O2 Related
Which of the following is NOT considered a high flow device?
A. Tandem setup
B. LVN
C. HFNC
D. They are all high flow
D. They are all high flow.
You arrive to the ED and come across an 18 year old. Her respirations is 36, I:E ratio 1:5, with inspiratory and expiratory wheezing, SPO2 88% on RA. There’s abdominal muscle use and tracheal tugging. What would you do?
LABA Sympathomimetic Bronchodilator - albuterol , levalbuterol
anticholinergic Bronchodilator - iprotropium,tiotropium
corticosteroid- budesonide , prednisone, beclomethasone ,This represents an asthma exacerbation
What kind of therapy would be suitable for a post-op lumbar patient to help with deep breaths and coughs and how frequently? Choose the BEST option
A: IS (10x/hr)
B: Acapella (15x/hr)
C: O2 NC @2L
D: force them to manually cough 5x.
E: SVN 10 minute treatment
A: Incentive spirometer 10x an hour.
(ortho patients love using incentive spirometry to get the anesthesia out of the body, as well as properly expand/exercise the lungs.)
This assessment of a patient reflects severe brain damage. Their positioning is abnormally stiff with bent arms toward body and chest.
What is decorticate posturing.
What does a negative score indicate on the RASS scale? (-4 for example)
A. Calm and alert
B. Deeply sedated, no response to voice, moves to physical stimulation.
C. Drowsy
D. Combative
B. Deeply sedated, no response to voice, moves to physical stimulation.
When is O2 therapy indicated?
For patients with SPO2<90%
and PaO2<60mmHg.
You hear bronchial sounds over pt.’s R middle lobe while assessing. Due to this finding, which condition would you expect?
A.Asthma
B. Pneumonia
C: Emphysema
D:Pleural effusion
E: none, it is normal
B. PNA
Tip:It’s normal to hear bronchial breath sounds over trachea, but over the lung field, it indicates consolidation. One of the quickest giveaways.
(Not used because cost and Same effectiveness can be Achieved with a cheaper aerosol device, and decreases cardiac output if not carefully used)
A: IPPB Intermittent Positive-Pressure Breathing.
Diaphoretic, SOB, tachycardia, tachypnea. Are all symptoms of a:
A: panic attack
B:edema
C: Pulmonary Embolism (PE)
D: influenza
C: PE
Which safety system helps reduce a high pressure gas to a working pressure. Also designed to prevent interchange of cylinders with dissimilar gases.
(Hint: It’s a threaded connection)
American Standard Safety System (ASSS)
This type of gas is known for its approved use in babies/kids, mainly for pulmonary hypertension.
A. Nitric oxide
B: nitrous oxide
C: Heliox
D:Carbogen
A: nitric oxide.
NO
You get called to a room to assess a patient. His RR is 28, HR 82, SPO2 90% on RA. You observe accessory muscle use, he struggles to speak in complete sentences. Has bilateral diminished breath sounds, with an expiratory wheeze with fine crackles. Has COPD. What will you do next?
*Assuming check pt. Chart, wash hands, introduce self and identify/explain to pt.:
Correct his saturation with O2 therapy. (NC 2-3L)
Give a bronchodilator or Duoneb. (Albuterol and Ipratroprium Bromide) administer MDI steroid.(Prednisone, Salmeterol) For inflammation which is common in COPD
This bronchial hygiene therapy consists of a weighted ball resting on a conical seat. It helps to mobilize secretions. Indications are: atelectasis, and routine in cystic fibrosis. Hazards: barotrauma, CV compromise, and hyperinflation.
A:IS
B: Acapella
C: pep therapy
D: flutter valve
D: flutter valve therapy
After the therapy, when the pt. Coughs forcefully, the removal of secretions is facilitated.
What medications would you use on someone who is hypertensive, febrile, and bronchoconstricted?
Metoprolol/amlodipine, Tylenol/Ibuprofen, Albuterol/Xopenex
What is a long acting beta agonist (SABA) used for?
A. Inflammation
B. Bronchospasm
C. airway clearance
B. Bronchospasm
This device provides a precise o2 concentration by mixing air and O2:
A: heliox
B: blender
C: reducing valve
D: concentrator
B: Blender (air to o2)
Physical examination of a pt. With pleural effusion might reveal which of the following?
A. Dec. tactile fremitus
B. Depressed hemidiaphragms
C. Diminished BS on affected side
D: all the above
D. All the above
This type of feeding is specified for patients without a functioning GI tract. Usually delivered intravenously.
Parenteral nutrition
It is for people who can’t get proper nutrition PO, so it bypasses the GI tract completely.
What is the definition of hypoxemia, what are the 4 major causes of hypoxemia, Signs & symptoms, And what are the normal to severe ranges?
Hypoxemia is defined as abnormally low O2 blood concentration.
S&S: dyspnea, tachycardia, cyanosis, LOC, tachypnea, slight hyperventilation, etc.
4: major causes Are :
Shunt, V/Q mismatch, low PaO2, and diffusion impairment.
Ranges: 80-100 is normal, 60-79 is mild, 40-59 is moderate, and <40 is severe.
Which of the following is an abnormal lab value?
A: BUN of 16mg/dL
B: WBC of 14,000 mill/mL
C: RBC of 5 millions/mL
D HCT of 14 gm/dL
B: WBC of 14000 millions/mL —- high values indicate infection.
Normal range is 5-10000
This O2 mask can be used as a substitute for a SM, NC and a PRM
What is an Oxymask?
Low flow mask delivering 24-90% o2 depending on the flow.
As you enter pt. Room to administer a neb treatment, you notice the pt. Is breathing rapidly and is in distress. During physical exam you notice: reduced chest expansion, hyperresonant percussion note on L side, absence of BS on L and a tracheal shift to R. This suggests:
A. L sided consolidation
B: L sided pneumothorax
C. Pleural effusion
D. R ride pneumothorax.
B: Left sided pneumothorax
(Trachea shifts opposite of affected side when has pneumothorax. Hyperresonance is an abnormal percussion sound that is result of air in a closed cavity.)
Indications: upper airway edema from post extinction, bypassed upper airway,.
Hazards: wheezing, bronchospasm, infection, over hydration.
Contraindications: bronchoconstriction, airway hyperresponsiveness.
What would a BUN level of 44 indicate? Is it normal or abnormal? High or low?
The normal range for adults is 6-20mg/dL
a high can indicate kidney disease or injury. It can mean a low blood flow to the kidneys, or a high sugar or blood pressure that affects the kidneys.
(The levels indicate the body’s ability to clear nitrogenous wastes in the form of urea in the urine.)
Who is responsible for on-site surveys at workplaces, ensuring proper infection control, work safety, and ethical practices throughout the facility (example: hospital)?
A: TJC (The Joint Commission)
B: ARC
C: CDC (center for disease control)
D: OSHA
A: TJC
they are recognized nationwide.