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how do you calculate total flow output
add the ratio parts together and multiply by liter flow
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what should you do if the patients fio2 doesn't reverse the hypoxemia from 60%? and theres no choice of increasing to 70%?
place the pt on CPAP
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to best determine the severity of smoke inhalation, use
HbCO
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a 3 year old generally tolerates which type of o2 delivery
oxy tent
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ability of the pt to follow instructions would be indicated by
performance of tasks when asked
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best diagnostic test to determine wheter a pulm embolism is present
v/q lung scan
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to increase a pt's alveolar min vent, the __ must be increased
vt
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failure to hyperoxygenate a pt on a vent before et suctioning may result in
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most reliable method of determining wheter a mech vent pt's lungs are getting stiffer and harder to ventilate is by measuring
static compliance
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after attaching the regulator to the E cylinder, gas is heard leaking from the cylinder, what should be done?
- tighten all connections
- replace the washer btwn the cylinder and regulator connections
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if not properly cleaned, which humidifier is most likely to contaminate a pt's airway w/ bacteria
heated jet nebulizer
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a baffle is used on a neb to
break the aerosol into smaller particles
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advantage of low pressure, high vol ET tube cuffs include
less occlusion to tracheal blood flow
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tracheal secretions tend to dry out in an intubated pt when inspired air has which characteristics
- absolute humidity of 24 mg/l of gas
- relative humidity of 100% at 25 centigrade
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important to monitor airway pressure on a mech vent pt bc it best reflects
lung compliance
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which resp stimulant will help prevent apneic spells
theophylline (aminophylline)
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et tube cuff pressure should not exceed below
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inspiratory stridor is the major clinical sign of
glottic edema
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what adjustments to make to increase mean airway pressure
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administration of high o2 concentrations to a neonate for a prolonged period of time may resuly in
- atelectasis
- retinopathy of prematurity
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what is the equation to determine cylinder duration
cylinder pressure x E (.28) H (3) / liter flow
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thorpe tube flowmeters needle valve is located
proximal to the thorpe tube
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MIP must be at least
20 cm h20
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t-piece (briggs adapter) setup falls off, it may result in
- fio2 decrease
- pt would entrain room air during inspiration
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use of the ins plateau setting on a vent results in
- inc diffusion of gases
- dec atelectasis
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COPD pt is complaining of SOB, change o2 delivery to
air entrainment mask 25-35%
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which device would be most indicated in the treatment of a patient with large amts of thick secretions
ultrasonic neb
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P(A-a)02 calculations
(747-47) x fio2 - (paco2 +10)
ans= PAO2
**subtract with Pao2
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if the CO2 detector is reading near zero then the tube is in the
esophagus
-
heavy smokers commonly have HbCO levels as high as
10%
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when decreasing pt fio2, which would you decrease first?
fio2 if its >60% then decrease peep after 60%
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cardioversion levels of jules
25-100 J
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which could inc to correct acid base abnormality
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if a leak on the ett is still heard after a large amt of air is placed in the cuff then the
outside diameter of the ET tube is too SMALL
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how do you calculate a pt alveolar min ventilation
(vt-vd) f
vd= pt lbs
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pt's pao2 increases after being placed on a vent at 21%. what accounts for the improved oxygenation status
inc distribution of ventilation
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how do you observe a optimal peep
look at the PVO2 and watch for a strange drop after a few increase
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IPPB- if the machine repeatedly cucles on shortly after the pt has begun expiration, you must adjust
sensitivity control
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what airway changes will affect the delivered vt on a pressure limited ventilator
- dec lung comp
- inc lung comp
- inc airway resistance
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COPD pt on a 50% air entrainment mask becomes drowsy and unresponsive. the pt's reactiong most likely is the result of
increased paco2
-
if you kink the o2 tubing and the humidifier produces a high pitched whistling sound then that indicates that
there are no leaks in the setup
-
pft- dec volumes and capacities and normal flow studies
obstructive studies- inc vol and capacities
should select a disorder that is not common
pulm fibrosis
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if you are asked to deliver a low percentage o2 to a pt with a rr of 30/min with a irregular breathing, you should give which device
venturi mask at 28%
-
i:e ratio calculations
ins flow/ mv
must get the mv calculations
must subtract 1 from your answer to get a i:e ratio
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ippb can result in
dec cardiac output
-
breathing that is deep and rapid breathing patter is
kussmauls respiration
-
bacterial filter on a vent needs to be cleaned which of the cleaning methods should be done
autoclaving
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which of humidifier will deliver the highest percent of body humidity
heated wick humidifier
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when performing a leak test on a vol vent, which adjustments should you make to the vent
set the high pressure limit to its maximal level
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ippb- if the pt is unable to cycle the machine off, what could be done?
- check for leak in the system
- dec the cycling pressure to 10 cm h20
-
when there is water in the aerosol tubing, the fio2
increases
-
to minimize an inc airway resistance produced by high density aerosol inhaltion, the respiratory therapist should
use a bronchodilator in conjuction with the aerosol
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