Quizzes and Last Examination Research Information
Ch. Three: High quality, affected person security and communication
• Assessment causes of potential areas of dangers to sufferers receiving respiratory care
• Assessment correct method to lifting heavy objects
• Assessment organizations liable for high quality and appropriateness of care given to Medicare beneficiaries
• Assessment parameters that require monitoring throughout ambulation
• Outline: Voltage, present, Ohms, Amps
• Organ most delicate shock: Coronary heart
• Objective of grounding electrical gear
• Assessment how O2 contributes to severity of fireside
• How is static electrical discharge minimized within the presence of O2
• RACE: what does it stand for
• Definition of channel in communication
• Nonverbal communication strategies
• Speaking empathy in direction of your sufferers
• Elements that influence outcomes of communication between affected person and practitioner
• How do you enhance listening abilities
• Assessment communication methods
Ch. Four: Ideas of an infection prevention and management
• % of sufferers who develop hospital related infections
• Major supply of an infection in healthcare
• How do ETT contribute to danger of an infection
• What are the chance elements that contribute to hospital related an infection (age, HIV…)
• Assessment various kinds of pathogen transmission routes
• Direct vs oblique transmissions
• Distance really helpful to steer clear of sufferers with SARS, COVID…
• Which ailments are airborne and require airborne isolation and use of N95
• Definition of surveillance
• Required vaccination for hospital workers (take into consideration those you obtained to go to clinic)
• Cleansing and sterilization of apparatus: First step is to scrub the gear
• Assessment Cleaning soap and its use to scrub gear
• Assessment which organisms are destroyed by disinfection brokers
• Assessment what you could do to your palms after treating sufferers with C-Diff
• How will we transport sufferers with infections
• Indication for steam sterilization
• glutaraldehyde (≥2.Zero%) use and indications
• Time-frame for hand washing
• ETO sterilization
• Commonest respiratory gear supply of affected person infections
• Ventilator circuit change frequency
• Which organisms are current with poorly disinfected bronchoscopes
• Assessment sorts of isolation- what’s transmitted via droplets, direct contact…
• Prevention Bundle
• SVN and related infections
Ch. 5: Moral authorized implications
• Definition of ethics/what does ethics try and reply
• Sanctions that apply when one breaks the regulation
• Significance of privateness/HIPAA
• Assessment AARC code of ethics
• Assessment phrases: Autonomy, nonmaleficence, Justice, Position constancy, veracity, beneficence. Malevolent deception, infidelity, double impact, distributive justice, compensatory justice
• Kinds of superior directives
• When can confidentiality by breached
• Consequentialism
• Advantage ethics
• Tort, felony, misdemeanor, litigation, battery, slander, assault, negligence
• Res ipsa loquitur, Respondent superior
Ch. 16. Bedside Evaluation of the Affected person
• Objective of an RT interview
• Social, private and intimate house
• Main questions
• Causes of improve drive to breathe
• Phrases: orthopnea, platypnea, eupnea, apnea
• Elements of an efficient 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 explanation for pedal edema
• Essential components of a sufferers previous medical historical past, social and environmental historical past
• What’s diaphoresis
• Causes for tripoding
• Altered sensorium results 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
• Regular very important signal ranges, causes for will increase and reduces
• Pulse strain
• Pursed lip respiration indications/advantages
• 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
• Extended exhalation related to bronchial asthma, COPD
• Hoover’s signal
• Tactile fremitus, bronchophony
• Subcutaneous emphysema causes
• Auscultation and percussion method
• Breath sound assessment
• Phrases epigastric, precordium
• PMI
Ch. 17: Deciphering medical lab knowledge
• Elements of a CBC
• Elements and what It means to have elevated or decreased WBC depend
• Causes for prime/low Hb
• Causes for prime/low WBC
• Causes for prime/low platletes
• Bands/Segs
• Essential values vs reference vary
• Kinds of anemia, MCH
• Ranges for electrolytes: Okay, HCO3, Ca, Cl, Na, Glucose
• Phrases for prime and low electrolytes (ex: hypokalemia)
• Objective of a sweat chloride check
• Anion hole, causes for metabolic acidosis
• Creatinine what does it signify
• Liver enzymes
• Cardiac enzymes
• Causes for elevated BNP
• Sputum pattern and quantity of epithelial cells
• Xpert® MTB/RIF in diagnosing TB infections
Ch. 11: Air flow
