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Chapter 35: Humidity and Bland Aerosol Therapy 1. What is the point in the resp

Chapter 35: Humidity and Bland Aerosol Therapy 1. What is the point in the respiratory track where inspired gas reaches body temperature, ambient pressure, saturated (BTPS) conditions? a. point of thermal equilibrium b. hygroscopic saturation boundary c. thermal inversion boundary d. isothermic saturation boundary As inspired gas moves into the lungs, it achieves BTPS conditions (body temperature, 37° C; barometric pressure; saturated with water vapor [100% relative humidity at 37° C]). This point, normally approximately 5 cm below the carina, is called the isothermic saturation boundary. 2. Which of the following is FALSE about the isothermic saturation boundary (ISB)? a. Below the ISB, temperature and relative humidity remain constant. b. Above the ISB, temperature and humidity increase during exhalation. c. The ISB is normally located just below the larynx (vocal cords). d. Above the ISB, temperature and humidity decrease during inspiration. This point, normally approximately 5 cm below the carina, is called the isothermic saturation boundary (ISB). Above the ISB, temperature and humidity decrease during inspiration and increase during exhalation. 3. Which of the following factors cause the isothermic saturation boundary (ISB) to shift farther down into the airways? 1. decreased ambient temperature 2. increased tidal volume (VT) 3. endotracheal intubation a. 1 and 2 b. 2 and 3 c. 1 and 3 d. 1, 2, and 3 The ISB shifts distally when a person breathes through the mouth rather than the nose; when he or she breathes cold, dry air; when the upper airway is bypassed (breathing through an artificial tracheal airway); or when the minute ventilation is higher than normal. 4. What is the primary goal of humidity therapy? a. decrease airway reactivity to cold b. maintain normal physiologic conditions c. deliver drugs to the airway d. reduce upper airway inflammation The primary goal of humidification is to maintain normal physiological conditions in the lower airways. 5. Indications for warming inspired gases include all of the following except: a. treating a patient whose airways are reactive to cold b. providing humidification when the upper airway is bypassed c. treating a patient with a low body temperature (hypothermia) d. reducing upper airway inflammation or swelling 6. Administration of dry gases at flows exceeding 4 L/min can cause which of the following? 1. structural damage 2. heat loss 3. water loss a. 1 and 2 b. 2 and 3 c. 1 and 3 d. 1, 2, and 3 Administration of dry medical gases at flows greater than 4 L/min to the upper airway causes immediate heat and water loss and, if prolonged, causes structural damage to the epithelium. 7. Inhalation of dry gases can do which of the following? 1. increase viscosity of secretions 2. impair mucociliary motility 3. increase airway irritability a. 1 and 2 b. 3 c. 1 and 3 d. 1, 2, and 3 As the airway is exposed to relatively cold, dry air, ciliary motility is reduced, airways become more irritable, mucous production increases, and pulmonary secretions become inspissated (thickened due to dehydration). 11. Clinical indications for delivering cool humidified gas include which of the following? 1. post-extubation edema 2. upper airway inflammation 3. croup (laryngotracheal bronchitis) 4. epiglottitis a. 2, 3, and 4 b. 1, 2, and 3 c. 1, 2, 3, and 4 d. 2 and 3 The delivery of cool humidified gas is used to treat upper airway inflammation resulting from croup, epiglottitis, and post-extubation edema. 12. What device adds molecular water to gas? a. agitator b. humidifier c. nebulizer d. atomizer A humidifier is a device that adds molecular water to gas. 13. Factors affecting a humidifier’s performance include all of the following except: a. surface area b. temperature c. time of contact d. outlet size The following four variables affect the quality of a humidifier’s performance: (1) temperature, (2) surface area, (3) time of contact, and (4) thermal mass. 14. What is the most important factor determining a humidifier’s performance? a. surface area b. temperature c. time of contact d. gas flow Temperature is an important factor affecting humidifier performance. 15. The greater the temperature of the gas, the: a. more water vapor it can hold b. less water vapor it can hold c. less efficient the humidifier is d. more water vapor is lost The greater the temperature of a gas, the more water vapor it can hold (increased capacity). 