Respiratory Therapy Review

Flashcards based on respiratory therapy lecture notes.

Air filled airways surrounded by infiltrated lungs.

Air Bronchogram

Auscultation of the mitral valve

5th Intercostal Space, Left Midclavicular Line

2nd Intercostal Space, Right sternal border, medial end

Auscultating the aortic valve

Auscultating the pulmonary valve

Medial end

Deep sulcus sign

Pneumothorax

Cephalization of the pulmonary blood flow

Pulmonary Edema

Predominance of edema in the hilar regions of both lungs with less edema

Bat wing

A patient with Patent Ductus Arteriosus will show what sign

Cyanosis

What heart pathology is present when there is a machinery-like cardiac murmur?

Patent Ductus Arteriosus

What makes the patient ineligible for pulmonary rehab?

Alzheimer’s disease

Vesicular breath sounds on equal duration of inspi and expi sounds

FALSE

Nail clubbing presented with the . Except?

Angle flattens out and decreases as severity increases - WRONG because it should INCREASE LATER ON AND AS SEVERITY INCREASES TO MORE THAN 180 DEGREES

Upon assessment, patient is unstable when systolic blood pressure drops to:

< 90 mmhg

Lung hyperinflation (or COPD) cause flattening of the diaphragm that produces a paradoxical inward movement of the lower rib during inspiration.

Hoover's sign

Discontinuous breath sound

RALES OR CRACKLES

MEDIAL AND LATERAL DIVISION OF THE LUNGS

HORIZONTAL FISSURES SEPARATES THE UPPER AND MIDDLE LUNG

LACK OF FALL OF JVP DURING INSPIRATION

Kussmaul's sign

X-RAY HORIZONTAL LINE IN THE LUNG PERIPHERY THAT EXTEND TO THE PLEURAL SURFACES ASSOCIATED WITH WHICH OF THE FF:

KERLEY B - PATHOGNOMONIC SIGN OF PULMONARY EDEMA

INCREASED AP DIAMETER CONFIRMED WHEN YOUR COSTAL ANGLE IS:

90 DEGREE ANGLE

PX WITH PATENT DUCTUS ARTERIOSUS WILL WHICH OF THE FF. ASSESSMENT FINDINGS:

MACHINERY LIKE MURMUR

AUSCULTATE MACHINERY LIKE MURMUR

PATENT DUCTUS ARTERIOSUS

WHICH OF THE FOLLOWING CAUSES SIGNIFICANT INCREASE OF RESONANCE UPON PERCUSSION

PNEUMOTHORAX

WHICH OF THE FOLLOWING SHOULD BE ASSESSED USING PALPATION, WITH THE USE OF FINGERS?

RIGHT VENTRICLE - THE CONTRACTION IS HERE

IN THE PLEURAL EFFUSION, LOCULATION OF PLEURAL FLUID IS MOST COMMONLY SEEN IN?

EXUDATIVE PLEURAL EFFUSSION

DEEP SULCUS SIGN IS SEEN IN PATIENTS WITH:

PNEUMOTHORAX

CEPHALIZATION OF PULMONARY BLOOD FLOW IS OFTEN CAUSED BY:

PULMONARY EDEMA

BAT WING

PREDOMINANCE OF EDEMA IS IN THE HILAR REGION OF BOTH LUNGS WITH LESS EDEMA IN THE LUNG PERIPHERY

WHEN YOU ASSESS MITRAL VALVE, THE BELL OF THE STETHOSCOPE IS:

5TH ICS LEFT MIDCLAVICULAR LINE

Patients who are enrolled in an exercise testing program should be on NPO for how long?

D.) 8 hours

performed postural drainage, the positions should be held for how long?

C.) 15-30 minutes

What should be the postural drainage position for clearing the secretions in the superior and inferior segments of lingula?

A.) Supine, left side up, foot of the bed elevated 12 inches

What should be the postural drainage position for clearing the secretions in the Antero medial segment of Left lower lung and Anterior segment of Right lower lung?

A.) Supine with foot of bed elevated 20 inches

Which of the following are most useful in determining restrictive lung disease?

A.) DLCO, TLC

What should be the postural drainage position for clearing he secretion in the Posterior segment of right upper lobe

C.) Prone, right side up supported by pillows

All of the statements are true regarding incentive spirometry, EXCEPT:

B.) Improves expiratory muscle performance

How frequent should sustained maximal inspiration maneuver be performed per hour?

B.) 5-10 SMI

Rest period between sustained maximal inspiration maneuvers should set at least 30 secs to 1 min to prevent:

D.) Respiratory Alkalosis

Which of the following is the least priority for the RT to discuss with the home care patient?

Pathology of the disease process

Which of the following should be suggested to help the patient conserves his oxygen demands

C.) Pulse dose oxygen system

The following exercises are useful for reconditioning the lower extremities of patients undergoing pulmonary rehabilitation, except:

D.) Rowing machine

The respiratory therapist obtains a vital capacity of 6 ml kg of body weight. The therapist should.