• Assessment all lung volumes and capacities
• Major perform of the lungs
• Assessment: PA, PBS, PAO, Ppl
• Assessment all lung strain gradients
• Assessment what happens throughout regular inspiration and expiration
• Assessment floor stress, airway resistance, elastic forces
• Hysteresis
• Presence of surfactant does what
• Compliance: how is it calculated, regular values, dynamic vs static
• Causes for will increase and decreased compliance
• Assessment VC, MIP
• Assessment airway resistance and causes for elevated RAW, method, regular worth
• Poiseuille’s regulation
• Frictional resistance the place does it happen, will increase
• Equal strain level (EPP)
• Drive x distance
• Quantity-pressure curve traits
• Speedy shallow respiration vs sluggish and deep, causes for every
• Regular oxygen consumption p.c
• Regional elements that have an effect on distribution of gasoline within the regular lung
• How is time fixed computed
• Optimum peep, how is it set
• Greatest indicator for adequacy or effectiveness of alveolar air flow
• Definition of hyperventilation, hyperpnea, hypoventilation
• Alveolar air flow, method, causes for improve and reduce
• Resting metabolic CO2 manufacturing and Oxygen consumption in ml/min
• VDphy what’s the regular worth, how will we overcome deadspace
• What can improve VD/VT
• Modified bohr equation used to calculate lifeless house
• Ve calculation
Ch. 12: Gasoline Change and Transport
• Definition of diffusion
• Quantity of PAO2, PaO2, O2 in cells
• Quantity of PACO2, PaCO2, CO2 in cells
• Casues for elevated PACO2
• Major determinant of PAO2, method
• Approx. PAO2 on 100% FIO2 at sea stage
• a/A ratio, PF ratio, A-a gradient/regular values
• highest PAO2 whereas respiration room air at sea stage
• gasoline diffusion should happen by transversing via what layers (AC membrane, RBC membrane…)
• regular values of PO2 and PCO2 in combined venous blood
• CO2 and CO diffuse sooner than O2 throughout AC membrane, what number of occasions
• Minimal period of time that blood should take for pulmonary capillary transit for equilibrium of O2 to happen throughout the AC membrane
• Shunting vs Deadspace air flow, V/Q mismatches
• How is O2 and Co2 carried within the blood
• CaO2, VO2 and DO2 method
• Hamburger phenomenon
• SVO2 worth
• O2 dissociation curve
• Bohr and Haldane impact
Ch. 36: Pharmacology
• All treatment names and doses, frequency together with:
o LAMA, LABA, SAMA, SABA, ICS, Mixture medication, mucolytics, bland aerosol, vasodilators, anti-infectives, anti-asthma
o Together with: (know generic and model 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 unwanted side effects, indications
• Mode of motion of all medication
• Receptor websites: 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
• Benefits of inhaled treatment route
• Catechol O-methyltransferase (COMT), phosphodiesterase, cholinesterase
• Use of I-neb
Ch. 37: Airway Administration
• Indications for suctioning, suction method/process steps, pre suction methods
• Uncomfortable side effects/issues of suctioning
• Tools wanted for suctioning
• Vacuum pressures grownup/peds/infants
• Suction catheter sizes
• Open vs closed suction methods
• Percutaneous dilation tracheostomy vs surgical tracheostomy
• Intubation indications for oral and nasal
• Tracheostomy indications
• Synthetic airway varieties
• ETT sizes (adults, peds, infants), intubation process and gear required
• Murphy eye
• Objective of cuff, cuff strain monitoring, troubleshooting
• Trach varieties and elements
• Miller vs macintosh
• Sniffing place, cricoid strain
• Time-frame for intubation try
• ETT affirmation process/location on CXR, ETT placement at lip
• Use of capnography
• Problems of intubation
• native anesthesia and vasoconstriction throughout nasal intubation
• limitations of utilizing a laryngeal masks airway
• submit extubation issues
• issues of trachestomy tubes
• cuff pressures
• weaning off a trachestomy tube
Ch. 39: Humidity and Aerosol Remedy
• Isothermic saturation boundary- location, how is it modified/shifted
• Objective of humidity remedy
• Indications to heat impressed air
• Penalties of not including humidity to flows >4L/min
• Objectives of delivering gases to nostril/mouth: 50% RH, at 20-22 levels C
• Objectives delivering gases to hypopharynx: 95% RH at 29-32 C
• Objectives delivering gases via synthetic airways: 100% RH at 32-35 C
• Indications for cool humidified gasoline
• Humidifier vs nebulizer
• Elements that impact a humidifier efficiency
• Most necessary issue for a humidifier = temperature
• Calculation of relative humidity, physique humidity
• Indicators and signs of insufficient airway humidification
• Kinds of humidifiers
• aid valve on a bubble humidifier does what
• At excessive stream charges, what do some bubble humidifiers produce?
