RES 154 Clinical Practice Flashcards

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.

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.