Polysomnography Guidelines and Best Practices, Exams of Nursing

Download Polysomnography Guidelines and Best Practices and more Exams Nursing in PDF only on Docsity! RPSGT EXAM-with 100% verified solutions The purpose of an intentional mask leak is to... Wash out CO2 and prevent rebreathing Recommended guidelines state that HSV can be considered when.... Cheyne Stokes and central Apneas have not been eliminated. What is aerophagia? The swallowing of air What is maxillomandibular advancement? Treatment that involves cutting and advancing the upper and lower jaw bones; enlarging and stabilizing the posterior airway. What is the PRIMARY function of the EPAP setting? To eliminate desaturations and arousals. According to guidelines, how many Hypopneas need to occur in peds pts prior to increasing pressure? 1 What are the AASM guidelines for supplemental O2 during PAP studies? 1lmp during PAP titration when SPO2 is less than or equal to 88% for 5 or more minutes and in the absence of obstructive events. If a pts Apneas are fixed at 10cm, but Hypopneas and snoring still occur at 16cm, what levels of BiLevel should be used? IPAP: 14 EPAP: 10 Which of the following can reduce the effectiveness of CPAP and why: Nasal spray, Alcohol, Anti depressants. Alcohol: impairs arousal response which can lead to longer than normal events and severe desats. Inhibits upper airway activity What syndrome would a pt with COPD and OSA have? Overlap syndrome What are hypoxemia and hypercapnia? Hypoxemia: very low 02 in the blood Hypercapnia: very high CO2 in the blood. What would a patient with both hypoxemia and hypercapnia most likely be diagnosed with? Hypoventilation What is an MWT's MOST important use? Measure patients ability to resist the urge to fall asleep Tricyclic antidepressants, large amounts of caffeine and large amounts of chocolate have been known to trigger what? REM sleep behavior disorder Recommended impedance for eeg and eog 5k ohms The amount of space needed to archive digitized data is MOST impacted by? Sampling rate Cortical activity is best described as Spontaneous arousal Calculate the AHI based on the following data 25 obstructive apneas 5 central apneas 23 mixed apneas 15 hypopneas 48 RERAS 65 arousals 360 min of sleep 11 According to RECOMMENDED guidelines, the minimum duration of a significant leg movement is WHEN REVIEWING A PATIENT'S HISTORY IN PREPARATION FOR A POLYSOMNOGRAM, PHYSIOLOGIC FINDINGS SUGGESTIVE OF HYPOVENTILATION INCLUDE HYPOXEMIA AND HYPERCAPNIA WHEN THE AMPLITUDE OF A SIGNAL EXCEEDS THE PHYSICAL LIMITATIONS OF A CHANNEL THE MOST IMPORTANT ADJUSTMENT THE TECH CAN MAKE TO OPTIMIZE WAVEFORM DISPLAY IS TO DECREASE SENSITIVITY WHEN INTERMITTENT 60 HZ ACTIVITY OCCURS IN THE F4-M1 ELECTRODES DURING REM SLEEP THE BEST IMMEDIATE ACTION WOULD BE TO RELY ON F3-M2 A PATIENT WITH MILD DEMENTIA BECOMES MORE CONFUSED AND/OR AGITATED IN THE EARLY EVENING. THE PATIENT IS MOST LIKELY EXPERIENCING SUNDOWNING THE MOST COMMON METHOD TO MONITOR BLOOD OXYGEN SATURATION DURING POLYSOMNOGRAPHY IS PULSE OXIMETRY THE MOST APPROPRIATE ACTION A TECHNOLOGIST WOULD TAKE WHEN THERE IS CONFIRMED VENTRICULAR TACHYCARDIA GREATER THAN 30 SECONDS IS INITIATE EMERGENCY RESPONSE SYSTEM A PATIENT'S CHART INDICATES THAT THEY USE 30 L/MIN OF OXYGEN AT HOME. THE TECH NOTES THAT THE PHYSICIAN'S ORDERS FOR THE PSG SPECIFIES THE STUDY WITHOUT SUPPLEMENTAL OXYGEN AND TO ADD 1.0 L/MIN OXYGEN IF THE SATURATION IS LESS THAN 89%. THE BEST ACTION FOR THE TECH IS TO CALL THE PHYSICIAN FOR CONFIRMATION WHICH OF THE FOLLOWING IS THE MOST LIKELY EFFECT OF ZOLPIDEM AND ZALEPLON ON SLEEP ARCHITECTURE INCREASED SLEEP LATENCY WHICH OF THE FOLLOWING BEST DESCRIBES A REFERENTIAL MONTAGE THERE IS POTENTIAL