Brad\'s Final Part 5.txt

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MagusB81
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Brad\'s Final Part 5.txt
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2011-12-06 18:03:55
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Final RESP 132
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Final RESP 132
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  1. 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?
    Concious sedation
  2. should include answering all the patient's questions. The RT usually has this responsibility and must understand all aspects of the procedure.
    Patient preparation
  3. What is the main drug that is used while doing a bronvhoscopy?
    Xylocaine ( both aerosol and topical is used)
  4. 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?
    Suction
  5. Safety protocols require that the bronchoscopist and RT wear
    gowns, masks, goggles, and gloves during the procedure.
  6. During bronchoscopy One RT (or registered nurse [RN]) watches the patient and monitors vital signs every _____ while the other RT directly assists the bronchoscopist.
    5 minutes
  7. 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.
    Conscious sedation
  8. There are how many cups that are needed at bed side during bronchoscopy?(each has a syringe)
    Four (these are the One cup questions)
  9. One cup containing 3 ml 4% topical Xylocaine to be used if
    needed above the vocal cords
  10. One cup containing 6 ml 2% topical Xylocaine to be used if
    needed below the vocal cords
  11. One cup containing 15 ml 0.9% sodium chloride (NaCl) for
    irrigation (a larger container may be necessary if BAL is needed)
  12. One cup containing a 1:19 solution of
    epinephrine (1 ml 1:1000 epinephrine diluted with 19 ml 0.9% NaCl)
  13. The nutritional needs of patients with lung disease have emerged as a major factor influencing
    acute and long-term outcomes
  14. Body heat is a result of a combustion process called
    metabolism
  15. Unless oxygen is delivered to the cells, the food eaten cannot be
    used
  16. respiration and nutrition are truely
    independent
  17. The respiratory system consists of
    neurologic components, cardiovascular components, respiratory muscles, and lungs
  18. Titrating the proper amount of oxygen and eliminating carbon dioxide (the metabolic �smoke� of the combustion process) is the job of the
    respiratory system
  19. dictate the amount of oxygen needing to be picked up in the lungs
    metabolic rates of the tissues
  20. 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
    Oxygen uptake (V?o2)
  21. If V.o2 is measured while a person is in a resting, nonstressed state, this can be calculated
    basal metabolic rate (BMR) or basal energy expenditure (BEE)
  22. is the measure obtained when a person is at absolute rest with no physical movement
    basal energy expenditure (BEE)
  23. 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.
    resting energy expenditure (REE)
  24. The Harris-Benedict equation is commonly used for estimating
    BEE
  25. According to the National Heart, Lung, and Blood Institute (NHLBI), approximately ____________ Americans suffer from some type of sleep disorder
    4 million
  26. The NHLBI estimates that of those with sleep disorders nearly _______ have some form of sleep apnea
    18 million
  27. With 1 in 6 Americans afflicted with
    sleep-disordered breathing (SDB)
  28. RTs are a major segment of the workforce responsible for conducting a diagnostic sleep study, or
    polysomnogram (PSG)
  29. Board for Registered Polysomnographic Technologists (BRPT) earn the Registered Polysomnographic Technologist (RPSGT) certification are known as
    sleep technologists
  30. Individuals without credentials who receive on-the-job training in a sleep laboratory to perform sleep studies are known as
    sleep technicians
  31. is actually an active process with continuous stimulation of specific regions of the brain throughout the night.
    sleep
  32. For adults and children, the two major states of sleep are
    non�rapid eye movement (NREM) and rapid eye movement (REM)
  33. NREM and REM stages cycle back and forth every?
    69-90 minx.
  34. how many cycles of NREM and REM in every 8 hours
    4-5
  35. While in NREM, ____________ tracings demonstrate diminishing brain activity, suggesting a resting or restorative state
    electroencephalogram (EEG)
  36. NREM has how many stages?
    3
  37. 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
    Stage 1
  38. How many minutes until Stage 2 of NREM
    2-10 mins
  39. 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
    Stage 2
  40. 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
    Stage 3
  41. slow-wave sleep, which is characterized by high-amplitude waves
    delta waves
  42. 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
    arterial carbon dioxide partial pressure (Paco2)
  43. NREM occupies about 75% of the sleep period normally and includes restorative sleep known as
    delta sleep
  44. REM occupies ____ of the sleep period and is characterized by active brain activity, dreaming, and partial paralysis of skeletal muscles.
