RES 154 Clinical Practice Flashcards
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Questions and Answers

What is the first step in evaluating new patient Slim Pickins?

  • Perform a physical assessment
  • Review the chart (correct)
  • Administer bronchodilator therapy
  • Conduct a chest x-ray

    • Which initial assessments would you perform for Slim Pickins? (Select all that apply)

  • Hepatojugular reflex
  • Vital signs (correct)
  • Exhaled nitric oxide
  • Cough (correct)
  • Chest auscultation (correct)

    • Which diagnostic procedures should be included in Slim Pickins' assessment? (Select all that apply)

  • Pulmonary function test
  • Arterial blood gases (ABG) (correct)
  • Spiral CT
  • Complete blood count (CBC) (correct)

    • What pre-op therapy would you recommend for Slim Pickins?

    <p>Bronchodilator therapy</p> Signup and view all the answers

    Which bronchodilator would you recommend for Slim Pickins?

    <p>Albuterol (Ventolin)</p> Signup and view all the answers

    How would you instruct Slim Pickins to use the small volume nebulizer?

    <p>Hold breath at the end of inspiration</p> Signup and view all the answers

    What additional therapy should you suggest for Slim Pickins?

    <p>Deep breathe and cough</p> Signup and view all the answers

    What would you inform Slim Pickins regarding smoking in the hospital?

    <p>No smoking is allowed in the hospital</p> Signup and view all the answers

    What would be your instruction for Patty Mitrail regarding sustained maximal inspiration?

    <p>At the end of a normal breath, inhale a slow deep breath and hold for 3 seconds and exhale slowly</p> Signup and view all the answers

    What is your recommendation for Patty Mitrail following surgery?

    <p>SMI therapy with a 1.0 L goal every hour while awake</p> Signup and view all the answers

    What should be done if Patty Mitrail becomes unresponsive and not breathing?

    <p>Check for a pulse</p> Signup and view all the answers

    What should you do for Patty Mitrail after checking for a pulse?

    <p>Administer rescue breaths with a resuscitation bag</p> Signup and view all the answers

    What would you recommend doing after resuscitation efforts have been initiated for Patty Mitrail?

    <p>Continue rescue breathing</p> Signup and view all the answers

    What would be your action after 5 minutes of CPR when the monitor shows normal sinus rhythm?

    <p>Continue monitoring the patient</p> Signup and view all the answers

    What vital signs should you monitor post-resuscitation?

    <p>All of the above</p> Signup and view all the answers

    What should you do after reviewing Ms. Bridges’ chart?

    <p>Change the oxygen flow to 8 LPM</p> Signup and view all the answers

    What action should you recommend when Ms. Bridges asks to remove her mask?

    <p>Check SpO2 on the non-rebreather mask</p> Signup and view all the answers

    What would you recommend for a patient who is feeling better and is on a non-rebreather mask?

    <p>Change to a nasal cannula at 5 L/min</p> Signup and view all the answers

    What does the pulse oximeter measure?

    <p>Percentage of oxygen on hemoglobin</p> Signup and view all the answers

    What should you do if the SpO2 reading suddenly drops?

    <p>Reassess oxygen delivery</p> Signup and view all the answers

    What should you do after charting results for Ms. Bridges?

    <p>Thank the patient and review with the clinical director</p> Signup and view all the answers

    What should you do if Mr. Fuller becomes furious with you?

    <p>Inform the supervisor on duty</p> Signup and view all the answers

    Which assessments should you include for a patient with acute dyspnea?

    <p>All of the above</p> Signup and view all the answers

    Which diagnostic tests would be recommended for the patient with COPD?

    <p>All of the above</p> Signup and view all the answers

    What is contributing to the acute exacerbation in the COPD patient?

    <p>Bacterial pneumonia</p> Signup and view all the answers

    What is the initial therapy beneficial for the COPD patient?

    <p>Oxygen therapy</p> Signup and view all the answers

    What is the most appropriate method for oxygen delivery to the patient?

    <p>28% air entrainment mask</p> Signup and view all the answers

    What additional therapy would you recommend after initial treatment?

    <p>Albuterol via SVN</p> Signup and view all the answers

    How would you treat streptococcal pneumonia?

    <p>Antibiotic therapy</p> Signup and view all the answers

    Which information should be included in respiratory progress notes?

    <p>All of the above</p> Signup and view all the answers

    Who should you contact if you accidentally leave without completing charting?

    <p>Clinical instructor</p> Signup and view all the answers

    What equipment is needed for Harry Bach's treatment?

    <p>Nasal cannula and flowmeter</p> Signup and view all the answers

    What causes a whistling sound from the flowmeter?

    <p>Obstruction in the tubing</p> Signup and view all the answers

    What actions should you take before starting the treatment for Harry Bach?

    <p>Wash hands and measure vital signs</p> Signup and view all the answers

    What should you monitor during the treatment for Harry Bach?

    <p>Pulse, color, and ECG monitor</p> Signup and view all the answers

    What is the first action you would recommend if you notice Harry Bach is experiencing issues?

