TBPQ3

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Quiz 3

Pharmacology

Traditionally, what percentage of a given dose of aerosolized medication reaches the lower respiratory tract, regardless of the type of delivery device being used?

10 to 15 %

You are administering an aerosol treatment to a patient via a gas small volume neb when you realize that the output appears to be lower than normal. On checking the flowmeter you see that it is set to 4 L/min. Your action is to:

Increase flow rate to 10 L/min

Two hypothetical small volume nebulizers, A and B, have the following specifications from the manufacturer: MD A. 1.7 um B. 1.5 um MMAD A. 3.2 um B. 7.7 um GSD A. 1.1 um B. 1.5 um Which nebulizer would be best to use in order to treat the lower respiratory tract?

Nebulizer A

What is the purpose of the end inspiratory breath-hold used in conjunction with aerosol delivery:

Allows better deposition through gravitational setting

An aerosol is best defined as:

A suspension of solid or liquid particles in a carrier gas

Which of the following are problems associated with patient use of MDI? I. Failure to coordinate inhalation and actuation of the inhaler II. A too rapid inspiratory flow rate III. Failure to shake and mix canister contents IV. Cessation of inspiration as the aerosol strikes the throat

I, II, III, and IV

A 2 year old child is seen in the ER of a local hospital and diagnosed with croup. The physician orders a dose of racemic epinephrine via small volume nebulizer to help with the subglottic swelling. What size aerosol particles are most likely to deposit in this region providing greatest therapeutic benefit to the patient?

5 to 10 um particles

After delivering an aerosol treatment you notice that approximately 0.5 cc of medication remains in the small volume nebulizer. Which of the following actions do you take?

Take no action and deliver the following dose with same SVN

Which of the following statements is true concerning the recommended volume of solution when delivering an aerosol treatment via small-volume nebulizer? I. A volume between 3 to 5ml of solution is recommended II. Increasing the Volume results in a decrease in the concentration of drug remaining in the dead volume when nebulization ceases III. Patient compliance is directly proportional to convenience IV. Increasing the volume of solution results in a net increase in the amount of active drug in the nebulizer

I, II, and III only

For pulmonary diagnostic and therapeutic applications the particle size range in interest is what?

1 to 10 um

The three main uses of aerosol therapy in respiratory care include the following: I. Humidification of dry gases II. Improve mobilization and clearance of secretions III. Delivery of aerosolized drug to the respiratory tract IV. Delivery of nutrients for patients unable to masticate

I, II, and III only

The physician has requested that you provide a patient with a reservoir device to use in conjunction with an MDI. Given a choice, which type of device would you give the patient?

Antistatic valve holding chamber

When teaching proper MDI technique to a patient, you should explain that failure to shake the device before action may result in:

A reduction in total dose and an increase in total dose

You are a therapist working in the ER when a 67-year-old male patient with chronic bronchitis presents in acute distress. His vital signs include a heart rate (HR) of 123 beats/min and a respiratory rate (RR) of 28 breaths/min. On auscultation you note faint expiratory wheezing. Which of the following devices would be the least appropriate by which to deliver an aerosolized drug to the patient?

Dry powder inhaler (DPI)

Your patient is receiving gentamicin (a high-viscosity antibiotic solution) via gas-powered small-volume nebulizer. To compensate for the increased viscosity of the aerosol solution, you should:

Set the gas flow to 12 L/min

What is often the first clinical sign that suggests the presence of hypoxemia?

Exertional dyspnea

What is primary method of transporting oxygen in blood?

Bound to hemoglobin

What of the following would be best used to assess arterial oxygenation?

CaO2

Which of the following parameters is the respiratory component of acid-base status?

PaCO2

What could cause tissue hypoxia with normal arterial oxygenation?

Inadequate cardiac output

Which of the following is not part of the brain?

Cranial nerves

Where in the nervous system is regulation of breathing located?

Brainstem

Which of the following diseases may be suggested by the involvement of multiple nerve roots?

Guillain-Barre syndrome

Injury to the cervical spine roots C3 to C5 is associated with which of the following abnormalities?

Paralysis of the diaphragm

Which of the following is the most important examination in the neurologic examination?

Level of consciousness

What is the most widely used instrument to quantify neurologic impairment?

Glasgow Coma Scale

Which Glasgow Coma Scale score is typically an indication for endotracheal intubation?

<9

Which of the following cranial nerves are evaluated with the gag reflex?

IX and X

Which of the following cranial nerves is intact if cough is present while suctioning the airway?

X

Which of the following is the most critical parameter to keep in mind when managing a patient with intracranial hypertension?

Cerebral perfusion pressure

Before an ABG is obtained, the patient's clotting parameters should be evaluated because:

Bleeding time may be prolonged if they are abnormal

What is the normal value for PaO2?

80-100 mm Hg

What is the normal value for CaO2?

16-20 vol%

What is the normal value for PvO2?

38-42 mm Hg

Which of the following would be the best indicator of tissue oxygenation?

PvO2

Which of the following is a true statement regarding the term hypoxemia?

It occurs when the patient's PaO2 is lower than predicted

What is the most common physiologic cause of hypoxemia?

V/Q mismatch

Which of the following shifts the oxyhemoglobin dissociation curve to the left?

Fetal Hb

A shift to the right in the oxyhemoglobin dissociation curve has what effect on the affinity of Hb for oxygen?

Decreased

What respiratory pattern consists of phases of hyperpnea that regularly alternate with episodes of apnea?

Cheyne-Stokes

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