    25%
  45. describes the pattern of various sleep stages that a patient enters throughout the night
    Sleep architecture
  46. A histogram of the sleep architecture visually depicts the
    cycling of sleep stages
  47. the brain is in a state of rest while the body can still move and respond to stimuli
    During NREM
  48. 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
    REM
  49. 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
    patients with SDB
  50. 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
    Stage 1 or 2 NREM
  51. such patients report they have not had dreams for �years� and experience early morning physical exhaustion and excessive daytime sleepiness (EDS)
    Patients with SDB
  52. 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.
    SDB
  53. The goal in the treatment of all SDB is to achieve
    normal sleep architecture
  54. 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 patient's sleeping habits.
  55. the most common problem found in SDB is
    sleep apnea
  56. 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
    sleep apnea
  57. is the documented record of brain wave activity collected from electrodes strategically being placed on the head and face
    EEG
  58. are used to document brain wave activity and to identify the levels or stages of sleep during a sleep study.
    EEG waveforms
  59. occurs when a patient's sleep is momentarily disrupted and is documented by a change in the EEG tracings during a sleep study
    EEG arousal
  60. When an EEG arousal lasts for 3 seconds, one of the criteria for
    sleep apnea has been met
  61. One of the most common findings associated with sleep apnea is
    snoring
  62. 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
    sleep apnea
  63. is the first sign of a SDB and can be found in children and adults
    Snoring
  64. Another common symptom associated with sleep apnea and other SDBs is excessive daytime sleepiness, or
    excessive daytime somnolence (EDS)
  65. is a tool used to assess daytime sleepiness
    Epworth Sleepiness Scale (ESS)
  66. is a survey instrument used to identify risk factors associated with sleep apnea.
    Berlin Questionnaire
  67. is a simple, eight-item questionnaire that measures daytime sleepiness and is essential for initial screening of sleep disorders.
    ESS
  68. 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
    appropriate and no EDS is noted
  69. If the ESS points are 7 or 8, the score is
    average
  70. An ESS score of 9 or greater indicates that
    the individual should consult a sleep specialist
  71. 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)
    Berlin Questionnaire
  72. The ESS assesses daytime sleepiness, and the Berlin Questionnaire identifies
    sleep apnea risk factors
  73. Patients are being discharged from the hospital to cut back on costs. There should be plans from when they are admitted.
    Some random reasons that it is going to be important for RTs in home care
  74. is the most common respiratory therapy modality seen in home care
    Oxygen
  75. The process of collecting the data involves the mental process called
    critical thinking
  76. requires many skills, including interpretation, analysis, evaluation, inference, explanation, and self-regulation
    critical thinking process
  77. 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?
    creating a record of the patient's interactions with any health care organization (HCO)
  78. 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
    responded to that treatment.
  79. 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
    The Joint Commission
  80. 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.
    The Joint Commission
  81. is defined as an instance of failure to use reasonable amount of care (�ordinary prudence�) that results in injury or damages to another
    Negligence
  82. is when a caregiver has failed to live up to a duty of care owed to another person.
    Negligence
  83. As an RT, you have a duty of care to your patients. The scope of your duty to a patient is outlined by your
    professional standards
  84. 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
    Cough
  85. 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
    Coughing
  86. The cough mechanism can be divided into the following three phases:
    Inspiratory phase,Compression phase,Expiratory phase
  87. 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
    Inspiratory phase
  88. 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
    Compression phase
  89. 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
    Expiratory phase
  90. The cough reflex may be _______________ and occurs in everyone from time to time
    vomluntary or involuntary
  91. 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)
    The effectiveness of a cough
  92. a cough that is sudden onset, usually severe with a short course, self-limiting
    acute
  93. a cough that is persistent and troublesome for more than 3 weeks
    chronic
  94. a cough that is periodic, prolonged, and forceful episodes
    paroxysmal
  95. a cough that is usually due to a viral infection involving the upper airway. It usually resolves in a few days
    acute self-limiting
  96. 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
    Chronic persistent
  97. In smokers, chronic cough is usually due to
    chronicbronchitis

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