RRT Study Guide: NBRC Q&A on Cardiopulmonary Physiology & Procedures (90 characters), Exams of Occupational therapy

Download RRT Study Guide: NBRC Q&A on Cardiopulmonary Physiology & Procedures (90 characters) and more Exams Occupational therapy in PDF only on Docsity! RRT Study Guide (NBRC) Questions And Answers Four vital functions - correct answer Ventilation Oxygenation Circulation Perfusion Signs - correct answer Objective information Color, pulse, edema Symptoms - correct answer Subjective information Dyspnea, pain, nausea Visual examination - correct answer 1st step in assessment RRT Study Guide (NBRC) Questions And Answers General appearance, sensorium, chest movement, posture, skin color Bedside examination - correct answer 2nd step in assessment Breath sounds, vital signs, chest auscultation, chest percussion, past medical history, cap refill Lab examination - correct answer 3rd step in assessment ABG, CBC, CXR, Lytes Special examination - correct answer 4th step in assessment Urinalysis, gram stain, MIP, VC Edema - correct answer Excessive fluid in the tissue Occurs primarily in arms and ankles RRT Study Guide (NBRC) Questions And Answers Cardiac index: Normal - correct answer 2.5-4.0 for patients of all ages Pectus carinatum - correct answer Anterior protrusion of the sternum Pectus excavatum - correct answer Depression of the sternum Kyphosis - correct answer Convex of the spine (lean forward) Kyphoscoliosis - correct answer A combination of kyphosis and scoliosis Reduced lung volumes Asymetrical - correct answer Unequal Eupnea - correct answer Normal respiratory rate, depth, and rythm 12-20 breaths/min RRT Study Guide (NBRC) Questions And Answers Cheyne Stokes - correct answer Gradually increase then decreasing rate and depth in a cycle lasting from 30-180 seconds Biots respiration - correct answer Increase RR and depth with irregular periods of apnea Kussmaul's - correct answer Increased RR (>20 breaths/min), increased depth, irregular rhythm, breathing sounds labored Diabetic ketoacidosis Evidence of difficult airway - correct answer Short receding mandible Enlarged tongue (macroglossia) Ascites - correct answer Accumulation of fluid in the abdomen RRT Study Guide (NBRC) Questions And Answers Caused by liver failure Normal urine output - correct answer 40 mL/hr (approximately 1 Liter/day) Normal Body temp - correct answer 37˚ C (98.6˚ F) Normal PR - correct answer 60-100 A change of more than 20 bpm is an adverse reaction (call nurse) Normal RR - correct answer 12-18 Normal BP - correct answer 120/80 HTN - correct answer > 140/90 RRT Study Guide (NBRC) Questions And Answers Gram stain - correct answer + or negative; cocci or rods; Streptococcus - correct answer Common type of bacteria associated with pneumonia Sputum culture - correct answer Matures sputum culture, then tests sensitivity to antibiotic therapy Acid-fast testing - correct answer Used after a gram stain to detect TB Decreased FEV1/FVC - correct answer Obstructive disease Decreased FVC - correct answer Restrictive disease Normal ABG values - correct answer pH: 7.35-7.45 RRT Study Guide (NBRC) Questions And Answers PCO2: 35-45 PO2: 60-80 Bicarb: 22-26 BE: 2-6 Radiograph - correct answer Low density tissue (radiolucent) - Lung tissue High density tissue (radiopaque) - Bone Computed tomography (CT) - correct answer Can visualize great deatail by cross- section MRI - correct answer Useful in evaluation of chest pathology Advantage in vascular structure imaging RRT Study Guide (NBRC) Questions And Answers Vt - correct answer The volume of air which moves in and out of the lungs Removes CO2 and replenishes O2 Elasticity - correct answer Physical tendency for an object to return to an initial state after deformation (Hooke's law) Vital capcity - correct answer Preformed with a respirometer Normal: 70 ml/kg Muscle weakness: 10-15 ml/kg Maximum inspiratory pressure (MIP) - correct answer Maximum output of the inspiration muscle Normal 10 Vent: Tidal volume - correct answer 6-10 ml/kg IBW RRT Study Guide (NBRC) Questions And Answers Pulse oximetry - correct answer Measures arterial blood oxyhemoglobin saturation levels VD/VT - correct answer Provides an index of wasted ventilation Capnography normals - correct answer Used during general anesthesia and mechanical ventilation PaCO2 = 40 torr PetCO2 = 30 torr EtCO2 = 3-5% Increase in PeCO2 or PetCO2% would indicate what? - correct answer Decrease in ventilation (ventilatory failure) Decrease in PeCO2 or PetCO2% would indicate what? - correct answer Increase in ventilation RRT Study Guide (NBRC) Questions And Answers Decreased perfusion (pulmonary embolism, hypovelemia) True or False: During CPR the PetCO2% should decrease - correct answer F Co-oximeter/hemoximeter - correct answer Normal COHb: 0-1% COHb for smokers: 2-12% CO poisoning: >20% More accurately measures COHb and O2Hb Trancutaneous PO2 and PCO2 measurement - correct answer Temp of 32-43 C improves capillary blood flow (perfusion) Electrode site should be changed every 4 hrs. If erythema occurs electrode should be moved RRT Study Guide (NBRC) Questions And Answers Calibration is done on room air (PaO2 = 150 torr, PaCO2 = 0 torr) and with a zeroing solution Air leaks will increase the TcPO2 to read higher than the PaO2 There are 3 factors that control blood pressure - correct answer Heart, blood, Vessels Heart: BP - correct answer Pump that creates the BP, changes in the PR and contractility will affect the BP Decrease in contractility will decrease BP Heart: BP drugs - correct answer Chronotropic drugs (Atropine) increase HR B-blockers or B-antagonsits (atenolol, propranolol, Labetalol) Blood: Bp drugs - correct answer Excessive fluid (increase pressure): treat with diuretics (lasix) RRT Study Guide (NBRC) Questions And Answers Normal HR - correct answer 60-100 If the R-waves are between 3 and 5 boxes, then the rate is normal CVP-right atrial pressure - correct answer Swan ganz catheter Normal 2-6 mmHg QRS complex - correct answer ECG: Tachycardia - correct answer Oxygen ECG: 1st degree heart block - correct answer Long PQ interval ECG: Bradycardia - correct answer Oxygen, Atropine RRT Study Guide (NBRC) Questions And Answers ECG: 2nd degree heart block (Mobitz type 1) - correct answer PQ gets longer and longer until QRS is dropped ECG: 2nd degree heart block (Mobitz type 2) - correct answer Random P waves ECG: 3rd degree heart block - correct answer P and QRS waves are completely disjointed and random ECG: Atrial flutter - correct answer Sawtooth ECG: Atrial fibrillation - correct answer P wave quivers randomly ECG: Premature ventricular contractions - correct answer Oxygen, Lidocaine, Amiodarone ECG: Ventricular tacycardia - correct answer Pulse present: Cardiovert Pulse absent: Defibrilate, CPR RRT Study Guide (NBRC) Questions And Answers Epinephrine, Amiodarone Pulmonary artery pressure - correct answer 25/8 mmhg at rest, 14 mean 30 mmhg during exercise is a sign of HTN Wedge pressure - correct answer ECG: Ventricualr fibrillation - correct answer Completely irregular Defibrillate, CPR Epinephrine, Amiodarone Asystole - correct answer Confirm in 2 leads first CPR, Epinephrine RRT Study Guide (NBRC) Questions And Answers It has been 5 minutes since your patient delivered her baby. The infant is crying weakly and is curling his arms and legs. He is pink all over with a pulse of 90 and weak respirations. What is his APGAR score? - correct answer 6 After assisting in the delivery of a newborn the infant is pale and limp, has a slow heartbeat but shows some respiratory effort. What APGAR score would you give this infant? - correct answer 2 You just delivered a baby boy. His body is pink, but his hands and feet are blue. Vital signs are P110, R rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His APGAR score is? - correct answer 7 A newly delivered infanthas a pink trunk and blue hands and feet, pulse rate of 60 and does not respond to your attempts to stimulate her. She also appears to be limp and taking slow, gasping breaths. What is her APGAR score? - correct