    <p>Pause the treatment and reinstruct the patient</p> Signup and view all the answers

    Which equipment should you use to assemble oxygen at 40% via cool aerosol?

    <p>Aerosol mask and large volume nebulizer</p> Signup and view all the answers

    What should you do if aerosol disappears during inspiration?

    <p>Increase the flowmeter setting</p> Signup and view all the answers

    What is your action if the patient's SpO2 is 90%?

    <p>Increase the FiO2 to 60%</p> Signup and view all the answers

    What additional equipment do you need for a tandem aerosol system?

    <p>Aerosol Y adapter and large volume nebulizer</p> Signup and view all the answers

    What total flow is delivered to the patient when each nebulizer is set for 60% oxygen at 10 LPM?

    <p>40 LPM</p> Signup and view all the answers

    What should you recommend if the patient does not like the mask on her face?

    <p>Change to a face shield</p> Signup and view all the answers

    Study Notes

    Slim Pickins - Patient Assessment and Therapy

    • Patient: Slim Pickins, 58 years old, admitted with hip fracture after a fall.
    • First step for evaluating: Review patient's chart.
    • Key patient data: 5'11", 85 kg (185 lb), 66 pack-year smoking history.
    • Initial assessment components: Vital signs, general appearance, chest auscultation, SpO2, sputum production, cough, clubbing, symptoms, jugular vein distention, diagnostic percussion, tracheal position, peripheral edema, breathing pattern, capillary refill.
    • Procedures to include in assessment: Arterial blood gases (ABG), CBC, ECG, serum electrolytes, chest radiograph.
    • Recommended pre-op therapy: Bronchodilator therapy, specifically Albuterol (Ventolin).

    Patty Mitrail - Pre-op Care and Emergency Response

    • Patient: Patty Mitrail, instructed on sustained maximal inspiration/incentive spirometry.
    • Instruction for SMI: Inhale deeply at the end of a normal breath, hold for 3 seconds, then exhale slowly.
    • Post-surgery order: Hyperinflation treatments recommended with SMI therapy, 1.0 L goal hourly while awake.
    • Emergency procedure: If a patient becomes unresponsive, check for pulse and establish an airway.
    • CPR sequence: Administer breaths every 5 seconds, use 100% oxygen, and check carotid pulse.
    • Monitoring post-rescue: Observe pulse, blood pressure, sensorium, ECG, temperature, respiratory pattern, breathing rate, and SpO2.

    Mr. R.T. Fuller - Patient Equipment and Interactions

    • Context: Clinical rotation at an urban hospital under R.T. Fuller.
    • Task includes checking oxygen equipment and pulse oximetry for patients in specific rooms.
    • Review for Ms. Bridges includes height, weight, admitting diagnosis, vital signs, CBC, chest x-ray, physician notes, nurse notes.
    • Immediate assessment for breathing difficulties: Check tubing, reservoir bag, liter flow, mask placement, valve function.
    • Recommended change for non-rebreather mask: Increase oxygen flow to 8 LPM.
    • Upon patient inquiry: Check SpO2 on both non-rebreather mask and room air.

    Ima Sycamore - Emergency and Diagnosis in ED

    • Patient: Ima Sycamore, female with COPD presenting with acute dyspnea.
    • Initial assessment includes general appearance, vital signs, chest auscultation, diagnostic percussion, and smoking history.
    • Recommended diagnostic tests: Chest radiograph, CBC, ECG, electrolytes, ABG, sputum culture.
    • Conclusion for diagnosis: Bacterial pneumonia.
    • Initial therapy recommendation: Oxygen therapy using 28% air entrainment mask and Albuterol via SVN.
    • Treatment for pneumonia: Antibiotic therapy.

    Harry Bach - Oxygen Therapy and Patient Management

    • Patient: Harry Bach admitted for respiratory distress with COPD.
    • Equipment assembly: Nasal cannula, flowmeter, bubble humidifier for 5 LPM oxygen.
    • Whistling sound from flowmeter indicates obstruction.
    • Recommended actions during treatment: Measure vital signs, wash hands, provide instructions, and position patient semi-fowlers.
    • Assessment during therapy includes breath sounds, color, pulse oximetry, heart rate, respiratory rate, and blood pressure.

    Flo Mieter - Aerosol Therapy Management

    • Order for oxygen delivery: 40% via cool aerosol.
    • Equipment needed: Aerosol mask, tubing, flowmeter, and large volume nebulizer.
    • Solution to aerosol disappearing during inspiration: Increase flowmeter setting.
    • Patient oxygen saturation check: Recommended FiO2 increase to 60% if SpO2 is at 90%.
    • Tandem aerosol system setup requires aerosol Y adapter and additional nebulizers.
    • Effective SpO2 increase noted at 96% with patient expressing discomfort in mask; recommendation to switch to a face shield.

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    Test your knowledge on clinical scenarios in respiratory therapy with these flashcards. Focus on patient evaluation and therapy recommendations common in clinical settings, using case studies like Slim Pickins. Perfect for students preparing for exams in respiratory care.

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