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Demi - Ch. 35

Demi - Ch. 35: Humidity & Bland Aerosol Therapy

QuestionAnswer
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