Posted: July 10th, 2020

Study Guide essay

Quizzes and Final Examination Analysis Info
Ch. Three: Top quality, affected particular person safety and communication
• Evaluation causes of potential areas of risks to victims receiving respiratory care
• Evaluation right technique to lifting heavy objects
• Evaluation organizations liable for top of the range and appropriateness of care given to Medicare beneficiaries
• Evaluation parameters that require monitoring all through ambulation
• Define: Voltage, current, Ohms, Amps
• Organ most delicate shock: Coronary coronary heart
• Goal of grounding electrical gear
• Evaluation how O2 contributes to severity of hearth
• How is static electrical discharge minimized throughout the presence of O2
• RACE: what does it stand for
• Definition of channel in communication
• Nonverbal communication methods
• Talking empathy in course of your victims
• Components that affect outcomes of communication between affected particular person and practitioner
• How do you improve listening talents
• Evaluation communication strategies
Ch. 4: Concepts of an an infection prevention and administration
• % of victims who develop hospital associated infections
• Main provide of an an infection in healthcare
• How do ETT contribute to hazard of an an infection
• What are the prospect parts that contribute to hospital associated an an infection (age, HIV…)
• Evaluation varied sorts of pathogen transmission routes
• Direct vs indirect transmissions
• Distance actually useful to keep away from victims with SARS, COVID…
• Which illnesses are airborne and require airborne isolation and use of N95
• Definition of surveillance
• Required vaccination for hospital employees (consider these you obtained to go to clinic)
• Cleaning and sterilization of equipment: First step is to wash the gear
• Evaluation Cleansing cleaning soap and its use to wash gear
• Evaluation which organisms are destroyed by disinfection brokers
• Evaluation what you may do to your palms after treating victims with C-Diff
• How will we transport victims with infections
• Indication for steam sterilization
• glutaraldehyde (≥2.Zero%) use and indications
• Timeframe for hand washing
• ETO sterilization
• Commonest respiratory gear provide of affected particular person infections
• Ventilator circuit change frequency
• Which organisms are present with poorly disinfected bronchoscopes
• Evaluation types of isolation- what’s transmitted through droplets, direct contact…
• Prevention Bundle
• SVN and associated infections
Ch. 5: Ethical licensed implications
• Definition of ethics/what does ethics try to reply
• Sanctions that apply when one breaks the regulation
• Significance of privateness/HIPAA
• Evaluation AARC code of ethics
• Evaluation phrases: Autonomy, nonmaleficence, Justice, Place fidelity, veracity, beneficence. Malevolent deception, infidelity, double impression, distributive justice, compensatory justice
• Sorts of superior directives
• When can confidentiality by breached
• Consequentialism
• Benefit ethics
• Tort, felony, misdemeanor, litigation, battery, slander, assault, negligence
• Res ipsa loquitur, Respondent superior
Ch. 16. Bedside Analysis of the Affected particular person
• Goal of an RT interview
• Social, personal and intimate home
• Principal questions
• Causes of enhance drive to breathe
• Phrases: orthopnea, platypnea, eupnea, apnea
• Components of an environment friendly cough
• Causes of dry non productive cough
• Phrases: sputum, phlegm, mucus
• Phrases: fetid, mucoid, purulent
• Hemoptysis, hematemesis
• Causes for pleuritic chest ache
• Phrases: angina, myalgia
• Commonest rationalization for pedal edema
• Important parts of a victims earlier medical historic previous, social and environmental historic previous