FOR ELECTRODE CONTAMINATION ACCORDING TO RECOMMENDED GUIDELINES, THE DEVICE THAT SHOULD BE USED TO MONITOR AIRFLOW AND DETECT APNEA DURING A DIAGNOSTIC STUDY IS ORONASAL THERMAL SENSOR WHICH PROCESS WOULD BE AN ADEQUATE ROUTINE FOR DISINFECTING CUP ELECTRODES AFTER REMOVING ADHESIVE RESIDUE, GEL AND ORGANIC MATERIAL, AND WASHING IN WARM WATER AND MILD DETERGENT SOAKING IN 1: 10 BLEACH AND WATER FOR 10 MIN. WHICH OF THE FOLLOWING WOULD BE MOST IMPORTANT TO DOCUMENT DURING A POLYSOMNOGRAM POSITION CHANGES THE ELECTRODE ARRAY USED FOR RECORDING PHYSIOLOGIC ACTIVITY IS REFERRED TO AS MONTAGE ACCORDING TO RECOMMENDED GUIDELINES, THE MAXIMUM ELECTRODE IMPEDANCE FOR EEG AND EOG RECORDING IS 5000 OHMS ACCORDING TO RECOMMENDED GUIDELINES, UNATTENDED PORTABLE MONITORING CAN BE USED AS AN ALTERNATIVE TO IN LAB TESTING WHEN THERE IS A HIGH PROBABILITY OF MODERATE TO SEVERE OSA WITHOUT COMORBID CONDITIONS A SELF REPORTING TOOL USED TO EVALUATE SUBJECTIVE SLEEP QUALITY AND DISTURBANCE OVER THE PREVIOUS MONTH IS PITTSBURGH SLEEP QUALITY INDEX THE MOST APPROPRIATE SETTING A TECHNOLOGIST WOULD USE TO CONTROL THE FREQUENCY BAND OF WAVEFORMS ON A RECORDING IS THE (LOW FILTER (HIGH PASS FILTER) WHICH OF THE FOLLOWING CAN NEGATIVELY IMPACT ALL BIOELECTRIC CHANNELS CONTAMINATED M1 WHICH OF THE FOLLOWING SUBSTANCES CAN REDUCE THE EFFECTIVENESS OF PAP THERAPY ALCOHOLIC BEVERAGES A PATIENT THAT INTENTIONALLY ENGAGES IN BEHAVIORAL PATTERNS THAT ARE INCONSISTENT WITH SLEEPING WELL IS DEMONSTRATING INADEQUATE SLEEP HYGIENE WHAT IS THE BEST TOOL THAT A PHYSICIAN COULD USE TO MORE CLEARLY EXPLAIN THE RESULTS OF THE SLEEP STUDY AND THE IMPORTANCE OF THERAPY TO A PATIENT HISTOGRAM REAL TIME ACCESS TO PAP COMPLIANCE DATA IS AN EXAMPLE OF EFFICACY MONITORING A PROCESS TO DECREASE FEAR OF ARTIFICIAL CIRCUMSTANCES BY REPEATED AND CONTROLLED EXPOSURE TO A FEARED SITUATION IS DESENSITIZATION WHAT HAS THE LARGEST IMPACT ON ADHERENCE TO PAP THERAPY PATIENT EDUCATION WHICH STATEMENT IS TRUE REGARDING CPAP THERE IS ONE LEVEL OF PRESSURE FOR INSPIRATION AND EXPIRATION SLEEP DEBT CAN BEST BE DESCRIBED AS THE CUMULATIVE EFFECT OF INSUFFICIENT SLEEP ACCORDING TO RECOMMENDED GUIDELINES FOR PEDIATRIC CPAP TITRATION, HOW MANY HYPOPNEAS MUST OCCUR PRIOR TO INCREASING PRESSURE ONE EXCESSIVE WARMING AND HUMIDIFICATION WILL CAUSE WATER TO POOL IN THE CPAP TUBING MAXILLOMANDIBULAR ADVANCEMENT TREATS OSA BY ENLARGING AND STABILIZING THE UPPER AIRWAY DURING A CPAP TITRATION AT 15 CM H20, THE PATIENT IS RESTLESS AND CONTINUES TO HAVE FREQUENT OBSTRUCTIVE RESPIRATORY EVENTS. THE BEST ACTION IS TO CHANGE TO BI LEVEL DC Channel PSG channel derived from an external piece of equipment such as a PAP device or oximeter. Stray Capacitance When electrical signals from external sources interfere w/ signals derived from the pt. Amperes are measured in what units? Coulombs/second Time Axis Horizontal positioning of the pen. Common Mode Rejection The process by which a differential amplifier rejects identical inputs (unwanted signals). Mechanical Baseline Pen's vertical position when the power to the PSG is turned off. Electrical Baseline The vertical positioning of the pen w/ power of PSG turned ON. Capnometer A device used to measure the level of CO2 in a sample of air. Frequency Measured in hertz(Hz) or cycles/second. Paper Speed for PSG 10 mm/sec When a pt. looks towards an EOG electrode it causes what? A positive charge, or downward deflection. Rise Time Amount of time it takes for a wave to reach 63% of its peak. Sensitivity Setting for EEG Channel 7uV/mm or 70uV/cm *In pt.'s w/ low amplitude EEGs, the sensitivity can be adjusted to 5uV/mm or 50uV/cm Filter Settings for Respiratory Effort & Airflow LFF= 0.1Hz HFF= 15Hz