Brad\'s Final Part 5.txt

before bronchscopy the physician must go over everything, possible side effects, and options. Durring this dicussion these drugs could be brought up as an option. What are Fentanyl and Versed used for?

should include answering all the patient's questions. The RT usually has this responsibility and must understand all aspects of the procedure.

What is the main drug that is used while doing a bronvhoscopy?

It is critical to keep the airway clear of mucus and blood and to help keep the bronchoscope lens clear during bronchoscopy. What should be done to keep it all clear?

Safety protocols require that the bronchoscopist and RT wear

During bronchoscopy One RT (or registered nurse [RN]) watches the patient and monitors vital signs every _____ while the other RT directly assists the bronchoscopist.

is a term used to denote a state of anesthesia in which the patient is in a �twilight zone� for approximately 15 to 30 minutes. The medications used to achieve this state are given intravenously and can be reversed in seconds by specific antagonists, also given intravenously.

There are how many cups that are needed at bed side during bronchoscopy?(each has a syringe)

One cup containing 3 ml 4% topical Xylocaine to be used if

One cup containing 6 ml 2% topical Xylocaine to be used if

One cup containing 15 ml 0.9% sodium chloride (NaCl) for

One cup containing a 1:19 solution of

The nutritional needs of patients with lung disease have emerged as a major factor influencing

Body heat is a result of a combustion process called

Unless oxygen is delivered to the cells, the food eaten cannot be

respiration and nutrition are truely

The respiratory system consists of

Titrating the proper amount of oxygen and eliminating carbon dioxide (the metabolic �smoke� of the combustion process) is the job of the

dictate the amount of oxygen needing to be picked up in the lungs

is a respiratory factor that can be measured in the laboratory or at the bedside.it is this measure that indicates the patient's energy requirement

If V.o2 is measured while a person is in a resting, nonstressed state, this can be calculated

is the measure obtained when a person is at absolute rest with no physical movement

is used when a person is simply resting. is most commonly reported and is often equal to BEE but is often a little higher than BEE since most measures are done when the patient is not at rest.

The Harris-Benedict equation is commonly used for estimating

According to the National Heart, Lung, and Blood Institute (NHLBI), approximately ____________ Americans suffer from some type of sleep disorder

The NHLBI estimates that of those with sleep disorders nearly _______ have some form of sleep apnea

With 1 in 6 Americans afflicted with

RTs are a major segment of the workforce responsible for conducting a diagnostic sleep study, or

Board for Registered Polysomnographic Technologists (BRPT) earn the Registered Polysomnographic Technologist (RPSGT) certification are known as

Individuals without credentials who receive on-the-job training in a sleep laboratory to perform sleep studies are known as

is actually an active process with continuous stimulation of specific regions of the brain throughout the night.

For adults and children, the two major states of sleep are

NREM and REM stages cycle back and forth every?

how many cycles of NREM and REM in every 8 hours

While in NREM, ____________ tracings demonstrate diminishing brain activity, suggesting a resting or restorative state

NREM has how many stages?

What stage of NREM:the eyes roll slowly and low-amplitude waves, the vertical height of the EEG tracings, are noted. Only 5% to 10% of the sleep period is spent in ______ NREM normally

How many minutes until Stage 2 of NREM

What stage of NREM: EEG tracings show sharp spikes called K-complexes and sleep spindles. In adults, approximately 40% to 50% of the total sleep period is spent in

What stage of NREM:is considered the deepest stage of sleep and is approximately 25% of the sleep period. The EEG demonstrates delta waves, or slow-wave sleep, which is characterized by high-amplitude waves. �Delta� sleep is thought to be restorative sleep. there is a very low level of responsiveness and it is difficult to awaken a person out of this stage of sleep. Essential growth hormones are also released during this stage

slow-wave sleep, which is characterized by high-amplitude waves

During NREM sleep,control of core body temperature and regulation of respiration is maintained, the respiratory rate will slow and tidal volume will decrease, resulting in a increase in

NREM occupies about 75% of the sleep period normally and includes restorative sleep known as

REM occupies ____ of the sleep period and is characterized by active brain activity, dreaming, and partial paralysis of skeletal muscles.

describes the pattern of various sleep stages that a patient enters throughout the night

A histogram of the sleep architecture visually depicts the

the brain is in a state of rest while the body can still move and respond to stimuli

Once is initiated, the brain becomes more active and the body experiences partial skeletal muscle paralysis, with ventilation, blood pressure, and heart rate becoming variable

in REM, the soft tissues of the oropharynx relax because of partial paralysis resulting in upper airway obstruction to airflow. With a loss of airflow and ventilation, the oxygen saturation via pulse oximetry (Spo2) declines, while the Paco2 rises

Because the brain is the most sensitive organ to changes in arterial oxygen partial pressure (Pao2) and Paco2, it disrupts sleep at REM onset by �pulling the patient up� out of REM and back into

such patients report they have not had dreams for �years� and experience early morning physical exhaustion and excessive daytime sleepiness (EDS)

patients may document 400 to 600 EEG arousals per night and the absence of REM sleep. It should be apparent that when the sleep architecture is disrupted, EDS would result.