• What’s diaphoresis
• Causes for tripoding
• Altered sensorium ends in what traits
• What regulates physique temperature
• Causes for hypo and hyperthermia
• Causes of tachycardia, tachypnea, bradypnea, bradycardia
• What’s a differential prognosis
• Causes of pulsus paradoxus
• Common essential sign ranges, causes for will improve and reduces
• Pulse pressure
• Pursed lip respiration indications/benefits
• Central cyanosis
• Causes of tracheal shifts
• Causes for JVD
• Causes of lymphadenopathy of the neck
• Barrel chest
• Phrases: kyphosis, kyphoscoliosis, pectus carinatum, evactum
• Causes for neuro respiration patterns, elevated ICP
• Cheyne stokes, biots, kussmauls, paradoxical
• Traits of an elevated WOB
• Speedy shallow, indicative of atelectasis
• Prolonged exhalation associated to bronchial bronchial asthma, COPD
• Hoover’s sign
• Tactile fremitus, bronchophony
• Subcutaneous emphysema causes
• Auscultation and percussion technique
• Breath sound evaluation
• Phrases epigastric, precordium
• PMI
Ch. 17: Deciphering medical lab information
• Components of a CBC
• Components and what It means to have elevated or decreased WBC rely
• Causes for prime/low Hb
• Causes for prime/low WBC
• Causes for prime/low platletes
• Bands/Segs
• Important values vs reference fluctuate
• Sorts of anemia, MCH
• Ranges for electrolytes: Okay, HCO3, Ca, Cl, Na, Glucose
• Phrases for prime and low electrolytes (ex: hypokalemia)
• Goal of a sweat chloride examine
• Anion gap, causes for metabolic acidosis
• Creatinine what does it signify
• Liver enzymes
• Cardiac enzymes
• Causes for elevated BNP
• Sputum sample and amount of epithelial cells
• Xpert® MTB/RIF in diagnosing TB infections
Ch. 11: Air movement
• Evaluation all lung volumes and capacities
• Main carry out of the lungs
• Evaluation: PA, PBS, PAO, Ppl
• Evaluation all lung pressure gradients
• Evaluation what occurs all through common inspiration and expiration
• Evaluation flooring stress, airway resistance, elastic forces
• Hysteresis
• Presence of surfactant does what
• Compliance: how is it calculated, common values, dynamic vs static
• Causes for will improve and decreased compliance
• Evaluation VC, MIP
• Evaluation airway resistance and causes for elevated RAW, technique, common value
• Poiseuille’s regulation
• Frictional resistance the place does it occur, will improve
• Equal pressure degree (EPP)
• Drive x distance
• Amount-pressure curve traits
• Speedy shallow respiration vs sluggish and deep, causes for each
• Common oxygen consumption p.c
• Regional parts that affect distribution of gasoline throughout the common lung
• How is time mounted computed
• Optimum peep, how is it set
• Biggest indicator for adequacy or effectiveness of alveolar air movement
• Definition of hyperventilation, hyperpnea, hypoventilation
• Alveolar air movement, technique, causes for enhance and cut back
• Resting metabolic CO2 manufacturing and Oxygen consumption in ml/min
• VDphy what is the common value, how will we overcome deadspace
• What can enhance VD/VT
• Modified bohr equation used to calculate lifeless home
• Ve calculation
Ch. 12: Gasoline Change and Transport
• Definition of diffusion
• Amount of PAO2, PaO2, O2 in cells
• Amount of PACO2, PaCO2, CO2 in cells
• Casues for elevated PACO2
• Main determinant of PAO2, technique
• Approx. PAO2 on 100% FIO2 at sea stage
• a/A ratio, PF ratio, A-a gradient/common values
• highest PAO2 whereas respiration room air at sea stage
• gasoline diffusion ought to occur by transversing through what layers (AC membrane, RBC membrane…)
• common values of PO2 and PCO2 in mixed venous blood
• CO2 and CO diffuse earlier than O2 all through AC membrane, what variety of events
