyzer control solution is __________. out of range
This type of analyzer measures accuracy of air/oxygen blender: Polygraphic Analyzer
A Bronch is most useful with a patient who has LOBAR ATELECTASIS
Proper depth of insertion of NPA: tip of earlobe to the tip of the nares
You notice asymmetrical chest wall movement and absent right BS. You would recommend: Needle Decompression
If you notice that a ALLENS TEST ON RIGHT PALM STAYS PALE (failed test), where would you obtain the sample? Try the LEFT PALM
Your Pt presents with Hemoptysis. A CT scan is done, Nodule found, what can assist with this Dx? Bronchoscopy
A PT presents w/ fever, chills, SOB, cough, bronchial BS. What would their LL-AP-CXR show? Increased density with air bronchograms (think Pneumonia)
To drain the APICAL segment/ UPPER lobes of both lungs . What position of drains would you recommend? Semi-fowlers Drains * remember gravity fluid drains DOWN
If you are unable to SXN your trach patient. What do you do next? Replace inner cannula
If there is NO blood flow on LEFT & SHUNT in RIGHT arm. Where else can you get the ABG from? Dorsalis Pedis (foot)
ETT positioned tip: 5 cm above the carina
MVV maneuver instruction: breathe deep & rapidly for 12 seconds
Following ABG collections; wash your _______. hands
An increase in alveolar deadspace would = _______ in PeTCO2 values. Increase
Decreased PaCO2, Increased P(A-a)O2 during exercise testing= ______ limitations to _______. pulmonary limitations to exercise
Post Trach tube insert/change could CAUSE: subcutaneous around neck/face
Created by: tumi6472
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