answer 3 One minute after birth, your newborn patient is actively crying in response to your bulb syringe. His body is pink, RRT Study Guide (NBRC) Questions And Answers and he is moving his extremities which are blue. His heart rate is 110. What is the newborns APGAR score? - correct answer 9 Starting at which number on the APGAR score should you need to start resuscitation efforts? - correct answer 6 Transillumination - correct answer When pneumothorax is suspected If + for pneumo a light halo will appear around the point of contact Infant normal HR - correct answer 110-160 Infant normal temp - correct answer 36.5 Diagnosing sleep apnea - correct answer Polysomnogram (Sleep lab) RRT Study Guide (NBRC) Questions And Answers L/S Ratio - correct answer The amount of Lexithin and sphingomyelin found in the amniotic fluid > 2:1 = Mature lungs Term infant weight - correct answer >3000g Pre-term weight - correct answer 1000g (28 weeks) Dubowitz and Ballard method - correct answer Gestational age 40 normal <40 pre-term >40 post-term Infant BGL - correct answer >30 RRT Study Guide (NBRC) Questions And Answers Chest percussion: Resonant - correct answer Normal lungs Chest percussion: Flat - correct answer Atelectasis Chest percussion: Dull - correct answer Fluid-filled Chest percussion: Tympanic or hyperresonant - correct answer Pneumothorax Adventitious - correct answer Abnormal breath sounds Pleural friction rub - correct answer Coarse grating raspy or crushing sound TB, pneumonia, cancer Recommend steroids and antibiotics RRT Study Guide (NBRC) Questions And Answers Crackles (fluid) - correct answer Coarse: Suction or instruct to cough Medium: Bronchial hygiene Fine: Oxygen, PPV, Lasix Wheeze - correct answer Unilateral: FBAO (bronchoscopy) Stridor - correct answer Supraglottic swelling: Epiglottitis Subglottic swelling: Croup Tx: Topical decongestant (racemic epinephrine) Heart sounds: Abnormal - correct answer Recommend ehocardiogram BP - correct answer Normal 120/80 RRT Study Guide (NBRC) Questions And Answers Systolic: 90-140 mmHg Diastolic: 60-90 mmHg Normal X-ray - correct answer Hemidiaphragms are rounded (dome- shaped) Right hemidiaphragm is higher that the left (liver) Trachea is midline, bilateral radiolucency Sharp costophrenic angles Head of clavicles should be level Radiograph exposure - correct answer Underexposed: Visualize the interverterbral discs Over exposed: Image will show black lung RRT Study Guide (NBRC) Questions And Answers 2) Deflate the cuff and the patient to cough 3) Remove the tube Extubation complications: Severe respiratory distress and/or marked inspiratory stridor - correct answer Reintubate the patient Extubation complications: Moderate distress/stridor - correct answer Oxygen, cool mist aerosol, racemic epinephrine, heliox therapy Moderate distress/stridor: Mild distress/stridor, soar throat - correct answer PRovide humidity, oxygen and /or racemic epinephrine as necessary What reasons should the tracheostomy tube be changed - correct answer Tube is obstructed (unable to pass suction catheter, remove tube, ventilate, and insert new tube Punctures cuff What substance do you clean trach's with - correct answer Hydrogen peroxide RRT Study Guide (NBRC) Questions And Answers Fenestrated tube - correct answer Tracheal button - correct answer Placed in stoma after trach tube is removed Used to maintain stome (tracheostomy opening) Extended tracheostomy tube - correct answer Designed to accommodate variation in the distance from the skin to the trachea Jackson trach tube - correct answer Metal trach tube Bivona cuff - correct answer Foam filled cuff Tracheal speaking devices - correct answer Cuff must be deflated Attaches to tracheostomy tube RRT Study Guide (NBRC) Questions And Answers Larygectomy - correct answer Surgeon removes larynx Laryngectomy tubes - correct answer Doesn't have an inflatable cuff Replace with endotracheal tube if PPV is required Suctioning indications - correct answer Accumulated secretions Obstructed airway Depressed cough