TMC general patient care

what are the top 3 methods that are included in smoking cessation?

instruction

group counseling and support

nicotine replacement

what is a physical method of disinfection and sterilization?

steam autoclave

what does ethylene oxide sterilize?

bird mark VII

flowmeters

non disposible resuscitation devices removed from a HIV room

what does cidex disinfect?

method used for reusable plastics like mouth pieces tubing, nebs, humidifiers

what does bleach disinfect?

most appropriate for surface disinfection like equipment surfaces and to clean blood spills

what is a nosocomial infection?

infection acquired at least 72 hours after admission to a hospital or health care facilities

what are biological indicators?

gold standard for sterilization

indicates conditions have been met to assure sterilization

equipment from patients with HIV and Hepatitis should be?

double bagged prior to gas sterilization

what is teh best way to administer aerosolized medication to prevent cross contamination?

meter dose inhaler

what are prevention protocols for VAP

• closed suction system

• oral hygiene

• post-pyloric feeding

• heart elevated 30-45 degrees

• not routinely change circuits

• drain tubing condensate appropriately

• use heated circuits or HME to prevent condensate

• MDI instead of SVN

• stress ulcer prevention

• sedation vacation daily to eval wean/ extubation readiness

what are the goals of pulmonary rehabilitation

decrease perception of level of dyspnea

improve ability to do ADL (activities of daily living)

decrease hospitalization frequency

what can the 6 or 12 minute walk test determine?

if the patient develops cardiac arrhythmia, angina, excessive hypoxemia

when setting up a home care program to assure patient safety what electrical requirements should be met? where should all oxygen systems be kept?

properly grounded 3 prong electrical outlets used for all equipment

circuit breakers should be used instead of fuses

oxygen systems should be kept on the ground floor

what is the criteria to determine if a patient will benefit from oxygen in the home?

• PaO2 less than 55 on room air

• exercise limitation that is responsive to O2 therapy

• pulse ox at rest, exercise and sleep is suggested

• polycythemia or core pulmonale

oxygen cylinders are appropriate for what type of use?

• pt who use small amounts of oxygen intermittently

• use as a back up system when liquid or concentrator is used for oxygen delivery in the home

what are benefits of liquid bulk oxygen systems? what are tehy NOT used for?

• last longer than cylinders, used often in homes

• non electrical, portable units are easily filled for trips

• NOT used as a backup system

what is teh principle of operation for oxygen concentrators?

• electrically powered and have limited portability

• uses molecular sieve that removes all other gasses from room air to concentrate the oxygen

for patient safety what should you instruct patients to do with oxygen concentrators?

• routinely check and change filters

• back up system (cylinder) must be available incase of power failure

if pt states no flow can be sensed from nasal cannula and after bubble test no bubbles are seen what should you check for?

• check power source

• check flow setting

• check humidifier for leaks

• check tubing for leaks, disconnections or obstructions

what should be provided for pt who require ventilation majority of the time at home?

backup ventilator