Respiratory Therapy Overview
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Questions and Answers

What is the main function of goblet cells in the lung?

  • To facilitate oxygen absorption
  • To secrete mucin and create a protective mucus layer (correct)
  • To assist in gas exchange
  • To regulate airflow in the bronchi

    • What characterizes the normal breath sounds?

  • Bronchial
  • Vesicular (correct)
  • Stridor
  • Rhonchi

    • What is the most recommended therapy for a post-operative patient after surgery?

  • Mucolytic therapy
  • Compression therapy
  • Oxygen therapy
  • Incentive spirometry (correct)

    • What are two possible therapies for long-term cystic fibrosis patients at home?

    <p>Vest and O2 therapy</p> Signup and view all the answers

    What is the recommended compression ratio for two rescuers when performing CPR on an infant?

    <p>15:2</p> Signup and view all the answers

    What is a common indication of oxygen therapy?

    <p>Hypoxemia</p> Signup and view all the answers

    Which ECG change could be observed if you hit the carina while suctioning an ETT?

    <p>Bradycardia</p> Signup and view all the answers

    What is the significance of observing wheezing after bronchodilator therapy?

    <p>It means there is air movement</p> Signup and view all the answers

    What can occur due to excessive oxygen administration?

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

    What is one hazard of oxygen therapy?

    <p>Nausea and dizziness</p> Signup and view all the answers

    What is the purpose of a sweat test?

    <p>To assess chloride levels in sweat</p> Signup and view all the answers

    What is the correct dosage for arformoterol tartrate?

    <p>15 mcg once daily</p> Signup and view all the answers

    What does the Murphy's eye facilitate?

    <p>Allow ventilation of the lung and prevent obstruction</p> Signup and view all the answers

    Which of the following is an indicator for heliox therapy?

    <p>Decreased inflammation, post-extubation stridor</p> Signup and view all the answers

    What is the primary indication for inhaled nitric oxide (NO)?

    <p>Pulmonary hypertension</p> Signup and view all the answers

    What type of problem do obstructive patients typically experience?

    <p>Restricted airflow</p> Signup and view all the answers

    What may cause a low-pressure alarm in a ventilator?

    <p>Rupture of the endotracheal tube cuff</p> Signup and view all the answers

    Which of the following is a common cause of a high-pressure alarm?

    <p>Airway secretions</p> Signup and view all the answers

    Which condition is NOT typically associated with high-pressure alarms?

    <p>Leaks in the ventilator circuit</p> Signup and view all the answers

    What is a potential complication of mechanical ventilation?

    <p>Pulmonary hyperinflation</p> Signup and view all the answers

    What is commonly used for non-invasive ventilation?

    <p>Patients with COPD</p> Signup and view all the answers

    Which test indicates restrictive lung disease based on decreased lung volume?

    <p>PFT</p> Signup and view all the answers

    What is a primary indication for performing an ABG?

    <p>To assess blood gas levels</p> Signup and view all the answers

    What condition is indicated by decreased flow during pulmonary function testing?

    <p>Obstructive lung disease</p> Signup and view all the answers

    What does NIF stand for and what is its normal range?

    <p>Negative Inspiratory Pressure, -20 to -40</p> Signup and view all the answers

    What condition is indicated by an ABG result of 7.59, 19, 25?

    <p>Uncompensated respiratory alkalosis</p> Signup and view all the answers

    In which patients is a peak flow meter typically used?

    <p>Asthma patients</p> Signup and view all the answers

    What is the normal range for PCO2 in mm Hg?

    <p>35-45</p> Signup and view all the answers

    What does PEEP stand for and what is its purpose?

    <p>Peak End Expiratory Pressure, used for oxygenation</p> Signup and view all the answers

    What can cause an increase in the peak inspiratory pressure (PIP)?

    <p>Secretions in the airway</p> Signup and view all the answers

    What does the RSBI represent and what is its normal value?

    <p>Rapid Shallow Breathing Index, normal is less than 105</p> Signup and view all the answers

    What is a common complication associated with the use of Pulmicort?