Nasal suctioning hazards - correct answer Trauma to mucosa (most common)- Lubricate catheter, use gentle technique Contamination- Use aseptic technique RRT Study Guide (NBRC) Questions And Answers Extrapulmonary air (air outside the lungs) - correct answer Pneumoperitomeum, pneumomediastinum, pneumopericardium FBOA - correct answer Radiograph for locating air-trapping FBAO are radiolucent and cannot be seen on x-ray Asymmetrical chest movements - correct answer Uneven expansion of chest wall during inhalation Pleural effusion, consolidation Tracheal deviation - correct answer Pathology occurs inside the lung: Deviation toward pathology Pathology occurs outside the lung: Deviation away from pathology Pulsus paradoxus - correct answer Significant reduction in pulse strength during inhalation RRT Study Guide (NBRC) Questions And Answers Pulsus alterans - correct answer Succession of strong and weak pulses LOC - correct answer What's your name (1) Do you know were you are (1) What is the current season (1) A&O x 3 = Patient is alert Radiology: ET tube - correct answer Radiology: Pneumothorax - correct answer Displacement fissures toward collapsed lung Heart shifts away from injury Tracheal deviation RRT Study Guide (NBRC) Questions And Answers Radiology: Pulmonary edema - correct answer Radiology: Alveolar disease - correct answer Infiltrates, air bronchograms ARDS - correct answer Bi-lateral white out Ground glass Heart normal size CHF - correct answer Increased vascular markings Increased heart size Computed tomography: Pneumothorax - correct answer RRT Study Guide (NBRC) Questions And Answers Expiratory reserve volume (ERV) - correct answer The maximum volume of additional air that can be expired from the end of normal expiration Residual volume - correct answer The volume of air remaining in the lungs after maximal expiration pH 7.45 pCO2 26 HCO3 16 A. Normal B. Respiratory acidosis fully compensated C. Respiratory alkalosis fully compensated D. Metabolic alkalosis fully compensated - correct answer C pH 7.28 pCO2 40 HCO3 18 A. Respiratory acidosis without compensation B. Respiratory alkalosis with partial compensation C. Metabolic alkalosis with partial compensation D. Metabolic acidosis without compensation - correct answer D RRT Study Guide (NBRC) Questions And Answers pH 7.50 pCO2 29 HCO3 24 A. Normal B. Respiratory acidosis with compensation C. Respiratory alkalosis without compensation D. Metabolic alkalosis with partial compensation - correct answer C pH 7.48 pCO2 28 HCO3 20 A. Respiratory alkalosis with partial compensation B. Respiratory alkalosis with complete compensation C. Metabolic alkalosis without compensation D. Metabolic alkalosis with complete compensation - correct answer A pH 7.21 pCO2 60 HCO3 24 A. Normal B. Respiratory acidosis without compensation C. Metabolic acidosis with partial compenation D. Respiratory acidosis with complete compensation - correct answer B pH 7.38 pCO2 38 HCO3 24 A. Respiratory alkalosis RRT Study Guide (NBRC) Questions And Answers B. Normal C. Metabolic Alkalosis D. None of the above - correct answer B pH 7.48 pCO2 42 HCO3 30 A. Metabolic acidosis without compensation B. Respiratory alkalosis without partial compensation C. Respiratory alkalosis with full compensation D. Metabolic alkalosis without compensation - correct answer D pH 7.33 pCO2 60 HCO3 34 A. Normal ABG values B. Respiratory acidosis without compensation C. Respiratory acidosis with partial compensation D. Respiratory acidosis with full compensation - correct answer C pH 7.33 pCO2 60 HCO3 34 A. Normal ABG values B. Respiratory acidosis without compensation C. Respiratory acidosis with partial compensation RRT Study Guide (NBRC) Questions And Answers breathing (ventilation) and circulation (perfusion) in all areas of the lungs Cardiopulmonary stress testing: results - correct answer EKG SpO₂ VO₂: 250 ml R values: 0.8-9.5 Respiratory quotient - correct answer Vc = Volume of CO₂ released Vo = Volume of O₂ consumed Intracranial pressure - correct answer Pressure of 