27. The relief valve on a bubble humidifier serves which of the following functions? 1. It indicates when flow has been interrupted. 2. It protects the device from pressure damage. 3. It warns you when the water level is low. a. 1 and 2 b. 2 and 3 c. 1 and 3 d. 1, 2, and 3 The relief valve on a bubble humidifier serves to warn of flow-path obstruction and to prevent bursting of the humidifier bottle. 32. What are some types of passover humidifiers? 1. simple reservoir 2. membrane 3. wick a. 1 and 2 b. 2 and 3 c. 1 and 3 d. 1, 2, and 3 37. Heat-moisture exchangers (HMEs) are mainly used to do what? a. warm and humidify gases delivered to the trachea via ventilator circuits b. humidify therapeutic gases delivered at high flows to the lower airway c. provide extra humidity for a patient with thick or retained secretions d. warm and humidify dry therapeutic gases delivered to the upper airway Traditionally, HME use has been limited to providing humidification to patients receiving invasive ventilatory support via endotracheal or tracheostomy tubes 78. For which of the following patients would you NOT recommend bland aerosol therapy administration? 1. patient with a history of airway hyperresponsiveness 2. patient with a bypassed upper airway 3. patient with active bronchoconstriction a. 1, 2, and 3 b. 2 and 3 c. 1 and 2 d. 1 and 3 79. Hazards and complications of bland aerosol therapy include all of the following except: a. bronchospasm b. overhydration c. infection d. hemoconcentration 82. Which of the following would indicate that administration of a bland water aerosol to a patient with post-extubation upper airway edema was having the desired effect? 1. decreased work of breathing 2. improved vital signs 3. decreased stridor or dyspnea 4. improved oxygen saturation a. 1, 2, and 3 b. 1, 2, 3, and 4 c. 3 and 4 d. 1, 2, and 4 87. Which of the following nebulizers uses a piezoelectric transducer to generate liquid particle aerosols? a. hydrodynamic nebulizer b. ultrasonic nebulizer c. jet nebulizer d. centrifugal nebulizer An ultrasonic nebulizer is an electrically powered device that uses a piezoelectric crystal to generate aerosol. 97. A physician orders bland water aerosol administration to a patient with a tracheostomy. Which of the following airway devices could you use to meet this goal? 1. tracheostomy mask 2. face tent 3. T-tube 4. aerosol mask a. 2 and 4 b. 1, 2, and 3 c. 1 and 3 d. 2, 3, and 4 Chapter 36: Aerosol Drug Therapy 1. Which of the following best defines an aerosol? a. suspension of liquid droplets in a gas b. suspension of particulate matter in a gas c. molecular water dispersed throughout a carrier gas d. suspension of liquid or solid particles in a gas An aerosol is a suspension of solid or liquid particles in gas. 2. With which of the following devices are therapeutic aerosols generated? 1. atomizers 2. nebulizers 3. humidifiers a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3 In the clinical setting, medical aerosols are generated with atomizers, nebulizers, or inhalers. 3. The mass of aerosol particles produced by a nebulizer in a given unit time best describes which quality of the aerosol? a. stability b. density c. output d. deposition Aerosol output is defined as the mass of fluid or drug contained in aerosol produced by a nebulizer generated per unit of time. 4. Which of the following describes the mass of drug leaving the mouthpiece of a nebulizer as aerosol? a. single dose b. emitted dose c. multiple dose d. output dose For drug delivery systems, emitted dose describes the mass of drug leaving the mouthpiece of a nebulizer or inhaler as aerosol. 9. What is the retention of aerosol particles resulting from contact with the respiratory tract mucosa called? a. stability b. density c. penetration d. deposition When aerosol particles leave suspension in gas they deposit on (attach to) a surface. 10. Which of the following factors affect pulmonary deposition of an aerosol? 1. size of the particles 2. shape and motion of the particles 3. physical characteristics of the airways a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3 Whether aerosol particles that are inhaled into the lung are deposited in the respiratory tract depends on the size, shape, and motion of the particles and on the physical characteristics of the airways and breathing pattern. 24. What is the process by which aerosol suspension changes over time? a. evaporation b. deposition c. aging d. sublimation The uploads/Sante/ study-guide 56 .pdf