    <p>Oral thrush</p> Signup and view all the answers

    Study Notes

    Incentive Spirometry

    • Recommended post op therapy

    Cystic Fibrosis

    • Home therapies: Vest, O2 therapy, PEP, mucolytic
    • Sweat test determines chloride levels in sweat

    Oxygen Therapy

    • Indications: Hypoxemia, Hypoxia, Cyanosis, Short term therapy (post op), Asthma, OSA, Use of accessory muscles
    • Hazards: O2 toxicity, Slows breathing/heart rate, Oxidative stress, Absorption atelectasis, Fire hazards, Increased hypoxic drive for COPD patients
    • Complications: Nausea, Dizziness, Muscle twitching, Vision loss, Loss of consciousness

    PEEP - Peak End Expiratory Pressure

    • Adverse Effects: Hypotension, Decreased venous return, Decreased cardiac output, Alveolar overinflation, Pulmonary Barotrauma

    Murphy's Eye

    • Allows lung ventilation when endotracheal tube bevel is occluded
    • Prevents obstruction and continues ventilation

    Signs of Oxygen Need

    • Hypoxemia/Hypoxia
    • Cyanosis
    • Diaphoresis
    • SOB

    Large Volume Nebulizer

    • Used for: Bland aerosol therapy, Post extubation stridor, Croup, Delivery of airway-moisturizing mist

    Obstructive vs. Restrictive Lung Problems

    • Obstructive: Flow problem, Restricted airflow, Breathing difficulties
    • Restrictive: Volume problem, Decreased lung capacity, Reduced elasticity

    Inhaled Nitric Oxide (NO)

    • Indications: Pulmonary hypertension, Hypoxic respiratory failure

    Ventilator Alarms

    • Low Pressure Alarm: Patient disconnecting, Leaks in ventilator circuit, Airway leaks, Chest tube leaks, Disconnecting tubing
    • High Pressure Alarm: Secretions/mucus buildup, Patient biting tube, Tube migration into right mainstem bronchus, Bronchospasm, Mucosal edema/secretions, Pneumothorax, Patient-ventilator asynchrony, Condensation in circuit, Kinks in inspiratory circuit, Valve issues

    Massive Oxygen Leak

    • Action: Put the flow meter back in

    High Pressure Limit Causes

    • Mucus plugging
    • Kink in the tube
    • Obstruction

    Low Pressure Alarm Causes

    • Leaks in ventilator circuit
    • Chest tube leaks
    • Disconnecting tube from ventilator circuit
    • Rupture of endotracheal tube cuff

    Ventilator Complications

    • Pulmonary Barotrauma
    • Lung injury
    • Pneumonia
    • Respiratory muscle weakness
    • Secretion retention
    • Hyperinflation
    • Occlusion in tube due to secretions

    Non-Invasive Ventilation

    • Used for: COPD, Obesity, OSA, Acute/Chronic respiratory failure

    PFT - Pulmonary Function Tests

    • Decreased lung volume: Restrictive lung disease
    • Decreased flow: Obstructive lung disease

    ABG - Arterial Blood Gas

    • Indications: Assess blood gas levels, Sign of respiratory distress, Assess mechanical vent settings, Assess non-invasive monitoring accuracy

    L/S Ratio

    • Used to determine surfactant levels

    Racisater Safety Feature

    • Pop off valve

    ABG Air Bubble

    • Decreases CO2 levels

    2 Rescuer CPR for Infants

    • Compression Ratio: 15:2
    • Preferred Technique: Circle (2 hands)

    Surfactant Cells

    • Type 2 alveolar cells

    Goblet Cells Function

    • Secrete mucin to create protective mucus layer

    Normal Breath Sounds

    • Vesicular

    Finger Clapping Sign

    • Chronic hypoxia, COPD

    Idiopathic

    • Unknown cause

    Epi Alternatives

    • Amiodarone
    • Racemic Epi

    Clot Risk Rhythm

    • Atrial Fibrillation (A-fib)