D.) FEV1

Which of the following will best determine a patient's compliance with the smoking cessation program?

C.) Provides improved ventilation before a cough effort

supplemental oxygen should be started to COP patients at what oxygen saturation?

< 83 %

What is the only pharmacological agent that decreases mortality in patients with COPD?

A.) Oxygen therapy

The following are contraindications for Cardiopulmonary Stress testing, except?

Mild pulmonary hypertension

How long should he abstain from salbutamol before starting the test?

12 hours

The following are indications for exercise-induced bronchospasm studies, EXCEPT

C. Patient with intermittent wheezing with a positive bronchoprovocation test

According to the Centers for Disease Control (CDC), tracheostomy tubes should be sanitized using:

D. Vinegar

The goal of treatment in a cardiopulmonary rehab program is ____ stroke volume and ____ heart rate for the same amount of work.

A. Increased, decreased

It refers to the measure of an individual's ability to perform common tasks

A. Functional Capacity

The following categories of disorders are appropriate for respiratory home care, except:

C. Acute restrictive disorder

B. 1,2, & 4

Disadvantages of using compressed 02 cylinders in the home include which of the following? Select all that apply.

Advantages of using compressed 02 cylinders in the home include which of the following? Select all that apply.

A. 1,2, & 3 only

Which of the following would the RT recommend as the solution used to fill a bubble humidifier used for home Oxygen Therapy?

B. Distilled water

1. 40. A home care patient receiving long-term oxygen therapy at 5L/min complains that her non-disposable humidifier is not bubbling properly. Upon inspection of the humidifier, the RT noticed hard white deposits in and around the diffusing element. Which of the following would the RT recommend to this patient?

B. Replace the device and fill with distilled water, not tap water.

1. To help prevent problems with home oxygen therapy, the RT should have the patient or caregiver check all delivery equipment at least how often?

• A. Once a day

What is the most common oxygen delivery system for long-term care?

• D. Nasal Cannula

1. After fitting a pulmo rehab patient with a CPAP nasal mask, you set the prescribed pressure and turn on the flow generator. At this point, the mask pressure reading is 0 cmH20. What is the most likely cause of this problem?

• D. Large system leak

1. The RT has been asked to organize a patient and family education program as part of a discharge plan for a patient requiring home ventilation support. Which of the following areas would the RT cover? Select all that apply.

   • I. Equipment operation and disinfection

   • II. Patient assessment and monitoring

   • III. Airway management and clearance

   • IV. Emergency procedures

1. B. 2 and 4

• A. The patient requires low concentrations of supplemental 02

1. Which of the following conditions is an indication for the application of noninvasive ventilation?

1. Which of the following can benefit most from intermittent use of NIV? 

• A. A patient with muscular dystrophy

1. Relative contraindications for using NIV include all of the following, except

• D. Absence of respiratory muscle activity

1. Oxygen saturation of patients with chronic obstructive pulmonary disease should be maintained at a level of

• B. 88%-95%

1. Which of the following are hazards of IPPB therapy? Select all that apply.

   • 1. Excessive ventilation

   • 2. Increased Cardiac output

   • 3. Decreased ICP

1. A. 1 only

1. A small-group discussion format for pulmonary rehabilitation educational sessions is recommended to foster which of the following? Select all that apply.

   • 1. Group interaction

   • 2. Peer support

   • 3. Group identity

d. 1,2,3

1. What are the indications for the use of the closed suctioning technique in mechanically ventilated patients?

• 1. Positive end-expiratory pressure ≥10 cm H20

• 2. Mean airway pressure ≥20 cm H20

• 3. Hemodynamically stable associated with ventilator disconnection

• 4. Respiratory infections requiring airborne or droplet precautions

• 5. Frequent suctioning (26 times/day)

• c. 1, 2, 4, 5

• d. tuberculosis

1. RT Maria is doing ICU rounds to monitor her patients; she was tasked to do nasotracheal suctioning. Which of the following is not contraindicated in doing nasotracheal suctioning?

1. You have just measured a tracheostomy tube's cuff pressure with a blood pressure-type mercury manometer. The pressure was 17 mmg. What would you recommend?

c. Rechecking the cuff pressure with a Cufflator device

 A 59 kg (130 Ib) woman must be intubated to initiate mechanical ventilation. What size tube should be used?

• c. 7.5-mm ID

1. An artificial airway that provides one lung ventilation so that the non-ventilated lung may undergo a surgical procedure.

• a. Double Lümen Tube

1. You have just measured a tracheostomy tube's cuff pressure with a blood pressure-type mercury manometer. The pressure was 17 mmg. What would you recommend?

