resp 117

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Author:
darrell2662
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158893
Filename:
resp 117
Updated:
2012-06-15 20:19:32
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test
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test 1
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  1. The presence of invasive devices...
    such as internal catheters and pacemakers, may add to the risk of serious harm from electrical shock
  2. What are the factors that determine the ammount of damage a patients gets from an electrical current?
    Objects with low resistance
  3. objects with low resistance...
    allow maximum current to flow through the object
  4. objects with high resistance...
    allow minimal or no current to flow through the object 
  5. What organ is most sensitive to electrical shock?
    the heart
  6. The harmful effects of current depends on...
    • The amount of current flowing through the body
    • The path it takes
    • the duration the current is applied
  7. The degree of resistance offered by the skin varies from prson to person based on...
    • The chemistry of the person's skin
    • The cleanliness of the skin
    • The amount of moisture on the surface
  8. Grounding
    Is simply a low resistance pathway to a point of zero voltage
  9. What is the purpose of grounding electrical equipment?
    To prevent the dangerous buildup of voltage that can occur on the metal frames of some electrical equipment
  10. What must exist for a fire to burn?
    • Flammable material must be present
    • Oxygen must be present
    • The flammable must be heated to or above its ignition temperature
  11. Communcation
    is a dynamic process involving sharing of information, meanings, and rules among people
  12. Communcation has five basic components:
    • sender
    • massage
    • channel
    • rece
  13. Conflict resolution
    Is the process by which people control and channel diagreements within an organaization
  14. There are five basic stragies for handling conflict resolutions!
    • Competing
    • accommodating
    • avoiding
    • collaborating
    • Compromising
  15. Competing
    • Is an assertive and uncooperative conflict resoultion strategy
    • is a power oriented method of resolving conflict
  16. Competing strategy may be useful when...
    an unpopular decision must be made or when one must stand up for his or her rights
  17. Accommodating
    • is the opposite of competing
    • Unasserative and cooperative
  18. When people accommodate others involved in conflict...
    they neglect their needs to meet the needs of the other party
  19. Accommodation is a useful stragtegy when...
    • it is essential to maintain harmony in the environment
    • Also, when an issue is much more important to one party or the other in a dispute
  20. Avoiding
    is both an unassertive and an uncooperative conflict resolution strategy
  21. Avoidance may be apporiate if...
    there is  no possibility of meeting ones goals
  22. Collaborating
    • Is the opposite of avoiding
    • It is assertive and cooperative
  23. In collaborating, the involved parties...
    Try to find mutally satisfying solutions to their conflict
  24. Collaboration usually takes...
    more time than other methods and cannot be applied when the involved parties harbor strong negative feelings about each other
  25. Compromising
    Is a middle ground strategy that combines assertiveness and cooperation
  26. Compromise is best used when...
    A quick resolution is needed that both parties can live with
  27. Medical record
    presents a written picture of occurrences and situations pertaining to a patient through out his or her stay in a health care intitution
  28. Medical Record
    Admission Sheet
    Records pertinent patient information (name, address, religion, nearest of kin), admitting physician, and admission diagnosis
  29. Medical Record
    History and Physical examination
    Records the patients admitting history and physical examination, as performed by the attending physician or resident
  30. Medical Record
    Physician's Orders
    Records the physician's orders and prescription
  31. Medical Record
    Progress Sheet
    Keeps a continuing account of the patients progress for the physician
  32. Medical Record
    Nurses note
    Describes the nursing care given to the patient, including the patients compliants (subjective symptons), the nurses observation (objective signs), and the patients response to therapy
  33. Medical Record
    Medication Record
    Notes drugs and intravenous fluids trhat are given to the patient
  34. Medical Record
    Vital Signs Graphic Sheet
    Records the patient's temperature, palse, respirations, and blood pressure over time
  35. Medical Record
    I/O Sheet
    Records the patient's fluid intake (I) and output (O) over time
  36. Medical Record
    Laboratory Sheet
    Summarizes the results of laboratory test
  37. Medical Record
    Consulation Sheet
    Records notes by the physicians who are called in to examine a patient to make a diagnosis
  38. Medical Record
    Surgical or Treatment Consent
    Records the patient's authorization  for surgery or treatment
  39. Medical Record
    Anesthesia and Surgical Record
    Notes key events before, during, and immediately after sugery
  40. Medical Record
    Specialized Therapy Records/Progress notes
    Records specialized treatments or treatment plans and patient progress for various specialized  therapeutic services (respiratory care, Physical therapy)
  41. Medical Record
    Specialized Flow Sheets
    Records measurements made over time during specialized procedures (mechanical ventilation, Kidney dialysis)
  42. How to handle medical charting Errors!
    If a mistake is made a single line should be drawn through the mistake and the word "error" printed above
  43. Ethical theories and principle
    provide the foundation for all ethical behavior
  44. The principle of Autonomy
    acknowledges patients personal liberty and their right to decide their own coarse of treatment and follow through plan on which they freely agree
  45. The principle of Veracity
    Binds the health care provider and the patient to tell the truth
  46. Benevolent deception
    The truth is withheld from the patient for his or her own good
  47. The principle of Nonmaleficence
    • Obligates health care providers to avoid harming patients and to actively prevent harm where possible
    • Double effect
  48. The principle of Beneficence
    requries that the health care provider go beyond doing no harm and actively contribute to the health and well being of their patients
  49. The principle of Confidentiality
    It obligates health care providers to respect the secrets which are confided which are confined even after the patient has died
  50. Advanced directives
    Allow the patient to give direction to health care providers about treatment in circumstances in which the patient may no longer be able to provide that direction