• Minimal time period that blood ought to take for pulmonary capillary transit for equilibrium of O2 to occur all through the AC membrane
• Shunting vs Deadspace air movement, V/Q mismatches
• How is O2 and Co2 carried throughout the blood
• CaO2, VO2 and DO2 technique
• Hamburger phenomenon
• SVO2 value
• O2 dissociation curve
• Bohr and Haldane impression
Ch. 36: Pharmacology
• All therapy names and doses, frequency along with:
o LAMA, LABA, SAMA, SABA, ICS, Combination remedy, mucolytics, bland aerosol, vasodilators, anti-infectives, anti-asthma
o Along with: (know generic and mannequin names)
 Atovent
 Spiriva
 Albuterol
 Serevent
 Tudorza
 Trelegy
 Advair
 Symbicort
 Pulmicort
 Flovent
 Anoro
 Aclidium bromide
 Breo Elipta
 Dulera
 Racemic epinephrine
 Xopenex
 Vilanterol
 Arfomterol
 Tobi
 Mucomyst
 Dornase alfa
 Hypertonic Saline
 Indacterol
 Olodaterol
 Qvar
 Survanta
 Performist
 Duoneb, Combivent
 Nitric Oxide
 Ciciesonide
 Leukotrienes
 Arnuity Ellipta
 Pentamidine
 Lloprost
 Asmanex
• Know undesirable unintended effects, indications
• Mode of movement of all remedy
• Receptor web sites: Alpha 1, Beta 1-2, Muscarinic (M1-Three)…adrenergic, anti-cholinergic
• Phrases: Expectorant,Tolerance, Drug administration, pharmacokinetic, pharmacodynamic, bioavailability
• Use of MDI, DPI, SMI’s, holding chambers, SVN’s. Mesh nebulizers
• Advantages of inhaled therapy route
• Catechol O-methyltransferase (COMT), phosphodiesterase, cholinesterase
• Use of I-neb
Ch. 37: Airway Administration
• Indications for suctioning, suction technique/course of steps, pre suction strategies
• Uncomfortable unintended effects/problems with suctioning
• Instruments wished for suctioning
• Vacuum pressures grownup/peds/infants
• Suction catheter sizes
• Open vs closed suction strategies
• Percutaneous dilation tracheostomy vs surgical tracheostomy
• Intubation indications for oral and nasal
• Tracheostomy indications
• Artificial airway varieties
• ETT sizes (adults, peds, infants), intubation course of and equipment required
• Murphy eye
• Goal of cuff, cuff pressure monitoring, troubleshooting
• Trach varieties and parts
• Miller vs macintosh
• Sniffing place, cricoid pressure
• Timeframe for intubation strive
• ETT affirmation course of/location on CXR, ETT placement at lip
• Use of capnography
• Issues of intubation
• native anesthesia and vasoconstriction all through nasal intubation
• limitations of using a laryngeal masks airway
• submit extubation points
• problems with trachestomy tubes
• cuff pressures
• weaning off a trachestomy tube
Ch. 39: Humidity and Aerosol Treatment
• Isothermic saturation boundary- location, how is it modified/shifted
• Goal of humidity treatment
• Indications to warmth impressed air
• Penalties of not together with humidity to flows >4L/min
• Targets of delivering gases to nostril/mouth: 50% RH, at 20-22 ranges C
• Targets delivering gases to hypopharynx: 95% RH at 29-32 C
• Targets delivering gases through artificial airways: 100% RH at 32-35 C
• Indications for cool humidified gasoline
• Humidifier vs nebulizer
• Components that impression a humidifier effectivity
• Most crucial concern for a humidifier = temperature
• Calculation of relative humidity, physique humidity
• Indicators and indicators of inadequate airway humidification
• Sorts of humidifiers
• help valve on a bubble humidifier does what
• At extreme stream fees, what do some bubble humidifiers produce?
• Passover humidifier varieties
• Wick
• HME varieties/makes use of, effieicent rating/hazards
• Heated humidifier indications and operation
• Use of MDI whereas HME is in place
• When using nebulizers, the place should you place them to attenuate hazard of contamination?