• Passover humidifier varieties
• Wick
• HME varieties/makes use of, effieicent score/hazards
• Heated humidifier indications and operation
• Use of MDI whereas HME is in place
• When utilizing nebulizers, the place must you place them to attenuate danger of contamination?
• heated-wire circuit use
• Hazards of bland aerosol
• Indications for water or isotonic saline aerosol, hypertonic
Ch. 40 Aerosol Drug Remedy
• Definition of a aerosol
• Kinds of nebulizers
• Aerosol output, density, deposition, sedimentation, inertial impaction, Brownian motion/diffusion
• Emitted dose
• Cascade impaction
• MMAD: ranges and the place they deposit within the airway
• GSD
• Heterodisperse
• Know elements have an effect on pulmonary deposition of an aerosol
• How do you improve deposition by inertial impaction
• Objective of a sustained maximal inspiration
• Time period ageing
• How do you reduce danger of an infection with aerosol drug remedy
• Know which medication or drug classes have been related to elevated airway resistance and bronchospasm throughout aerosol administration
• Know which brokers has been related to elevated intraocular strain
• How do you lower danger of thrush
• Limitations of DPI and breath actuated programs
• MDI use, propellants use, use on kids…
• DPI use, benefits/disadvantages
• SVN use and design, how does it work, what occurs if it isn’t upright place, if stream is about to excessive…
• Lifeless quantity left with SVN
• How do you lower an infection with SVN use
• really helpful dosage for steady bronchodilator remedy (CBT)
• use and indications of peak stream meters
Ch. 41: Storage and supply of Medical Gases
• Assessment 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
• Elements of medical air compressors
• Hospital air compressors able to sustaining 50 PSI and 100L/min
• Why and the way is He used as a therapeutic gasoline
• Tanks: Colours, Tank elements, markings, DOT, method for length, testing and materials product of, yolk system/PISS, ASSS, DISS, storage of tanks, full PSI
• How are gasoline vs liquid tanks measured for contents
• Liquid tank length
• Bourdon gauge vs Thorpe tubes; how do regulators work, a number of stage/single stage, working pressures…
Ch. 42: Oxygen supply units
• Hight stream vs low stream, what are the traits of every
• All oxygen supply units: know stream/troubleshooting/indications and drawback and advantages for
o NRM
o Partial rebreathing
o NC
o HFNC
o Easy Masks
o Transtracheal catheter
o Venturi masks
o Reservoir cannulas
• Indications and advantages of O2 remedy; assessment SpO2 ranges for adults/kids
• Heliox use, 70/30 and 80/20 elements, what system is used to ship it
• Carbogen use
• Signs of extreme hypoxemia
• Signs of hyperoxia/substernal chest ache
• O2 toxicity, how a lot FIO2 and for a way lengthy, penalties of O2 toxicity
• ROP, absorption atelectasis, hyaline membrane formation
• How will we reduce danger of fireside hazard with O2 in use
• Approximate FIO2 with O2 units
• Excessive stream programs ship a minimum of what stream
• Whole stream calculation
• O2 mixing programs vs entrainment programs
• How do you verify correct functioning of a mixing system
• Enclosure programs, minimal flows required, indications
• NO remedy, indications, hazards, quantity used
• NO2 what’s it, points with it
• Hyperbaric use, indications, settings, physiological results
Ch. 43: Lung growth remedy
• Definitions for compression atelectasis, spontaneous pneumothorax, reabsorption atelectasis
• Who’s liable to creating ATX
• Causes of ATX in submit operative sufferers
• CXR findings of ATX
• How do modes of lung growth lead to lung growth
• Transpulmonary strain gradient, how can it’s elevated
• Know indications/contraindications, use, objectives, troubleshooting, hazards for:
o Incentive spirometer
o Pep units
o CPAP
o **There shall be no questions on IPPB, however assessment in your personal data
• Kinds of IS, train IS preoperatively
• How have you learnt if a pt with ATX is bettering?