15-20 mmhg compress the capillary bed and compromise microcirculation Chest tube - correct answer Tube placed in the pleural space from outside the chest wall RRT Study Guide (NBRC) Questions And Answers Indications: Pneumothorax, empyema, hemothorax, hydrothorax Pulmonary capillary wedge pressure (PCWP) - correct answer 4-12 Central venous pressure (right arterial pressure) - correct answer Preload 2-6 Mean arterial pressure (MAP) - correct answer 120/80 Pulmonary artery catheter: Troubleshooting - correct answer Pressure dampening occurs when the monitor does not the normal dicrotic notch and the catheter is somehow obstructed Empyema - correct answer Puss in the pleural space Hemothorax - correct answer Blood in the pleural space RRT Study Guide (NBRC) Questions And Answers Hydrothorax - correct answer Fluid in the pleural space Echocardiogram - correct answer Uses sound waves to produce images of your heart Can identify abnormalities in the heart muscle and valves Smoking history: Pack-year - correct answer 4 packs/day x 10 years = 40 pack years Environmental respiratory factors - correct answer Work: Construction (dust), esthetician (chemicals), Home: Pet dander, mold, 2nd hand smoke Daily living: Pollution, allergens Lateral neck radiograph: Epiglotitis - correct answer Thumbprint sign RRT Study Guide (NBRC) Questions And Answers Active expiration - correct answer High and variable expiratory flow pattern Airway secretions - correct answer Sawtooth pattern Auto cycling - correct answer When RR increases suddenly without patient input (exhaled volume and minute ventilation decrease) Typically occurs due to a leak Spontaneous breathing trials - correct answer Discontinuation of ventialtory support of breathing, which allows the Pt. to spontaneously breath (5-10 min.) Several times interspersed throughout the day 1-4 hour rest period between sessions Apnea monitoring - correct answer Alert clinicians of recurrent apnea, bradycardia, and hypoxemia RRT Study Guide (NBRC) Questions And Answers CPAP/NPPV titration study - correct answer In-lab sleep study used to calibrate CPAP and NPPV Tracheal tube cuff pressure - correct answer 20-30 cm H₂O Sputum induction - correct answer Ultrasonic nebulizer induces patient to cough up a sputum specimen Usually Mycobacterium TB or Pneumocystis carinii pneumonia (PCP) MetaNeb Bronchoscopy (endoscope) - correct answer Insertion of a visualization instrument into the bronchi Used to inspect, remove objects, collect samples, and place devices RRT Study Guide (NBRC) Questions And Answers Broncoalveolar lavage - correct answer Sterile salin is lavaged through the ET tube or bronchoscope and recovered fluid is quantitatively cultured Exhaled gas analysis: CO - correct answer Measured with an electrochemical sensor Reported in patients with asthma, rhinitis, and cystic fibrosis NO (FENO) - correct answer Released from epithelial cells of the bronchial wall during inflammation Can support a diagnosis of asthma when other evidence is lacking Thoracentesis - correct answer An invasive procedure to remove fluid or air from the space between pleura and the wall of the chest Needle is inserted RRT Study Guide (NBRC) Questions And Answers Inserted anatomically with lubricant Head-tilt chin lift - correct answer Airway during CPR Jaw thrust - correct answer Airway during CPR (suspected neck fracture) Manual resuscitation bag (self inflating) - correct answer Provide 95-100% O2 @ 15 Lpm If a manual resuscitation bag fills rapidly and collapses easily on minimal pressure, what should the clinician do? - correct answer Check the inlet valve When there is a problem, do not attempt to fix, find another form of ventilation Mouth-to-valve mask ventilation device - correct answer Delivers 16-17% O2 RRT Study Guide (NBRC) Questions And Answers V.A.N.E. - correct answer Valium/Versed (sedative) Atropine (bradycardia) Narcan (Narcotic overdose) Epinephrine (Asystole) Sellick maneuver - correct answer Check cricoid pressure to assess risk of aspiration Cuff pressure - correct answer 25-35 Assessment of tube position - correct answer Inspection- Look for bilateral chest expansion CXR- 2-6cm above carina or at the aortic knob/notch (best indicator) RRT Study Guide (NBRC) Questions And Answers If the light on the laryngoscope doesn't work, what should you do? - correct answer Tighten bulb (some bulbs are on the handle rather than the blade) Change blades Check batteries Magill forceps - correct answer Used for nasal intubation Endotracheal tube sizes - correct answer Pre-term infants: 2.5-3.0 Full-term infants: 3.0-3.5 Adult males: 8.0-8.5 Adult females: 7.0-7.5 Complications of intubation - correct answer VAP RRT Study Guide (NBRC) Questions And Answers Atelectasis Consolidation - correct answer Solid white area Pneumonia/pleural effusion Hyperlucency - correct answer Extra pulmonary air COPD, asthma attack, pneumothorax Vascular markings - correct answer Lymphatics, vessels, lung tissue Increased with CHF Absent with pneumothorax Diffuse - correct answer Spread throughout RRT Study Guide (NBRC) Questions And Answers Atelectasis/pneumonia Opaque - correct answer Fluid, solid Consolidation of white stuff Pulmonary edema: Terminology - correct answer Fluffy infiltrates Butterfly pattern Batwing pattern Pulmonary edema: Description - correct answer Diffuse whiteness Infiltrate in shape of butterfly Pulmonary edema: Treatment - correct answer Lasix (Diuretics RRT Study Guide (NBRC) Questions And Answers Atelectasis: Terminology - correct answer Patchy infiltrates Platelike infiltrates Crowded pulmonary vessels Crowded air bronchograms Atelectasis: Description - correct answer Scattered densities Thin-layered densities Atelectasis: Treatment - correct answer Lung expansion therapy (SMI, IPPB, CPAP, PEEP) ARDS or IRDS: Terminology - correct answer Ground glass appearance Honeycomb pattern RRT Study Guide (NBRC) Questions And Answers Pulmonary embolus: Treatment - correct answer Heparin Streptokinase TB: Terminolgy - correct answer Cavity formation TB: Description - correct answer Often in upper lobes TB: Treatment - correct answer Antitubercular agent Bronchograms - correct answer Injection of radiopaque contrast medium into the tracheobronchial tree EEG - correct answer Measures electrical activity of the brain Evaluation of sleep disorders RRT Study Guide (NBRC) Questions And Answers Pulmonary angiography - correct answer High clinical suspicion for pulmonary embolism Inconclusive V/Q scan and/or CT scan Cardiac catherization - correct answer Percutaneous coronary intervention (PCI) angiography ICP monitoring - correct answer Normal value: 5-10 mmHg Recommend initiating treatment if ICP > 20 mmHG Therapy to reduce ICP - correct answer Hyperventilation: Target PaCO2= 25-30 torr Treat JVD: Keep head of bed elevated ≥30˚; minimize straining or coughing Sedation and analgesia: Narcotics (benzodiazepines) RRT Study Guide (NBRC) Questions And Answers Osmotic agents (remove fluid from the brain): Mannitol, hypertonic saline Cerebral perfusion - correct answer Normal: 70-90 mm Hg Exhaled nitric oxide (FEno) testing - correct answer Decrease in FEno = Decrease in airway inflammation Exhaled carbon monoxide (FEco) testing - correct answer Non-smokers (normal): <7 and certainly under 10 CBC: Normal - correct answer 4-6 mill/ml Hemoglobin: Normal - correct answer 12-16/100 ml of blood Hematocrit: Normal - correct answer 40-60% WBC: Normal - correct answer 5,000-10,000 RRT Study Guide (NBRC) Questions And Answers Mucoid (white/gray): Chronic bronchitis Yellow: Bacterial infections Green: Gram negative bacteria; bronchiectasis Brown/dark: Old blood, aerobic lung infection Bright red: Hemotysis Pink frothy: Pulmonary edema Sputum analysis: Culture - correct answer Identifies the bacteria present Takes 48-72 hr. Sputum analysis: Sensitivity - correct answer Identifies what antibiotics will kill the bacteria Takes 48-72 hrs RRT Study Guide (NBRC) Questions And Answers Sputum analysis: Gram stain - correct answer Identifies gram - or + Takes 1 hr Sputum