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wwallace rt test 2

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show 10 to 20 cmH2O  
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show 10 to 25 cmH2O  
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What type Pt benefit most for IPV   show
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What is an IVP   show
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show mechanical insufflations exsufflation, artificial cough machine, used mostly for pts with neuromuscular, usually at home, press plus 30 to 50 1 to 3 secs then neg 30 to 50 2 to 3 secs, oral nasal mask or trach  
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show neuromuscular ie muscular dystrophy myasthenia gravis etc. caustion with spinal shock and avoid abdominal distention with decreased insufflations pressure  
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8 complications of CPT and actions to be taken   show
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What action should be taken for pt who has potential for hypoxemia during CPT   show
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show stop, return to resting position, give 100 percent O2, call doc  
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show stop, return to resting position, call doc  
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What action should be taken for a pt who has a pulm hemorrhage during CPT   show
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show stop, use care return to resting position, call doc  
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show stop, clear airway (suction prn) admin O2, return to resting position, call doc  
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show stop, return to resting position, admin or increase O2, call doc, admin bronchodilators  
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show stop, return to resting position, admin or increase O2, call doc  
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4 complications of PEP   show
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show 1. Full inspiration followed by breathing at low lung volume to unstuck periph 2. Breathing at low to middle volumes collects mucus in middle airways, 3 evacuation, middle to large volume then huff  
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show no absolutes, sinusitis, ear infection, epitaxis (nose blead, recent head or face surgery  
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Frequency range for high frequency chest wall oscillation   show
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show 15 hz for flutter and 1.6 to 3.75 hz for IPV  
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Describe directed cough   show
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What is manually assisted cough   show
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Describe staccado cough   show
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show open glottis, say huuufff, used in CF, bronchiectisis and emphysema  
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4 phases of a cough and what happens in each phase   show
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show irritation cns, inspiration pain or restriction, compression surgery or nerve damage, expulsion obstruction weakness copd  
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Absolute pre and post assessments for postural drainage   show
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show explain Huff, inspiration larger thatn normal, but not full, active exhale but not forcefull, pap of 10-20 (use nuemometer), I:E is 1 to 3 10 to 20 breaths if they are still alive, 2 to 3 huffs repeat 4 to 8 times or 20 minutes  
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show active cycle breathing 1. relax and control breathing then 3 or 4 expansion breaths, 2 repeat, 3 repeat then 1 or 2 huff coughs relax control and done  
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show ineffective cough, absent or increased sputum production, lobored breathing, decreased BS, crackle, rhonki, tachypnea, tachycardia, fever  
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show 1.6 to 3.75 hz  
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Who controls percussive cycle in IPV   show
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How long does the vest therapy usually last   show
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Vest therapy may not be as effective as postural drainage or percussion in what pt   show
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show dangling  
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clinical signs observed with retained secretions   show
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show tender areas, site of trauma or surgery or bony spot  
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Normal airway clearance requires   show
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Mucociliary clearance mechanism   show
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Ciliated epithelial cells move secretions   show
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Why is the cough important   show
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The 4 distinct phases of a normal cough are   show
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Abnormal airway clearance is   show
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show increase WOB, air trapping, over distention, and V/Q mismatch (vent/perfusion imbalance)  
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Which one of the 4 phases of a normal cough can retained secretions interfere with ?   show
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show anesthesia, cns depression  
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Mechanisms impairing the cough inspiration phase   show
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Mechanisms impairing the cough compression phase   show
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Mechanisms impairing the cough expulsion phase   show
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Diseases associated with abnormal clearance of mucus   show
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Most common conditions affecting cough reflex are   show
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show to mobilize and remove retained secretions with the ultimate goal of improving gas exchange and reducing WOB  
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show acutely ill with copious secretions, acute respiratory failure with retained secretions, acute lobar atelectasis, and V/Q abnormalities caused by lung disease  
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show COPD, pneumonia and uncomplicated asthma  
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show CF, bronchiectisis, ciliary dyskinetic Syndromes and chronic bronchitis  
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show 25 to 30 mL or one fluid ounce  
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What are the best documented preventive uses of bronchial hygiene therapy   show
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show postural drainage and percussion vibration therapy  
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show 1 postural drainage, 2 coughing and expulsive techniques, 3 PAP adjunct (PEP, CPAP and EPAP), 4 high frequency compression oscillation (vest and flutter) 5 mobilization and exercise  
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The 3 types of postural drainage are   show
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Turning   show
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show severe diarrhea, agitation, increased ICP, decreased BP, dyspnea, hypoxia, arrhythmias  
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Proning and acute lung injuries   show
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Plumbing problems and turning   show
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Postural drainage is   show
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How long should the position be held in postural drainage   show
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show 25 -30 mL/day (1 fluid ounce or 1 shot glass)  
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show identify lobe or segment, position pt, avoid aspiration wait 1.5 hrs after food, coordinate treatment with pain meds, explain procedure, take baseline (HR, RR, SPO2, BS), check wiring tubing ect rail up, pt comfortable, restore pt posit,document/follow up  
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Initial assessment of need for bronchial hygiene therapy from medical records includes   show
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Initial assessment of need for bronchial hygiene therapy from Patients include   show
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Percussion and vibration refers to   show
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Documentation and follow up includes   show
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show mimics spontaneous cough, helps voluntary control reflex, compensate for physical limits  
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What is the most effective way to clear the central airways   show
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show cilia  
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What are the three important factors for good patient teaching   show
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show place pt in sitting position, shoulders rotated inward, head and spine slightly flexed, forearms relaxed or supported, support feet (raise head of bed if needed)  
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show good deep inspiration, bear down against glottis (straining like stool)  
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Manually assisted cough   show
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show (HUFF cough) a modification to the directed cough, one or two forced expirations of middle to low lung volumes with out closure of glottis, followed by diaphragmatic breathing and relaxation  
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show FET including breathing exercises, and thoracic expansion.  
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ACB sequence   show
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show big expansive inhalation with relaxed exhalation (may include percussion, vibration or compression)  
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show repeated cycles of breathing control, thoracic expansion and huff or FET  
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Autogenic drainage is   show
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Mechanical insufflation exsuffation   show
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PAP adjuncts   show
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PEP   show
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show improves distribution of inspired volume, prevents airway collapse, generates pressure distal to mucus obstruction  
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Contraindication to PEP   show
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show no more than 20 mins, active but not forcible breathing  
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What is an effective alternative to postural drainage and percussion that a pt can perform independently with few side effects?   show
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show disassembled after each use and rinsed in water wash in soap every 2 days and disinfect by soaking in 1 to 3 solution of vinegar and water for 15 mins dry and reassemble  
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Created by: williamwallace
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