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RPC 204 Unit I

This valve will rotate to the off position when a terminal flow of l liter per minute is reached ((the red piece that is on the sensitivity control)) Bennett Valve
The Bennett Valve allows the respirator to be _______________ limited/sensitive. Flow
Adjustment of this control causes automatic cycling (ie. assist/control mode) Rate
With an IPPB, the I/E ratio is initially set at at? 1 to 1.5
What are the available breath per minute rates on IPPB? 0 -70 breaths per minutes
What are the two controls for nebulization? inspiratory and expiratory
The nebulizer operates on what gas source percentage? 100%
True or false: The typical gas source that a nebulizer is ran on is oxygen? TRUE
During a Oxygen Neb treatment on an IPPB, if the source pop offs or begins to hiss during treatment, what would you do? recommend decreasing flow to nebulizer
If you are giving a neb treatment and you do not see mist coming from the treatment, what should you do? increase the inspiration neb dial
A patient is on an IPPB machine and the SPO2 begins to decrease. The air mix function is on and there are no leaks or problems with the machine. What would you recommend for the patient? turn the air mix off to give 100% Oxygen.
True or False: A patient is de-sating and you turn the Air Mix off to provide 100% oxygen. Since it is providing 100% 02, there is no need to adjust the flow? False, With the Air-Mix Off, it would decrease the flow therefore changing the I:E ratio. You would need to re-set the flow to adjust for the changes to the I:E ratio.
What would you adjust If a patient goes apneic? adjust your expiratory time, so it can become or deliver a mechanical ventilation breaths
What would you do as a RT if you have any small leaks around the mouthpiece or mask? What if the leaks are large? adjust the terminal flow to compensate for the leak ((if large leak, look for leak in mask))
What is the usual I:E ratio set for on a COPD patient? set at 1:3 and 1:4
What is the initial pressure set on an IPPB? 10 to 15 cmh20
What is the initial sensitivity set at? -1 to -2
When adjusting pressure, When have you reached a sufficient pressure for the patient? once you hear bilateral air movement in the basses of the lungs
What are the desired outcomes for IPPB Treatment? 1)Absence of or improvement in atelectasis2)Dec resp rate 3)dec fever4)Normal pulse rate 5)Absence of crackles or impr in dim breath sounds 6)Normal chest xray 7)Inc PaO2 & dec PaCO2 8) Inc VC & Pk Exp Flow 9)Normal FRC or VC 10)Inc insp muscle tone
What are the eight major hazards of IPPB therapy as outlined in class? 1)hyperventilation 2)Impeding venous return 3)Exacerbation of brnchspsm 4)Hypoxia due 2 break in mask 02 therapy 5)Inappropriate as sole treatment 4 major lung collapse or consolidation 6)Barotrauma 7)Fatigue 8)Discomfort 2ndary 2 inadequate pain
What are some of the signs or symptoms of hyperventilation on an IPPB machine? 1) Dizziness 2) Tingling of fingers (from excessive elimination of CO2) have patient slow-down respirations (hyperventilation)
Impeding venous return causes a back pressure on the left side of the heart. What are some of the signs/symptoms of this occurring on IPPB therapy? 1) decreased cardiac output 2) Increased intracranial pressure 3) Gastric distention - can cause vomiting/aspiration 4) Pneumothorax 5) Excessive oxygenation and increased air trapping in COPD patients. ((Hi FiO2 can knock out their drive to breath))
What size syringe is contained in the ABG kit? 3-5 cc syringe
What size needle(s) are contained in the ABG kit? 22 gauge x 2 needle (one needle is long than the other, one for the femoral)
List the prepackaged contents contained in an ABG kit? 1)3-5 cc syringe 2)Pre-heparinized – ball of heparin inside the syringe 3)22 gauge x 2 needles (one needle is longer than the other, one for the femoral) 4) Alcohol swab 5)Gauze pad 6)Biohazard bag 7)Misc. items (IE.Iodine, band aid, chart)
What do you Transport an ABG specimen to the run location in? biohazard bag.