analysis: Acid-fast stain - correct answer Identifies mycobacterium TB Activated partial thromboplastin time (APTT): Normal - correct answer 24-32 sec. Troponin - correct answer Protein found in myocardial cells Levels > 0.1 are at high risk for MI or death Brain natriuretic peptide (BNP) - correct answer Normal: <100 Elevated levels indicate CHF RRT Study Guide (NBRC) Questions And Answers Oscilloscope - correct answer ECG monitor Holter monitor - correct answer Portable EKG Electrophysiology of the heart - correct answer SA node (pacemaker): Hearts electrical impulse QRS complex: Ventricular depolarization T wave: Repolarization 10mm = 1 millivolt MI diagnosis - correct answer Right axis deviation (RAD) Occurs in left ventricle Right ventricular hypertrophy diagnosis - correct answer Right axis deviation RRT Study Guide (NBRC) Questions And Answers Increaseing flow will decrease volume (because of turbulance) Bird Mark 7: Troubleshooting - correct answer Loss of pressure: Leak, insufficient flow Excessive pressure: Obstruction, Excessive flow Fail to cycle into inspiration: Adjust sensitivity, tight seal around mouthpiece Fail to cycle off: Leak, fenestrated trach tube open Pressure does not rise normally: Insufficient flow CPAP: Purpose - correct answer Improve oxygenation Support oxygenation at lower FiO2 RRT Study Guide (NBRC) Questions And Answers Nasal CPAP - correct answer Useful with neonates since they are obligate nose breathers CPAP: Troubleshooting - correct answer Loss of pressure: Leak, insufficient flow Increased pressure: Obstruction, if excessive pop-off valve venting will occur Bronchial hygiene: Indications - correct answer Accumulated or retained secretions Ineffective cough Ciliary dysfunction Cystic fibrosis Bronchiectasis Bronchial hygiene: Hazards - correct answer Unstable cardiovascular system RRT Study Guide (NBRC) Questions And Answers Unstable pulmonary system Unstable post-operative status Untreated TB Bronchial hygiene: Body positions - correct answer Prone, supine Fowlers/semi fowlers: Hypoxic, obese, dyspnea, post-op, pulmonary edema Trendelenburg: Hypotension Lateral fowlers: Dyspnea, obese Lateral flat: Prevent aspiration Chest percussion technique - correct answer Cupped hand position Rhythmic RRT Study Guide (NBRC) Questions And Answers If whistling occurs: Oxygen flow is excessively high or kinking in tubing Heat moisture exchanger humidifier/hydroscopic condenser humidifier/artificial nose - correct answer Absorbs heat and moisture from patients exhaled air Medications that can be administered by SVN - correct answer Short acting beta agonists (albuterol, levalbuterol) Inhaled corticosteroids (fluticasone, budesonide, triamcinolone) Antibiotics (tobramycin) Small particle aerosol generator (SPAG) - correct answer Treats respiratory syncytial virus RSV Metered dose inhaler (MDI) - correct answer Must be able to understand and cooperate Used to treat asthma and COPD RRT Study Guide (NBRC) Questions And Answers DPI - correct answer Keep dry to avoid caking or clumping Modify aerosol therapy - correct answer Change type of equipment- ultrasonic nebulizers are used to treat thick secretions Adjust temperature of aerosol- If thick secretions occur Nasal cannula - correct answer Delivered FiO2: 0.24-0.45 Flow: 1-6 L/min (Fio2 increases 4% for every 1L/min) Initial device for COPD, stable RR and VT Simple mask - correct answer Delivered FiO2: 0.40-0.55 Flow: 6-10 L/min Flow must be at least 6 liters to flush out exhaled CO2 RRT Study Guide (NBRC) Questions And Answers Non-rebreather mask - correct answer Delivered FiO2: 0.21-1.0 Indications: Mixed gas therapy (He/O2 and CO2/O2) Has 3 one-way valves If bag collapses increase the flow T-piece (Brigg's adapter) - correct answer Delivered FiO2: 0.21-1.0 T-piece troubleshooting: Aerosol dissapears - correct answer Increase the flow Add more reservoir tubing Set up a device to provide more flow (blender, tandem set-up, change flowmeter) Trach collars (masks) - correct answer Delivered FiO2: 0.21-1.0