    ABG - Radial vs. Brachial Artery

    • Radial artery is more superficial, making pulse easier to detect

    RSBI - Rapid Shallow Breathing Index

    • Calculation: RR/VT
    • Normal value: Less than 105

    ET Tube Suctioning - Carina

    • Can cause bradycardia due to vagus nerve stimulation

    Wheezing Post-Bronchodilator

    • Indicates air movement

    Heliox 80:20

    • Factor: 1:8

    Heliox 70:30

    • Factor: 1:6

    Heliox Therapy Indications

    • Decrease inflammation
    • Post-extubation stridor

    Xopenex Doses

    • 0.31 mg
    • 0.63 mg
    • 1.25 mg

    Heated Humidifier Temperature

    • 37-39 degrees Celcius

    Laryngeal Edema vs. Laryngeal Stenosis

    • Laryngeal Edema: Fluid buildup and swelling in larynx tissues
    • Laryngeal Stenosis: Scarring in larynx that limits normal opening

    Brovana

    • Name: Arformoterol tartrate
    • Dose: 15 mcg (once daily)
    • Category: Long-acting beta agonists (LABAs)

    Tracheostomy Patient Speech

    • Methods: Fenestrated trach, Speaking valve, Deflated cuff

    Mucomyst Dose

    • 10% and 20%
    • Know individual doses for each percentage

    NIF, MIP, RSBI

    • NIF: Negative inspiratory pressure. Normal: -20 to -40
    • MIP: Maximum inspiratory pressure
    • RSBI: Rapid shallow breathing index. Normal: < 105

    SBT Parameters

    • NIF
    • Vital capacity
    • Heart Rate (HR)
    • Respiratory Rate (RR)

    ABG Interpretation 7.59 19 25

    • Uncompensated respiratory alkalosis

    Peak Flow Meter

    • Used with: Asthma patients

    Laryngeal Blades

    • Miller (straight)
    • MacIntosh (curved)

    O2 Pulse Device with High CO2

    • Reading: 100% O2
    • Appearance: Pink

    BiPAP Adjustment for Low O2 and CO2

    • Adjust EPAP and FiO2

    SpO2 vs PaO2

    • SpO2: Peripheral oxygen saturation
    • PaO2: Partial pressure of oxygen in arterial blood

    CPAP Indications

    • OSA
    • Pulmonary edema
    • CHF
    • COPD
    • Obesity

    Bubbler/Nasal Cannula Wheezing

    • Cause: Kink in the tube

    Ventilator Waveform - Fast I Time

    • Square waveform

    PEEP - Peak End Expiratory Pressure

    • Meaning: Positive pressure applied at the end of expiration
    • Purpose: Improve oxygenation

    SBT Failure Signs with T Piece

    • Increased heart rate
    • Increased work of breathing
    • Low RR

    Allen Test

    • Purpose: Assess collateral blood flow to the hand
    • Procedure: Apply pressure to radial and ulnar arteries, release ulnar pressure, observe blood return in 8-10 seconds

    ET Tube End Piece (2 Holes)

    • Murphy's eye

    BiPAP Adjustment for High CO2

    • Increase IPAP (to increase gradient between IPAP and EPAP)
    • Backup RR

    ETT Placement Confirmation

    • Auscultation
    • Chest rise
    • Chest X-ray

    Capnography Colors

    • Yellow: ET tube in correct place
    • Purple: Problem with ET tube placement
    • Brown: Unknown ET tube placement

    Rising PIP (Peak Inspiratory Pressure)

    • Actions: Suctioning, Bronchodilator, Switch to pressure control

    Incorrect Pulse Reading

    • Actions: Change location, ABG, Manual check

    FiO2 1L

    • 24% (know the rule of four)

    PCO2 Normal Range

    • 35-45 mm Hg or Torr

    Pulmicort Dosages

    • Corticosteroid medication
    • 0.5 mg
    • 1 mg

    Pulmicort Complications

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    Oral Questions - Respiratory Therapy PDF

    Description

    This quiz covers essential topics in respiratory therapy, including postoperative care, treatments for cystic fibrosis, indications for oxygen therapy, and the use of PEEP. Test your knowledge on tools like incentive spirometry and large volume nebulizers, as well as the importance of recognizing signs of oxygen need.

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