Upgrade to remove ads
Clinical Midterm Review Part 3 of 4 Humidity and bland aerosol therapy Respiratory Therapy
Terms in this set (37)
2 - 1 um
What particle size is needed to enter the alveoli?
Primary role of the upper airway, the nose.
Where does the primary exchange of heat and moisture occur?
Normally _______ below the carina is isothermic saturation boundary (ISB)
Decrease and Increase
Above ISB, temperature and relative humidity ______ during inspiration, and __________ during exhalation.
The ratio between amount of water in given volume of gas and maximum amount it is capable of holding at that temperature. Is expressed as percentage and is obtained with hygrometer.
What is relative humidity?
Absolute humidity capacity x 100
How can you find relative humidity?
The amount of water in given volume of gas; its measurement is expressed in mg/L.
What is absolute humidity?
The relative humidity at body temp and is expressed as percentage, capacity of water at body temp is 44 mg/L. Take absolute humidity/44 mg/L x 100.
What is body humidity? How do you find this?
The inspired air that is not fully saturated at body temperature, deficit is corrected by body's own humidification system. Take 44 mg/L - absolute humidity.
What is humidity deficit? How can you find this?
Mucociliary escalator, moves approximately 100 mL of secretions to the oropharynx per day., normal cough mechanism and phagocytosis by type 3 alveolar cells.
Inhaled particles are removed from the respiratory tract by what three mechanisms?
Large, slow tidal volumes then hold breath for 3 to 4 seconds to ensure maximum deposition.
What is the ideal ventilatory pattern for aerosol treatments (neb and MDI)?
Fast inspiratory flow rate
What is the ideal ventilatory pattern for Dry powder aerosols?
Presence of airway edema, laryngotracheobronchitis, subglottic edema, postextubation edema, postop management of the upper airway, presence of a bypassed upper airway-heated bland aerosol, need for sputum specimens or mobilization of secretions.
What are some indications of administering bland aerosol therapy? delivery of aerosolized sterile water and isotonic or hypertonic saline?
Bronchoconstriction, history of airway hyperresponsiveness, wheezing or bronchospasm and bronchoconstriction when artificial airway is used.
What are some contraindications/hazards and complications when indicating aerosol therapy?
Atelectasis, Dry, nonproductive cough, increased airway resistance, increased incidence of infection, increased WOB, patient complaint of dryness, and thick dehydrated secretions.
What are some signs and symptoms of inadequate airway humidification?
1. Temp, 2. Surface area, 3. Time of constant, and 4. Thermal mass.
What are the 4 variables or principles that affect the quality and performance of a humidifier?
1. To improve bronchial hygiene (cough, function of Mucociliary escalator), 2. Humidity gases delivered to patients with artificial airways (LVN), aerosol delivered to patients with artificial airways should be heated.
3. Delivery medications by SVN, MDI or DPI.
What are the goals of aerosol therapy?
Jet Aerosol Generators (Gas Powered)
These generators use jet mixing to produce an aerosol and entrain a second gas, a system of baffles is used to impact large particles out of suspension, commonly used for delivery of meds (SVN) and humidification (LVN), heating increases water content of delivered gas.
What is the recommended fill volume for a SVN?
The higher the flow, the smaller the particle size.
How is the particle size affected by flow of the nebulizer?
6 to 8 L/min
What is the recommended flow for a SVN?
1. Fill the neb with the drug and diluent to the optimal fill volume, 4 to 6 mL. 2. Place the neb in the inspiratory limb of the circuit at least 30 cm from the patient's Y piece. 3. Attach the neb tubing to the neb outlet on the vent or to an external source of gas flow. 4. Ensure that flow through the nebulizer is 6 to 8 lpm or preferred to be synchronized and connected with the MV. 5. Ensure patient tidal volume is sufficient, 6. If Neb is not synchronous with the ventilator, then you may have to adjust alarms to compensate for the additional flow, may also cause an increase in PEEP. 7. Remove or bypass HME if present, 8. Checkt he nebulizer for adequate aerosol generation, 9. Disconnect neb after treatment, 10. Reset to original ventilator alarms/settings. 11. Rinse the neb with sterile water, let air dry and store properly.
How do you set up and deliver a SVN medication treatment during mechanical ventilation?
At least every 24 hours.
How often should you change SVNs?
Depends on the patient coordination and technique, lung deposition in adults may vary between 10% and 25% of the nominal dose.
Effect use of the MDI depends on what?
A canister containing the drug, propellants and an actuator.
MDI contains what?
Warm the MDI canister, insert canister into actuator and shake vigorously, prime the MDI, open mouth wide, breathe out normally, breathe in slowly,, actuate the MDI just after beginning of inspiration, inhale to TLC, hold breath for 4 to 10 seconds, wait 30 seconds between puffs.
What is the proper technique for use of the MDI?
What device may be used with an MDI to help aid the patient with poor hand breath coordination?
Fast inspiratory flow rate (30 to 60 L/min)
DPI requires what to deliver an effective dose?
Acute bronchospasm, and should not deliver high doses.
DPIs should not be used for patients with what?
97%, 55%, ultrasonic produce more therapeutic.
Ultrasonic produce ______ of aerosol particles that fall in the therapeutic range of 1 um to 5 um while Jet nebs produce ______ of aerosol particles produced fall in the therapeutic range of 1 to 5 um.
Active humidifiers and passive humidifiers
What are the two types of humidifiers?
This type of humidifier adds water vapor to the inspired gas?
This type of humidifier is an HME?
What are the three types of Active humidifiers?
34 to 37 degrees celsius
When using heated humidifiers, systems are usually heated to achieve what temperature range and 100% relative humidity at the patient's airway.
_______________ are capable of maintaining adequate humidification for short-term (up to 72 hours) and periodic use (16 to 20 hr/day) in patients with chronic disease.
Remove it or switch it over to Aerosol.
What should you do to the HME when giving an aerosol treatment to the patient?
THIS SET IS OFTEN IN FOLDERS WITH...
Basic ECG Interpretation
EXIT EXAM, NBRC RRT EXAM
TMC Practice Exam B
YOU MIGHT ALSO LIKE...
Humidity and Bland Aerosol Therapy
ch 6 humidity and aerosol therapy (med gas)
Chapter 3 & 4
Chapter 38 egans
OTHER SETS BY THIS CREATOR
Tachycardia ACLS Stable/unstable
ACLS Acute Coronary Syndrome
ACLS Ch. 1 - 4 Outline Respiratory therapy