TMC for May 2020 Question and Answers

If a patient is on 8-12L/min, what would be the fio2? - ANSWER 50% If minute ventilation stays the same but dead-space is added, what will increases? - ANSWER PaCO2 What is the static compliance equation? - ANSWER Exhaled Vt/(Pplat - PEEP) Before chest physiotherapy is done, what should the respiratory therapy do FIRST? - ANSWER Review patient chart history What should a therapist do when a family is asking to put the patient on the mechanical ventilator when they have a DNI order in place? - ANSWER Start with NPPV What phrase would describe a patient having dyspnea? - ANSWER "I have to stop and catch my breath" A patient who has a neck injury but needs their airway protected. What should you put in place? - ANSWER Oropharyngeal airway A patient is unconscious, what should you do to establish a patent airway? - ANSWER Head tilt chin A patient has accessory muscle and scalene usage, what does this indicate? - ANSWER Increased work of breathing Unevenly spaced beats decreased pulse strength during inspiration, is indicative of what? - ANSWER Pulsus paradoxus What positions do you place a patient in for right lung secretions? - ANSWER Left lateral decubitus What the correct endotracheal tube placement? - ANSWER 5cm above the carina or 4-6cm Chest x-ray looks normal but they have been sitting for an extended period of time and is experiencing dyspnea. What is likely the cause? - ANSWER Pulmonary embolism Chest x-ray showing a deflated lung. What is a likely diagnosis? - ANSWER Tension pneumothorax A patient has hemoptysis, what do you do? - ANSWER Bronchoscopy Broncholavage should be done with what? - ANSWER Mini ball-vap After intubation there is a lack of breath sounds on the left side, what could be the cause? - ANSWER Right mainstem bronchi intubation There is a hyperresonance and tracheal shift with distant breath sounds, what is a likely diagnosis? - ANSWER Pneumothorax What is a V/Q scan used to identify? - ANSWER Pulmonary embolism What is the name of the gestational age test? - ANSWER Ballard score What is used to diagnose cancer? - ANSWER PET scan Bronchogram is used to diagnose what? - ANSWER Bronchiectasis A patient has left sided chest pain, what diagnostic test should be done? - ANSWER Chest x-ray Midclavicular is the place for what lead? - ANSWER V4 leads What percentage of PaCO2 is normal? - ANSWER 5% What is the normal value of ejection fraction? - ANSWER 60 How is VD/VT calculated? - ANSWER PaCO2-PeCO2/PaCO2 is 30 Patient was taken from a burning house, what diagnostic test should be done? - ANSWER Co-oximeter/hemoximeter Low urine output can be caused by what? - ANSWER Low PCWP What is the reversal agent of OPIODS? - ANSWER Narcan What do you give for stridor? - ANSWER Racemic epinephrine A patients endotracheal tube is 18cm at the lip, cuff pressure is 19cmH2O, and there is still gurgling, what should you do? - ANSWER Advance the ET tube Unequal breath sounds - ANSWER What should be done after ABG sampling? - ANSWER Change the gloves What type of heated humidifier should be placed for a patient with tracheostomy? - ANSWER HME (Heat and moisture exchanger) The Semi fowler position is used for what? - ANSWER Anterior apical upper lung segmented lobes Blood for sampling for an ABG must be done. There is no collateral circulation to the right arm and there is a shunt in place on the left arm, what site should the ABG be done? - ANSWER Dorsalis pedis 123 cardioversion, what supplies are necessary? - ANSWER No transcutaneous pacemaker A patient has a long-term (chronic) cough, what medication should be administered? - ANSWER Mucolytic Bronchodilator should be given for a COPD patient? - ANSWER Atrovent Increased nitric oxide can cause what condition? - ANSWER Methemoglobinia CO2 analyzer has what electrode? - ANSWER Severinghuas electrode Radial artery is used for what reason? - ANSWER Collateral circulation Peripheral artery and pulmonary artery, should be used for what? - ANSWER Hemodynamic monitoring What waveform will show auto-PEEP? - ANSWER Flow waveform What does it mean if there is a low tidal volume and exhale volume alarm? - ANSWER System leak PaO2 decreases what will increase? - ANSWER p(A-a) What should be monitored what a patient has Guillain-Barre or Myasthenia gravis? - ANSWER FVC MIP is used for monitoring of what? - ANSWER Muscle strength in weaning What are the instructions for doing a MVV maneuver? - ANSWER Have the patient breath in and out as fast as possible for 12sec A patient is on helium dilution for 70/30 but is still experiencing dyspnea. What should be done for the patient? - ANSWER Go to 80/20 IPAP 8-12 and EPAP 4-6, and the patient is having increased work of breathing. What should the respiratory therapist do? - ANSWER Increase IPAP What should a patient be placed on when they have central sleep apnea? - ANSWER BiPAP A patient had slightly snoring and a AHI of 3, despite being on a CPAP of 8cmH2O.