• heated-wire circuit use
• Hazards of bland aerosol
• Indications for water or isotonic saline aerosol, hypertonic
Ch. 40 Aerosol Drug Treatment
• Definition of a aerosol
• Sorts of nebulizers
• Aerosol output, density, deposition, sedimentation, inertial impaction, Brownian movement/diffusion
• Emitted dose
• Cascade impaction
• MMAD: ranges and the place they deposit throughout the airway
• GSD
• Heterodisperse
• Know parts affect pulmonary deposition of an aerosol
• How do you enhance deposition by inertial impaction
• Goal of a sustained maximal inspiration
• Time interval ageing
• How do you cut back hazard of an an infection with aerosol drug treatment
• Know which remedy or drug courses have been associated to elevated airway resistance and bronchospasm all through aerosol administration
• Know which brokers has been associated to elevated intraocular pressure
• How do you decrease hazard of thrush
• Limitations of DPI and breath actuated applications
• MDI use, propellants use, use on youngsters…
• DPI use, advantages/disadvantages
• SVN use and design, how does it work, what happens if it is not upright place, if stream is about to extreme…
• Lifeless amount left with SVN
• How do you decrease an an infection with SVN use
• actually useful dosage for regular bronchodilator treatment (CBT)
• use and indications of peak stream meters
Ch. 41: Storage and provide of Medical Gases
• Evaluation therapeutic gases
• Know traits of O2, NO, He, N2, CO2, air
• Know what fractional distillation is
• Purity stage of O2 per FDA
• Bodily separation of O2 in dwelling care setting
• Components of medical air compressors
• Hospital air compressors capable of sustaining 50 PSI and 100L/min
• Why and the way in which is He used as a therapeutic gasoline
• Tanks: Colors, Tank parts, markings, DOT, technique for size, testing and supplies product of, yolk system/PISS, ASSS, DISS, storage of tanks, full PSI
• How are gasoline vs liquid tanks measured for contents
• Liquid tank size
• Bourdon gauge vs Thorpe tubes; how do regulators work, various stage/single stage, working pressures…
Ch. 42: Oxygen provide items
• Hight stream vs low stream, what are the traits of each
• All oxygen provide items: know stream/troubleshooting/indications and disadvantage and benefits for
o NRM
o Partial rebreathing
o NC
o HFNC
o Straightforward Masks
o Transtracheal catheter
o Venturi masks
o Reservoir cannulas
• Indications and benefits of O2 treatment; evaluation SpO2 ranges for adults/youngsters
• Heliox use, 70/30 and 80/20 parts, what system is used to ship it
• Carbogen use
• Indicators of maximum hypoxemia
• Indicators of hyperoxia/substernal chest ache
• O2 toxicity, how so much FIO2 and for a manner prolonged, penalties of O2 toxicity
• ROP, absorption atelectasis, hyaline membrane formation
• How will we cut back hazard of hearth hazard with O2 in use
• Approximate FIO2 with O2 items
• Extreme stream applications ship a minimal of what stream
• Complete stream calculation
• O2 mixing applications vs entrainment applications
• How do you confirm right functioning of a mixing system
• Enclosure applications, minimal flows required, indications
• NO treatment, indications, hazards, amount used
• NO2 what’s it, factors with it
• Hyperbaric use, indications, settings, physiological outcomes
Ch. 43: Lung development treatment
• Definitions for compression atelectasis, spontaneous pneumothorax, reabsorption atelectasis
• Who’s liable to creating ATX
• Causes of ATX in submit operative victims
• CXR findings of ATX
• How do modes of lung development result in lung development
• Transpulmonary pressure gradient, how can it is elevated
• Know indications/contraindications, use, goals, troubleshooting, hazards for:
o Incentive spirometer
o Pep items
o CPAP
o **There shall be no questions on IPPB, nonetheless evaluation in your private information
• Sorts of IS, prepare IS preoperatively
• How have you ever learnt if a pt with ATX is bettering?