  51. What are the two types of advanced directives available?
    • Living will
    • The durable power of attorney for health care
  52. The durable power of attorney for health care allows...
    the patient to identify another person to carry out his or her  wishes to respect to health care
  53. A living will states...
    a patients health care prefences in writing
  54. The principle of Justice
    involves the fair distrubition of care
  55. The viewpoint that relies on rules and principles...
    Formalism
  56. The viewpoint in which decisions are based on the assessment of consequences
    Consequentialism
  57. Formalism
    Asserts that certain features of an act itself determine its moral rightness
  58. Consequentialism
    an act is judged to be right or wrong based on its consequences
  59. What are the four D's of Negligence?
    • The practitioner owes a Duty to the patient
    • The practitioner was Direlict with that duty
    • The breach of duty was the Direct cause of damanges
    • Damage or harm came to the patient
  60. Medicare Frad
    states that anyone who knowingly or willfully solicits, receives offers, or pays directly or indirectly any remuneration in return for medicare business is guilty of criminal offense
  61. What are the responsibilites of the medical director of the respiratory department?
    • Responsible for the clinical function of the department
    • provides oversight of the clinical care that is delivered
    • Must be available on a 24 hour  basis for consultation with  and to give advise to both other physicians and the respiratory care staff
    • must possses administrative and medical skills
  62. Licensure
    is the process in which the government agency gives an individual permission to practice an occupation
  63. Respiratory care protocols are...
    guidelines for delivering appropiate respiratory care treatments and services
  64. Key elements of a respiratory care protocol program!
    • Strong and committed medical director
    • Capable therapists
    • Active quality monitoring
    • Collaborative environment among RTs, physicians, and nurses
    • Responsiveness of participants to address and correct problems
  65. Elements of a Respiratory Care protocol!
    • Clearly stated objectives
    • Outline that includes an algorithm
    • Description of alternative choices at decision and action points
    • Description of potential complications and corrections
    • Description of end points and decisions points at which the physician must be contacted
    • Protocol program
  66. What is the purpose of respiratory care protocols?
    To provide therapy to patients needing and likely to benefit from therapy but to advoid delivering services to patients not likely to benifit
  67. The accuracy of a measuring instrument is...
    how well it measure a known reference value
  68. The percision is...
    • Reproducibility
    • reliability
    • opposite of variability
    • Indicated by standard deviation (SD)
    • Small SD= High precision
  69. What is the primarily problem with obstructive lung disease?
    Increased airway resistance (Raw)
  70. The normal FEV1 should be...
    • 70% of FVC
    • Lung power
  71. What is the percent change for a significiant improvement in flows (FEV1) post bronchodilators?
    A 15% or greater improvement in FEV1 and at least a 200 ml increase in FEV1
  72. What methods are used to determine lung volumes?
    • Helium dilution
    • Nitrogen washout
    • Plethysmography
  73. What is the normal range for (Vt) Tidal volume?
    500 to 700 ml
  74. What is the normal range for (IC) Inspiratory capacity?
    3600 ml
  75. What is the normal range for (IRV) inspiratory reserve volume?
    3.10 L
  76. What is the normal range for (ERV) expiratory reserve volume?
    1.20 L and represents 20 to 25% of the VC
  77. What is the normal range for (VC) vitial capacity?
    4.80 L and represents 80% of TLC
  78. What is the normal range for (TLC) total lung capacity?
    6.00 L
  79. What is the normal range for (RV) residual volume?
    1.20 L and represents 20% of TLC
  80. What is the normal range for (FRC) Functional residual volume?
    2.40 L and represents 40% of the TLC
  81. When would the right heart boarder not be visible?
    • if adjecent lung tissue is filled with fluid
    • Pulmonary consolidation or pleural effusion
  82. What view gives the technician the best quality chest film?
    The PA view
  83. what portion of the chest should the heart take up?
    mediastinum and no more than 50%
  84. Signs of a Pneumothorax!
    • Abnormal collection of air within the pleural space
    • Visceral pleura becomes visible
    • Spontaneous or results from an invasive procedure , or as a complication of PPV (barotrauma)
    • Air accumulates over the top of lung in upright patient (lack of vascular marking)
    • More subtle in supine position (deep sulcus sign)
  85. What is the optimal position of the tip of the endotracheal tube?
    • Neutral neck position
    • 5-7 cm above carina (midtrachea) (C5-C6)
  86. What is a V/Q lung scan good for?
    evaluating for pulmonary embolism
  87. What problems are a rotated person goin to persent on a chest film?
    projecting midlines structures to the right or left
  88. Infiltrates
    • Fluid that passes threw body tissues
    • Patchy, increased density shadows or opacities
  89. What are some of the signs for ARDS on a chest X ray film?
    • The edema is patchy and bilatereral and does not predominate in the central hilar regions
    • Also lacks the cardiomegaly
    • cephalization
    • Kerly B lines
  90. Signs of atelectasis on chest X ray film!
    • Lobar collapse
    • Unlateral diaphragmatic elevation
    • Mediastinal shift
    • Narrowing of the space between the ribs
    • Hilar displacement
  91. Indications for pulmonary function testing!
    • To identify and quantify changes in pulmonary function
    • To evaluate need and quantify therapeutic effectiveness
    • To perform epidemiological surveillance for pulmonary disease
    • To asses patients for risk of post operative pulmonary complications
    • To determine pulmonary disability
  92. What is the most common test for airway mechanics?
    FVC (forced vital capacity)
  93. What gas law is the body box based on?
    Boyles law
  94. AARC code of ethic!
    Represents a set of general principles and rules that have been developed to help ensure that the health needs of the public are provides in a saft, effective, and caring manner

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