HLTH 408 Comprehensive Respiratory Therapy Review

Question-and-Answer style flashcards covering RT scope of practice, aerosol devices, lung expansion therapy, airway clearance, chest tubes, capnography, HBOT, and filtration principles.

Define an aerosol in respiratory care.

A suspension of solid or liquid particles in a carrier gas.

List two factors that influence aerosol deposition.

Particle size and humidity (others: flow rate, device technique).

What device delivers a pressurized, metered dose of medication and often requires coordination?

Pressurized Metered-Dose Inhaler (pMDI).

State one advantage and one disadvantage of pMDIs.

Advantage: portable and fast; Disadvantage: technique-dependent/needs coordination.

Why are spacers or valved holding chambers used with pMDIs?

They decrease oropharyngeal deposition and improve pulmonary delivery.

How does a valved holding chamber differ from a simple spacer?

It contains one-way valves that hold aerosol until inhalation begins.

What activates a Dry-Powder Inhaler (DPI)?

The patient’s inspiratory flow (breath-actuated).

List two drawbacks of DPIs.

Performance depends on adequate inspiratory flow; sensitive to humidity.

Name the three major categories of DPI designs.

Single-dose, multi-dose blister, and reservoir DPIs.

Which nebulizer type uses compressed gas to generate aerosol?

Jet nebulizer.

Describe how mesh nebulizers create aerosol.

Medication is forced through a vibrating mesh containing microscopic holes.

What key limitation do ultrasonic nebulizers have?

Aerosol output can be altered by drug viscosity/saline concentration.

What does SVN stand for and what is a primary drawback?

Small Volume Nebulizer; relatively inefficient and time-consuming.

Define atelectasis.

Collapse or closure of alveoli within the lung.

Differentiate gas-absorption versus compression atelectasis.

Gas-absorption: blocked airway prevents ventilation; compression: external pressure (e.g., pleural effusion) collapses alveoli.

What creates lung expansion during therapy?

A pressure gradient between alveolar pressure and transthoracic pressure.

Give two common postoperative causes of atelectasis.

Sedation, pain, or mucus plugs.

Why is early mobilization recommended post-surgery?

It improves ventilation, mobilizes secretions, and reduces atelectasis risk.

How frequently should incentive spirometry be performed while awake?

10 sustained-maximal inspirations per hour.

When is IPPB indicated over incentive spirometry?

When a patient cannot or will not use IS effectively or needs short-term positive pressure assistance.

What is the primary goal of CPAP in lung expansion therapy?

Maintain positive airway pressure throughout the respiratory cycle to keep alveoli open.

State one benefit of High-Flow Nasal Cannula (HFNC).

Delivers heated, humidified oxygen at high flows to improve oxygenation and reduce work of breathing.

What is breath stacking and why is it used?

Sequential inspiratory efforts without exhalation to increase lung volume and recruit alveoli.

Why is removal of retained secretions important?

To prevent infection, airway obstruction, and subsequent atelectasis.

List two indications for oral suctioning with a Yankauer tip.

Visible secretions or audible gurgling/obstruction.

How do you measure insertion depth for nasopharyngeal suctioning?

From the tip of the nose to the earlobe (tragus).

Give the safe suction pressure range for an adult.

100–150 mmHg.

Contrast open versus closed suctioning systems.

Open: new sterile catheter each pass; Closed: inline catheter remains in ventilator circuit for repetitive use.

What is the rule of thumb for selecting catheter size for suctioning an ETT?

Twice the internal diameter (mm) of the ETT, then choose the next smaller French size.

Name three sterile methods for obtaining sputum samples.

Induced sputum, tracheal aspirate, or bronchoscopy (using a Luken’s trap).

What keeps the lungs inflated under normal conditions?

Negative pressure in the pleural space relative to atmospheric pressure.

Define pneumothorax.

The presence of air in the pleural space causing lung collapse.

Describe a tension pneumothorax.

A life-threatening condition where intrapleural pressure rises, causing mediastinal shift and cardiovascular compromise.

Differentiate transudative versus exudative pleural effusions.

Transudative: from systemic factors (e.g., CHF); Exudative: from local pathology (infection, malignancy).

Which intercostal space and line are typical insertion sites for a chest tube draining air?

Second intercostal space, mid-clavicular line (anterior chest).

What is the purpose of the water-seal chamber in a three-bottle chest drainage system?

Acts as a one-way valve allowing air/fluid to exit while preventing backflow into the pleural space.

What does continuous bubbling in the water-seal chamber indicate?

An air leak in the system or patient.

Define capnometry.

Numeric measurement of the concentration or partial pressure of exhaled CO₂ (EtCO₂).

What are the two common sampling methods for capnography?

Mainstream (sensor at the airway) and sidestream (gas aspirated to sensor).

Identify phase III of a normal capnogram.

The alveolar plateau, representing mostly alveolar gas.

How does hyperventilation affect EtCO₂?

It decreases EtCO₂ values.

What capnography pattern suggests esophageal intubation?

A near-flat line with no significant CO₂ waveform.

Define Hyperbaric Oxygen Therapy (HBOT).

The therapeutic administration of 100% oxygen at pressures greater than atmospheric in a sealed chamber.

List three accepted indications for HBOT.

Air embolism, carbon monoxide poisoning, decompression sickness (also necrotizing infections and chronic wound healing).

Name two potential risks of HBOT.

Barotrauma and oxygen toxicity (others: claustrophobia, fire hazard).

Which federal body regulates hyperbaric chambers in Canada?

Health Canada.

List four filtration mechanisms used in respiratory filters.

Inertial impaction, diffusion, interception, and electrostatic attraction.

Why might electrostatic filter performance decline in humid conditions?

Humidity reduces electrostatic charges, decreasing particle capture efficiency.

State one advantage of mechanical (pleated) filters over electrostatic filters.

Consistent filtration performance regardless of humidity.

When are hydrophobic filters preferred in ventilator circuits?

When moisture repulsion is needed, especially with humidified gases.

What particle size range must ventilator filters effectively capture to block most bacteria?

Approximately 0.5–2.0 microns.

Why are viruses harder to filter than bacteria in respiratory circuits?

Viruses are smaller (~0.02–0.3 microns) and require high-efficiency filtration mechanisms.