• Make clear instruction for a sustained maximal inspiration, how prolonged must it last
• Diaphragmatic respiration
• Monitoring of IS, what variety of breaths, how sometimes…
• Widespread set off for CPAP to not ship set pressure

Ch. 44: Airway clearance treatment
• Know common traits of a cough
o Compression
o Closure of glottis
o Deep breath
o Explusion using stomach muscle tissues
• What triggers coughing
• What’s required to have a standard airway clearance
• What would possibly provoke a cough?
• Penalties of getting retained secretions/mucus plugs, partial or full obstructions
• Understand completely completely different causes for ineffective cough- weak inspiratory muscle tissues, poor compression and so forth
• What impairs mucocilliary clearance in intubated victims
• Illnesses that alter common mucus clearance
• Causes of Bronchiectasis
• What outcomes the cough reflex
• Targets of airway clearance
• Amount of mucus produced a day anticipated amount after chest bodily treatment
• What labs or assessments may very well be indicative for the need for airway clearance
• Airway clearance strategies and items, know when to make use of
o Postural drainage and percussion
o IS
o Optimistic airway pressure
• Contraindications to postural drainage
• Contraindications to turning victims
• How do you identify place of affected particular person primarily based totally on CXR
• Postural drainage: indications, indicators of enchancment with use, hazards, contraindications
• Use, indications, hazards of PEP, PAP, EPAP, CPAP…
• Huff coughing
• Oscillation / vest treatment, indications settings, use
• Flutter system, Acapella, EZPAP: indications, how the resistance works…
Ch. 45: Respiratory Failure
• How is respiratory failure acknowledged (check out FIO2, pH, PaO2, PaCO2…)
• Hypercapnic failure: Evaluation causes
• Sort I and Sort II failure: Causes, cures
• Hypoxemic failure: causes (V/Q mismatch, hypoventilation, shuting…)
• Shunting and V/Q mismatching
• Indicators and indicators of hypoxic failure, CXR look
• Blended venous factors, commonest set off = Cardiac sickness
• Common A-a gradient on room air and with 100% O2
• Remedy for shunting
• Choices of Gullian-Barre
• Energy vs acute respiratory failure, how have you ever learnt any individual has acute on persistent?
• WOB, indicators and indicators
• Indication to intubate, pH decrease than 7.2
• Parameters that time out should intubate: MIP, VT, VC, Ve, RR, VD/VT, A-a gradient
• Common PF ratio
• Adequacy of alveolar air movement
• Assessing muscle energy: FVC, MIP, MVV
• Contractile respiratory muscle fatigue
• Causes of elevated WOB in intubated victims: ETT, vent circuit, Auto-PEEP
• What modes should be used for acute failure
• What mode is admittedly useful for hypoxemic failure: CPAP
• Stress administration used with ARDS
• Largest hazard of Auto-peep = COPD
• Causes of dynamic hyperinflation (elevated E-time, elevated RAW, decreased exp stream)
• How do you cut back auto-peep
Ch. 46: Mechanical Ventilators
• Definition of ventilators
• Ventilator vitality provide
• Equation of motion
• Definition of cycle, set off, limit
• Affected particular person vs machine set off/cycle
• Set off variables (pressure, stream, amount)
• Goal of vent alarms
• Circuit compliance and resistance
• Amount administration, pressure administration, pressure regulated amount administration breath varieties.