• c. Rechecking the cuff pressure with a Cufflator device

 A patient receiving ventilator support is being provided with humidification using a heat-moisture exchanger (HME). The physician orders a bronchodilator drug administered using a metered-dose inhaler (MDI) via a ventilator circuit. Which of the following must be performed to ensure the delivery of drugs to the patient?

• b. The HME must be removed from the circuit during MDI use 

1. A type of tracheostomy tube that is used for mechanical ventilators in preventing aspiration.

• a. Cuffed Tracheostomy tube

1. A stylet with a smooth end used to facilitate the direction of the tube when inserting or changing a tracheostomy tube.

• C. Obturator

1. During the insertion of the oropharyngeal airway, the patient begins to gag or retch during the procedure. Which of the following should the Respiratory Therapist do?

• Remove the airway immediately and reassess the necessity of oropharyngeal airway

An airway tube that bypasses the upper airway and the glottis and, therefore, avoids any potential injury and offers lower airflow resistance.

• d. Tracheostomy Tube

When inflating a cuff of a Laryngeal mask airway, is it important to set the maximum pressure at what level?

• C)60 cmH20

1. To avoid the risk of aspiration after a fiberoptic bronchoscopy procedure, what would you recommend to the patient?

   • 
     

• B. Remain in a sitting position and NPO until sensation returns

A patient exhibits persistent stridor after a fiberoptic bronchoscopy procedure. Which of the following would you recommend?

aerosol therapy with racemic epinephrine

1. Which of the following approaches may be used in weaning a patient from a tracheostomy tube? Select all that apply.

   • 1. using progressively smaller tube

   • 2. using a fenestrated tube

   • 3.using a tracheostomy button

D. 1, 2, 3

1. To minimize the problems associated with pharyngeal aspiration in intubated patients, which of the following could you recommend? Select all that apply.

1. Position the patient in a semi-recumbent position

2. Insert the feeding tube into the duodenum

3. Suction above the tracheal tube cuff

4. Provide continuous aspiration of subglottic secretions.

C. I, II, III, IV

1. Serious complications of oral intubation include which of the following? Select all that apply.

1. cardiac arrest

2. acute hypoxemia

3. Bradycardia

4. Tongue lacerations

B. I, II, III

1. A physician is concerned about the potential for tracheal damage due to tube movement in a patient who recently underwent tracheostomy and is now receiving 40% oxygen through a T-piece (Briggs adapter). Which of the following would be the best way to limit tube movement in this patient?

• D. Switch from the T-piece to a tracheostomy collar.

1. During intubation of an apneic patient, the patient suddenly develops arrhythmias. RT should remove the blade and endotracheal tube immediately and provide:

• C. 100% oxygen via manual resuscitation bag/mask system

1. Removing the tracheal secretions from your adult patient is difficult when you use -60 mmHg of vacuum pressure. What should you do?

• C. Increase the vacuum pressure to -80 mmHg

1. An adult patient is recovering from her neuromuscular disease. She has a standard tracheostomy tube and only requires mechanical ventilation during the night when sleeping. The physician asks for your recommendation about what can be done to enable her to communicate during the day, but be put on the ventilator at night. What would you recommend?

• B. Put a tracheostomy button into her during the day

1. Patients nb w/ hypoxemia due to hypothermia should also be aware of the ff. 

HYPOGLYCEMIA

Head of a neonate contaminated with meconium emerges at birth, the infant has good muscle and  a strong respiratory eff

ONLY ROUTINE MONITORING

Flow volume curve with concave shape on the expiratory tracing-

ASTHMA

 RIGHT MIDDLE LOBE

1. nfiltrate in the lower half of the right lung. Right heart border is obliterated.

1. Patient 42 week infant small for his gestational age.

1. MAS

1. Therapists select a 3.0 mm diameter insertion tube to be used for flexible bronchoscopy.

1. PREPARE THE INSERTION TUBE FOR ATTACHMENT TO THE FLEXIBLE BRONCHOSCOPE

PROVIDE SUPPLEMENTAL O2

1. During a bronchoscopy procedure on a pediatric patient, the therapist notices that SPO2 drops to 90%.

1. Symptomatic LTB and respiratory compromise.

1. RACEMIC EPI

Equals in pich across all regions of the chest, loudest vicinity of the sternum.

TRACHEA

1. Injuries event that's ass. with tracheomalacia.

1. NEONATAL VENTILATION WITH HIGH PRESSURE

1. RSV infection does have little adverse effect on older children but its often life-threatening to a younger child. 

YOUNGER CHILD HAS FEWER RESPI BRONCHIOLES

Infants with atresia seem to lessen when infants cry?

INFANTS BREATH MORE THROUGH THE MOUT

1. Hot potato voice, posterior pharynx reveals a displaced retropharynx.
   

1. RETROPHARYNGEAL ABSCESS

1. ENDOBRONCHIAL COMPRESSION

1. An 11 month old has been treated with bronchodilators for persistent wheezing without a positive clinical response.