• Clarify instruction for a sustained maximal inspiration, how lengthy ought to it final
• Diaphragmatic respiration
• Monitoring of IS, what number of breaths, how typically…
• Widespread trigger for CPAP to not ship set strain
Ch. 44: Airway clearance remedy
• Know regular traits of a cough
o Compression
o Closure of glottis
o Deep breath
o Explusion utilizing belly muscle tissues
• What triggers coughing
• What’s required to have a traditional airway clearance
• What might provoke a cough?
• Penalties of getting retained secretions/mucus plugs, partial or full obstructions
• Perceive totally different causes for ineffective cough- weak inspiratory muscle tissues, poor compression and so forth
• What impairs mucocilliary clearance in intubated sufferers
• Ailments that alter regular mucus clearance
• Causes of Bronchiectasis
• What results the cough reflex
• Objectives of airway clearance
• Quantity of mucus produced a day anticipated quantity after chest bodily remedy
• What labs or assessments could be indicative for the necessity for airway clearance
• Airway clearance methods and units, know when to use
o Postural drainage and percussion
o IS
o Optimistic airway strain
• Contraindications to postural drainage
• Contraindications to turning sufferers
• How do you establish place of affected person based mostly on CXR
• Postural drainage: indications, indicators of enchancment with use, hazards, contraindications
• Use, indications, hazards of PEP, PAP, EPAP, CPAP…
• Huff coughing
• Oscillation / vest remedy, indications settings, use
• Flutter system, Acapella, EZPAP: indications, how the resistance works…
Ch. 45: Respiratory Failure
• How is respiratory failure recognized (take a look at FIO2, pH, PaO2, PaCO2…)
• Hypercapnic failure: Assessment causes
• Kind I and Kind II failure: Causes, remedies
• Hypoxemic failure: causes (V/Q mismatch, hypoventilation, shuting…)
• Shunting and V/Q mismatching
• Indicators and signs of hypoxic failure, CXR look
• Blended venous points, commonest trigger = Cardiac illness
• Regular A-a gradient on room air and with 100% O2
• Therapy for shunting
• Options of Gullian-Barre
• Power vs acute respiratory failure, how have you learnt somebody has acute on persistent?
• WOB, indicators and signs
• Indication to intubate, pH lower than 7.2
• Parameters that point out must intubate: MIP, VT, VC, Ve, RR, VD/VT, A-a gradient
• Regular PF ratio
• Adequacy of alveolar air flow
• Assessing muscle power: FVC, MIP, MVV
• Contractile respiratory muscle fatigue
• Causes of elevated WOB in intubated sufferers: ETT, vent circuit, Auto-PEEP
• What modes must be used for acute failure
• What mode is really helpful for hypoxemic failure: CPAP
• Stress management used with ARDS
• Biggest danger of Auto-peep = COPD
• Causes of dynamic hyperinflation (elevated E-time, elevated RAW, decreased exp stream)
• How do you scale back auto-peep
Ch. 46: Mechanical Ventilators
• Definition of ventilators
• Ventilator energy supply
• Equation of movement
• Definition of cycle, set off, restrict
• Affected person vs machine set off/cycle
• Set off variables (strain, stream, quantity)
• Objective of vent alarms
• Circuit compliance and resistance
• Quantity management, strain management, strain regulated quantity management breath varieties.