How does a patient's temperature affects an ABG reading? With an increase in patient temp: an increase in PO2, PCO2 and a decrease in pH With an decrease in patient temp, would see a decrease in PO2, PCO2, and an increase in pH
What three components comprise the ABG analyzer? o Electronic circuitry o Electrolyte solution o Electrodes
This takes electrical current changes produced in the electrodes and provides a visual display Electronic circuitry
Electronic circuitry uses the changes received from the _________ and converts those changes into a display (picture or visual) Electrodes
The Electrodes are Utilized to measure which values of an ABG? pH, PCO2, PO2
True or False: With the exception of pH, PCO2, PO2, and SPO2, All other blood gas values are calculated False: SPO2 is also calculated.
The pH Electrode is also name? And refers to the ______/_______ balance. Sanz Electrode// Acid Base
The pH Electrode consists of how many electrodes? Are they external or Internal Electrodes? two internal electrodes.
What do the two pH electrodes measure or do? One electrode is used for the sampling and/or measuring of the blood. The other electrode is used as a reference electrode against each measuring electrode and electrolyte solution
PCO2 Electrode is also called ___________ and measures what? Called Severinghause electrode and It measures the pressure of carbon dioxide within the sample
The PO2 Electrode is also called? What does it measure? Called the Clark Electrode and It measures the pressure of oxygen within a sample
True or False: The PO2 Electrode is Labeled as a polarographic electrode? TRUE
What are the four blood gas values that are not measured but are calculated as discussed in class? 1) SaO2 2) HCO3 3) BE 4) TCO2
Most ABG machines are programmed to calibrate how often? every 30 minutes
Most calibrations are used to ensure what? 1) to insure appropriate electronic function of all the electrodes 2) to insure pH, PCO2, PO2 electrodes are functioning correctly
This type of calibration uses low concentration and a high concentration of both ends of the physiological range to be measured 2-Point Calibration
This calibration method is a Multiple-Point Calibration and is used to verify whether the gas analyzer is linear/within range or not. Multiple-Point Calibration (3 or more points)
This calibration process has two separate buffers that provide approximate values of 6.840 to 7.384 buffer pH Electrode
What is the purpose of performing the Modified Allen’s? It is used to ensure that there is adequate collateral circulation or blood flow before performing an ABG.
A 60-90 degree angle is used when getting ABG sample from what location? Brachial artery
When should a sample from the brachial artery be obtained? Should only be used when a sample cannot be retrieved from the radial artery.
This site is the easiest to stick, however it is very painful and deep? The femoral artery
True or False: The Dorsalis Pedis Artery is a large artery that is used often. False
After obtaining ABG how long should pressure be applied to site? for at least 5 minutes. Patients on blood thinners may take longer. In this case, until the blood clots.
List the major hazards discussed when drawing an ABG? 1) Hematoma 2) Cutting of the artery/arterial laceration 3) Hemorrhage-clot breaking lose 4) Vasovagal reaction/nerve response pain can cause a sympathetic nervous system response 5) Losing a limb - the biggest complication
Fill in the Blank: The nervous system has a cluster of nerves that surround the artery, thus when drawing from the radial artery, those nerves can cause tremendous ____. Causing the ________ nervous system response to pain. Pain, Sympathetic
What is the biggest complication to arterial slicing? Loss of limb
What is the biggest complication of drawing an ABG? Slicing of or laceration of the artery
How should a blood gas specimen be collected? Anaerobically
True or False: air bubbles should be expelled immediately. True
What happens to the Ph and the PO2 of a reading if air is not expelled? Why? The PH and the PO2 increase. It is consuming extra oxygen that is in the air bubble.
What happens to the CO2 reading if air is not expelled? It will decrease
Created by: jlsteely
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