Respiratory therapy exam 1

What was the title given to the first health care specialist in the field of respiratory?

Inhaltation therapist/oxygen technician

What is the BLB mask?

Used adminstering oxygen to persons at high altitudes or used for anesthesia

What is the purpose of the Clark electrode?

Measurement of arterial po2/pa02=how in blood

What scientists are linked with the development of the Iron lung?

Phillip Drinker and jack emerson

What scientist developed the water seal spirometer?

Josh Hutchinson

According to the AARC, what are the seven major competencies required for Rts by the year 2015?

1.diagnostics

2.chronic disease state management

3.evidence-based medicine and respiratory care protocols

4.patient assessment

5.leadership

6.emergency and critical care

7.therapeutics

What will happen to the oxygen concentration on a low flow system if a patients minute ventilation increases?

After room air dilutes/o2 decreases fio2 decreases

Who is professionally responsible for the clinical function of the respiratory care department?

Medical Director

What organizational committee reviews respiratory care education programs to insure quality?

AARC (American association respiratory care)

What are the two levels of general practicing in Respiratory Care?

Associates and bachelors

What organization is responsible for credentialing Rts?

NBRC (National Board of Respiratory Care)

What are competencies?

reflects the ability of the student to understand, know, etc.

What organization provides the NPSG for hospitals?

Joint Commission

What is the purpose of the pt interview

1. Obtain health information

2. Determine expectations

3. Provide & clarify information on procedure (including anesthesia)

4. Assess emotional state & readiness ( want to know their expectations about outcomes)

What conditions can cause an increase to breathe?

Kossomals respiration, Cheyenne stokes, Biots respiration

Introduction space which is done approximately 4-12 feet from patient is known as what?

Social space

orthopnea

ability to breathe easily only in an upright position

Platypnea

shortness of breath in the upright position

eupnea

normal breathing

apnea

absence of breathing for more than 19 seconds

Which respiratory disease/conditions is most likely to cause a dry non productive cough?

CHF, pulmonary Fibrosis

sputum

mucous secretion from the lungs, bronchi, and trachea expelled through the mouth

phlegm

thick mucus secreted by the tissues lining the respiratory passages, not compromised by oral secretions

fetid

foul-smelling; putrid sputum

purulent

Sputum containing pus cells

mucoid

resembling mucus

tenacious

Holding fast; holding together firmly; persistent

Term used to describe the coughing up of blood-streaked sputum

Hemoptysis

lethargic

acting in an indifferent or slow, sluggish manner

diaphroesis

excessive sweating, can be caused by fever, severe stress, increased metabolism and acute anxiety

cochexia

"wasting away" muscle loss, weight loss, loss of appetite

tripodding

the sitting position that emphysema patients use when they are in trouble

How to calculate a pack a year history when it comes to smoking

Packxyear

What respiratory condition is usually used to describe a patient in the tripod position?

Severe pulmonary hyperinflation

Normal range for blood pressure

systolic: 100-140 mmHg

diastolic: 60-90 mmHg

What respiratory condition is commonly associated with JVD?

CHF, cor pulmonale

cor pulmonale

serious cardiac disease associated with chronic lung disorders, such as emphysema

CHF

congestive heart failure

systolic pressure

Blood pressure in the arteries during contraction of the ventricles.

diastolic pressure

occurs when the ventricles are relaxed; the lowest pressure against the walls of an artery

barrel chest

a condition characterized by increased anterior-posterior chest diameter caused by increased functional residual capacity due to air trapping from small airway collapse. A barrel chest is frequently seen in patients with chronic obstructive diseases, such as chronic bronchitis and emphysema.

Angina

a condition of episodes of severe chest pain due to inadequate blood flow to the myocardium

What conditions will Shift the trachea?

Tension pneumonothorax/ large pleural effusion

tension pneumothorax

a type of pneumothorax in which air that enters the chest cavity is prevented from escaping

A large pleural effusion commonly demonstrates which of the following findings during a chest assessment?

1. Increased tactile and vocal fremitus

2. Hyperresonant percussion note

3. Diminished breath sounds

4. Tracheal shift

A) 1

B) 2, 3

C) 3, 4

D) 1, 3, 4

C) 3/4

Past Medical History (PMH)

information gathered regarding the patient's health problems in the past

Chief Complaint (CC)

specific symptom or problem for which the patient is seeing the provider today

tracheal shift

• The trachea is pushed to the unaffected (or healthy) side with an aortic aneurysm, a tumor, unilateral thyroid lobe enlargement, and pneumothorax.