• Stress assist
• Tendencies, waveforms= use/objective
• Spontaneous, assisted and managed/obligatory breath
• Objectives of mechanical air flow
Ch. 47: Physiology of Ventilator assist
• Spontaneous air flow results vs obligatory respiration
• **Observe there shall be no questions on destructive strain air flow
• How does PPV work: Ppl strain will increase, Palv will increase, alveolar strain exceeds Ppl strain
• 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 vary: 5-7 ml/kg
• Mechanical quantity vary: Four-8ml/kg (restrictive Four-6 and regular 6-Eight)
• Charges: usually 10-20, set increased for met acidosis, ARDS, ICP (possibly), resp acidosis
• Compliance: Static vs dynamic, causes for will increase/decreased, method
• Consequence of lower compliance
• Imply airway strain: What can improve it (PEEP, I-time, Sq. to ramp waveform, PIP)
• Throughout PC quantity varies relying on: set strain restrict, affected person lung mechanics, affected person effort
• Know what happens throughout strain and quantity air flow
• Recruitment maneuvers
• Assessment modes: CPAP, CMV, IMV, PSV; when are they used, how do they work, which one would improve WOB essentially the most
• Regular WOB: Zero.6-Zero.9 J/L
• Plateau strain: how is it obtained, what does it signify, what values will we attempt to hold it beneath (28 cmH2O)
• How does PEEP assist with Auto-PEEP, and used with COPD
• Detrimental results of PEEP
• Contraindications to make use of of PEEP
• Sq. vs ramp waveform
• What results in affected person ventilator asynchrony
• Why are affected person turned each two hours on the vent
• What occurs to PIP on VC when the RAW will increase
• Causes for low quantity on the vent
• What are time constants?
• Who would you employ inverse ratios on
• What are the indications for APRV
• Stress assist: affected person triggered, strain restricted, stream cycled
• Uncomfortable side effects/hazards of mechanical air flow: decreased perfusion
Ch. 48: Affected person ventilator interplay
• Causes of affected person ventilator asynchrony:
o Set off points (poor sensitivity setting)
o Irregular respiratory drives
o Auto-peep
o Circulation asynchrony
o Change in medical standing
o Double triggering/quick or lengthy I-times
o Ache, anxiousness
• Opposed results of poor affected person ventilator interplay
• How is auto-peep minimized
• How is stream asynchrony in quantity air flow corrected
• How deep ought to the ETT be on an grownup male affected person?
• How does the traches shift with extreme pneumothorax
• What do you do in case your affected person turns into severely distressed and alarms are sounding
• Which modes trigger the least asynchrony (PAV, NAVA)
• Which mode does asynchrony mostly happen (VC)
• Auto-peep: How does it impact triggering, how do you appropriate it
• Regular set off delay
• Causes of auto-triggering
Ch. 49: Initiating and adjusting invasive air flow assist
• Commonest explanation for acute respiratory failure requiring mechanical air flow
• Calculation of Ve
• Calculation of VA
• Objectives of mechanical vent assist
• Hazards related to the vent
• Benefits of Help Management air flow
• Benefits of strain management air flow
• Benefits of quantity management air flow
• VT ranges for regular and restrictive lungs
• How do you enhance respiratory acidosis
• Low volumes, increased charges/increased PEEP= ARDS
• Vent order contains: Mode, FIO2, price, VT, PEEP sometimes
• Know definition of AC
• Desired PaCO2 and PaO2 formulation
• Permissive hypercapnia: what’s it, when will we do it
• Stress assist, when is it used, what does it do
• How do you lower CO2 manufacturing on a affected person
• Circulation triggering
• Appropiate I:E ratios
• FIO2, what stage will we use/begin
• Pronning, use/indications
• Optimum peep
• When must you acquire an ABG after initiating the vent
• Alarm settings
Ch. 50: NIV
• Indications, contraindications for NIV
• Objectives of NIV
• When will we use ST vs CPAP
• Correcting giant air leaks
• Advantages of utilizing CPAP and NIV
• Use of NIV for OSA, hypoventilation sufferers
• What happens in case you over tighten a masks
• Nasal vs face masks
• Hazards/unwanted side effects of being on NIV
• Settings, IPAP, EPAP, Price, FIO2, Ramp, C-Flex
• IPAP – EPAP = Stress assist, used to appropriate CO2
• When will we add humidity
• Physiological results of NIV
• When would you intubate a affected person on NIV
• Commonest complication with NIV
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