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Demi - Ch. 35
Demi - Ch. 35: Humidity & Bland Aerosol Therapy
| Question | Answer |
|---|---|
| What is the primary role of the upper airway? | Heat-moisture exchange |
| What is the most effective humidifier/heater on the body? | Nose |
| What puts stress on the lower airway in order to provide heat and moisture? | Artificial airway |
| Administration of dry medical gases at flows greater than 4 L/min. are necessary. True/False | True |
| Following intubation of a patient, it is indicated that the patient needs humidification and warming of inspired gases. True/False | True |
| What is a device that adds molecular water to gas? | Humidifier |
| Humidifiers work by... | Evaporating water from a surface. |
| The higher the temperature of the gas in the humidifier... | The more water it can hold. |
| When temperature is increase, potential humidity is also increased. True/False | True |
| Evaporation does not increase as contact time increases. True/False | False (decrease the temperature of gas, the longer it takes to pass through water) |
| What type of humidifier breaks an underwater gas stream into small bubbles? | Bubble humidifier |
| Are bubble humidifiers normally heated? | No |
| The goal of a bubble humidifier is to... | Raise the water vapor content of the gas to ambient levels. |
| What type of humidifier directs gas over a water surface? | Passover (blow-by) |
| What type of humidifier is normally used for mechanical ventilation? | Reservoir |
| What type of humidifier does not have bubbles or aerosol and has a tube coming out the top end? | Wick |
| What type of humidifier allows vapor to pass, but not water? | Membrane (hydrophobic membrane) |
| What kind of patients use a Passover humidifier? | Patients on home CPAP units/neonatal nursery |
| Passover humidifiers have a high efficiency and high exposure time. True/False | False (low efficiency/low exposure time) |
| What type of humidifier deals with Bernouli's principle? | Jet |
| What is Bernouli's principle? | When gas in a tube exerts lateral wall pressure due to the gas velocity |
| What type of humidifier uses a filter? | Heat-moisture exchangers (HME) |
| What type of humidifier is known as the "artificial nose?" | HME |
| HMEs do not add heat or water to the system. True/False | True |
| What does an HME do? | Captures exhaled heat and moisture which is then applied to the subsequent inhalation (holds patient's own heat & water) |
| How often is an HME changed? | Every 24 hours |
| In bubble and passover humidifiers, heat improves... | The water output (absolute humidity) |
| Heating systems are usually used for what type of patients? | Patients with bypassed upper airways and those on mechanical ventilation |
| What is a risk that patients are exposed to when inhaling heated gases? | Airway burns |
| Heated humidifiers can evaporate more than... | 1 L/day |
| To avoid constant refilling, large water reservoirs and gravity feed systems exist. True/False | True |
| How much humidity is recommended for intubated patients? | 30 mg/L |
| Inhaled gas is supposed to be maintained at... | 35-37 degrees C |
| Condensation does not pose any risks to patient/caregivers. True/False | False (it does) |
| Condensation can waste lots of water. True/False | True |
| Condensation can block gas flow through the circuit. True/False | True |
| What risk due to condensation can the patient experience? | Inhalation of condensation |
| What can be used to minimize the risk of inhalation of condensation? | Water traps or heated circuits |
| What does VAP stand for? | Ventilator acquired pneumonia |
| What can cause a bacterial colonization in the circuit? | Built-up condensation |
| Minimizing condensation can help to reduce OR achieve the risk of bacterial colonization? | Reduce |
| What consists of liquid particles suspended in a gas (oxygen or air)? | Bland aerosol |
| What are the most common devices used for bland aerosol therapy? | Large-volume jet nebulizers |
| How are large-volume jet nebulizers powered? What are they connected to? | Pneumatically powered; directly to a flowmeter |
| How does a large-volume jet nebulizer work? | Liquid particles are generated by passing gas at high velocity through a small jet orifice. |
| What is the optimal size for particles passing through the large-volume jet nebulizer? | 2-5 micrometers |
| 0.25 - 1.0 micro meters: minimal settling in the lungs 1.0 - 2.0 micro meters: enter alveoli 2.0 - 5.0 micro meters: deposit/settle to alveoli 5.0 + micro meters: too big to enter airway True/False | True |
| Unheated large-volume jet nebulizers can produce... | 26 to 35 mg/H2O/L |
| Heated large-volume jet nebulizers can produce... | 35 to 55 mg/H2O/L |
| What device is electronically powered and uses a piezoelectric crystal to generate aerosol? | Ultrasonic nebulizer |
| The crystal transducer converts ______________________ into high-frequency mechanical vibrations that produce the aerosol. | radio waves |
| Particle size is inversely proportional to... | Signal frequency (frequency sound waves: 1.35-1.65) |
| Name four types of airway appliances used with large-bore tubing. | Aerosol mask Face tent T-tube Tracheostomy mask |
| Mist tents and hoods are normally used to deliver aerosol therapy to what type of patients? | Infants and children |
| Name one problem that RTs have with mist tents. | Heat and CO2 buildup |
| What do high flows in mist tents help to do? | "Wash out" CO2 and reduce heat buildup |
| Name six problems with bland aerosol therapy. | Cross-contamination and infection Environmental safety Inadequate mist production Over-hydration Bronchospasm Noise |
Created by:
demi.doucet
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