• The trachea is pulled toward the affected (diseased) side with large atelectasis, pleural adhesions, or fibrosis.

• Tracheal tug is a rhythmic downward pull that is synchronous with systole and that occurs with aortic arch aneurysm.

pleuritic chest pain

Sharp, stabbing pain in the chest that is worsened by a deep breath or other chest wall movement; often caused by inflammation or irritation of the pleura.

What are some critical elements of a patients past medical history?

Chief complaint, past medical history (pmh), history of present illness(hpi), family/social/environmental history, occupational therapy

Normal respiratory rate

12-20 breaths per minute

Normal heart rate

60-100 bpm

Mean Arterial Pressure (MAP)

pressure forcing blood into tissues, averaged over cardiac cycle

central cyanosis

bluish discoloration of the skin or mucous membranes due to hemoglobin carrying reduced amounts of oxygen

subcutaneous emphysema

The presence of air in soft tissues, causing a characteristic crackling sensation on palpation.

wheezes

continuous high-pitched whistling sounds produced during breathing

stridor

strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx

crackles

(rales) abnormal, discontinuous, adventitious lung sounds heard on inspiration

bronchial breath sounds

loud, high-pitched, hollow sounds normally heard over the trachea and the large bronchi

What are some methods to evaluate effectiveness of O2 therapy?

Decreased WOB increased spo2

WOB

work of breathing

SpO2 (saturation of peripheral oxygen)

abbreviation for the percentage of hemoglobin that is saturated with oxygen in arterial blood as measured by a pulse oximeter

Fi02

INSPIRED CONC OF 02 MEASURED FRACTIONS, BUT MORE COMMONLY IT IS REFERRED TO IN CLINICAL PRRACTICE AS %

02

Oxygen

PIO2

partial pressure of inspired O2

What will an increase in back pressure of an air entrainment port (venti Mask) do tonthe FiO2?

Increase delivered in fraction to inspired fio2

What should the doctors orders for o2 include?

Fio2/liter flow oxygen delivery method

When receiving an order for O2, what should the therapist do first?

Verify order

oxygen toxicity

A serious, even life-threatening condition that occurs if too much oxygen is delivered for too long a period of time.

oxygen toxicity

A condition of excessive oxygen consumption resulting in cellular and tissue damage.

mild hypoxemia

PaO2 60-79 mmHg

severe hypoxemia

PaO2 < 40 mmHg

oropharyngeal airway

a tube inserted through the mouth and the pharynx to establish and maintain airway patency

Compression to ventilation ratio

30 compressions to 2 breaths

moderate hypoxemia

PaO2 40-59 mmHg

Conditions that cause dyspnea

Asthma, COPD, interstitial lung disease, CHF

interstitial lung disease

refers to a group of almost 200 disorders that cause inflammation and scarring of the alveoli and their supporting structures

Asthma

A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing.

COPD (chronic obstructive pulmonary disease)

A group of lung diseases that block airflow and make it difficult to breathe.

Common landmark for second rib

Sternal angle

sternal angle

Ridge between manubrium and body at second rib

Sound present at Suprasternal notch

Tracheal/bronchial breath sounds

suprasternal notch

hollow U-shaped depression just above the sternum, in between the clavicles

Common sound for asthma

Wheezing(high pitched whistle sounds)

stridor

strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx

In what areas may a percussion note of hyperresonance be heard?

Tympanic

Normal value of PaCO2

35-45 mmHg

Stethoscope bell

detects low-frequency sounds such (but not limited to) as heart murmurs

Stethoscope diaphragm

high pitched sounds lungs

Obtunded

Less than full alertness (altered level of consciousness), typically as a result of a medical condition or trauma.

Thoracic landmarks

Clavicle, suprasternalnotch, sternal angle, fourth rib

vocal fremitus

assessment of the lungs heard by a stethoscope on the chest wall with certain spoken words

sterile

no living microbes

cross-contamination

the process by which bacteria or other microorganisms are unintentionally transferred from one substance or object to another, with harmful effect.

vector transmission

transmission of an infectious agent by an insect, arthropod, or animal

aseptic

free from disease-causing microorganisms

CPGs

clinical practice guidelines

What numerical value determines hypoventilation?

PaCO2 35-45

What is the purpose of the nasal pendant?

Reduces the o2 supply flow necessary to achieve adequate o2 sat

What is the minimal amount O2 flow for a simple mask?

5ml