The goal in the treatment of all SDB is to achieve

Although the physical examination may be normal for the SDB patient, the role of the RT is key during routine patient assessment through questioning

the most common problem found in SDB is

is defined as the cessation of airflow for at least 10 seconds during sleep caused by an obstruction in the airway, a 4% decrease in Spo2, or a change in the EEG, or an EEG arousal, that is at least 3 seconds in length

is the documented record of brain wave activity collected from electrodes strategically being placed on the head and face

are used to document brain wave activity and to identify the levels or stages of sleep during a sleep study.

occurs when a patient's sleep is momentarily disrupted and is documented by a change in the EEG tracings during a sleep study

When an EEG arousal lasts for 3 seconds, one of the criteria for

One of the most common findings associated with sleep apnea is

Snoring is the noise produced during inspiration during sleep as a result of soft tissue vibrations in the palate and pillar regions of the oropharynx. Snoring is never a healthy sign, and many snorers may eventually develop significant

is the first sign of a SDB and can be found in children and adults

Another common symptom associated with sleep apnea and other SDBs is excessive daytime sleepiness, or

is a tool used to assess daytime sleepiness

is a survey instrument used to identify risk factors associated with sleep apnea.

is a simple, eight-item questionnaire that measures daytime sleepiness and is essential for initial screening of sleep disorders.

Ess presents eight situations, and the patient is asked to rate the chances of dozing in each situation with the value �0� representing no chance of dozing, �1� as a slight chance of dozing, �2� being a moderate chance of dozing, and �3� reporting a high chance of dozing. The sleepiness score is totalled, and if the ESS total is 1 to 6, sleep is

If the ESS points are 7 or 8, the score is

An ESS score of 9 or greater indicates that

10-item survey is divided into three categories with category 1 addressing snoring, category 2 identifying EDS, and category 3 assessing current blood pressure and body mass index (BMI)

The ESS assesses daytime sleepiness, and the Berlin Questionnaire identifies

Patients are being discharged from the hospital to cut back on costs. There should be plans from when they are admitted.

is the most common respiratory therapy modality seen in home care

The process of collecting the data involves the mental process called

requires many skills, including interpretation, analysis, evaluation, inference, explanation, and self-regulation

To serve as a legal record of the care and service provided, To collect evidence in support of the patient's problems and needs, To provide communication between members of the health care team, To support appropriate reimbursement, To support the operation of the HCO and its allocation of internal resources and to provide documentation of compliance with The Joint Commission and regulatory standards of care, To serve as an educational tool are all the reasons for?

A retrospective review of patient charts can provide health care professionals and students with the opportunity to see how patients with a certain problem were diagnosed, what treatment was given, and how the patients

formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO; commonly pronounced �JAYCO�), is the largest accreditation organization in the United States. It is an independent, nonprofit organization that accredits over 15,000 health care providers and programs in all care settings

Who set forth the standards for documentation provide direction to all clinicians about what should be charted, how often, and to what level of detail. Without such standards, documentation would vary so much between health care facilities that patient records would be of little value.

is defined as an instance of failure to use reasonable amount of care (�ordinary prudence�) that results in injury or damages to another

is when a caregiver has failed to live up to a duty of care owed to another person.

As an RT, you have a duty of care to your patients. The scope of your duty to a patient is outlined by your

is one of the most common symptoms seen in patients with pulmonary disease. It is the powerful protective reflex arising from stimulation of receptors located in the pharynx, larynx, trachea, large bronchi, and even the lung and the visceral pleura

can be caused by inflammatory, mechanical, chemical, or thermal stimulation of cough receptors found anywhere from the oropharynx to the terminal bronchioles or simply by tactile pressure in the ear canal

The cough mechanism can be divided into the following three phases:

reflex opening of the glottis and contraction of the diaphragm, thoracic, and abdominal muscles cause a deep inspiration with a concomitant increase in lung volume accompanied by an increase in the caliber and length of the bronchi

closure of the glottis and relaxation of the diaphragm while the expiratory muscles contract against the closed glottis can generate very high intrathoracic pressures and narrowing of the trachea and bronch

opening of the glottis, explosive release of trapped intrathoracic air, and vibration of the vocal cords and mucosal lining of the posterior laryngeal wall, which shakes secretions loose from the larynx and moves undesired material out of the respiratory tract

The cough reflex may be _______________ and occurs in everyone from time to time

is reduced if one or more of the following conditions exist:Weakness of either the inspiratory or expiratory muscle, Inability of the glottis to open or close correctly, Obstruction, collapsibility, or alteration in shape or contours of the airways, Decrease in lung recoil as occurs with emphysema, Abnormal quantity or quality of mucus production (e.g., thick sputum)

a cough that is sudden onset, usually severe with a short course, self-limiting

a cough that is persistent and troublesome for more than 3 weeks

a cough that is periodic, prolonged, and forceful episodes

a cough that is usually due to a viral infection involving the upper airway. It usually resolves in a few days

a cough that is most commonly caused by postnasal drip syndrome, followed by acute asthma, acute exacerbation of chronic obstructive pulmonary disease (COPD), allergic rhinitis, gastroesophageal reflux disease (GERD), chronic bronchitis, bronchiectasis, and other conditions such as left heart failure, bronchogenic cancer, and sarcoidosis

In smokers, chronic cough is usually due to