• Stress help
• Tendencies, waveforms= use/goal
• Spontaneous, assisted and managed/compulsory breath
• Targets of mechanical air movement
Ch. 47: Physiology of Ventilator help
• Spontaneous air movement outcomes vs compulsory respiration
• **Observe there shall be no questions on damaging pressure air movement
• How does PPV work: Ppl pressure will improve, Palv will improve, alveolar pressure exceeds Ppl pressure
• Shunt: give PEEP, refractory to FIO2
• PEEP: Indications, How does it work, what does it do, how will we set it and what are the hazards
• Spont VT fluctuate: 5-7 ml/kg
• Mechanical amount fluctuate: 4-8ml/kg (restrictive 4-6 and common 6-Eight)
• Costs: often 10-20, set elevated for met acidosis, ARDS, ICP (probably), resp acidosis
• Compliance: Static vs dynamic, causes for will improve/decreased, technique
• Consequence of decrease compliance
• Suggest airway pressure: What can enhance it (PEEP, I-time, Sq. to ramp waveform, PIP)
• All through PC amount varies counting on: set pressure limit, affected particular person lung mechanics, affected particular person effort
• Know what occurs all through pressure and amount air movement
• Recruitment maneuvers
• Evaluation modes: CPAP, CMV, IMV, PSV; when are they used, how do they work, which one would enhance WOB primarily probably the most
• Common WOB: Zero.6-Zero.9 J/L
• Plateau pressure: how is it obtained, what does it signify, what values will we try to carry it beneath (28 cmH2O)
• How does PEEP help with Auto-PEEP, and used with COPD
• Detrimental outcomes of PEEP
• Contraindications to utilize of PEEP
• Sq. vs ramp waveform
• What ends in affected particular person ventilator asynchrony
• Why are affected particular person turned every two hours on the vent
• What happens to PIP on VC when the RAW will improve
• Causes for low amount on the vent
• What are time constants?
• Who would you use inverse ratios on
• What are the indications for APRV
• Stress help: affected particular person triggered, pressure restricted, stream cycled
• Uncomfortable unintended effects/hazards of mechanical air movement: decreased perfusion
Ch. 48: Affected particular person ventilator interaction
• Causes of affected particular person ventilator asynchrony:
o Set off factors (poor sensitivity setting)
o Irregular respiratory drives
o Auto-peep
o Circulation asynchrony
o Change in medical standing
o Double triggering/fast or prolonged I-times
o Ache, anxiousness
• Opposed outcomes of poor affected particular person ventilator interaction
• How is auto-peep minimized
• How is stream asynchrony in amount air movement corrected
• How deep must the ETT be on an grownup male affected particular person?
• How does the traches shift with excessive pneumothorax
• What do you do in case your affected particular person turns into severely distressed and alarms are sounding
• Which modes set off the least asynchrony (PAV, NAVA)
• Which mode does asynchrony principally occur (VC)
• Auto-peep: How does it impression triggering, how do you applicable it
• Common set off delay
• Causes of auto-triggering
Ch. 49: Initiating and adjusting invasive air movement help
• Commonest rationalization for acute respiratory failure requiring mechanical air movement
• Calculation of Ve
• Calculation of VA
• Targets of mechanical vent help
• Hazards associated to the vent
• Advantages of Assist Administration air movement
• Advantages of pressure administration air movement
• Advantages of amount administration air movement
• VT ranges for normal and restrictive lungs
• How do you improve respiratory acidosis
• Low volumes, elevated fees/elevated PEEP= ARDS
• Vent order accommodates: Mode, FIO2, worth, VT, PEEP generally
• Know definition of AC
• Desired PaCO2 and PaO2 formulation
• Permissive hypercapnia: what’s it, when will we do it
• Stress help, when is it used, what does it do
• How do you decrease CO2 manufacturing on a affected particular person
• Circulation triggering
• Appropiate I:E ratios
• FIO2, what stage will we use/start
• Pronning, use/indications
• Optimum peep
• When should you purchase an ABG after initiating the vent
• Alarm settings
Ch. 50: NIV
• Indications, contraindications for NIV
• Targets of NIV
• When will we use ST vs CPAP
• Correcting big air leaks
• Benefits of using CPAP and NIV
• Use of NIV for OSA, hypoventilation victims
• What occurs in case you over tighten a masks
• Nasal vs face masks
• Hazards/undesirable unintended effects of being on NIV
• Settings, IPAP, EPAP, Worth, FIO2, Ramp, C-Flex
• IPAP – EPAP = Stress help, used to applicable CO2
• When will we add humidity
• Physiological outcomes of NIV
• When would you intubate a affected particular person on NIV
• Commonest complication with NIV

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