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Review Sheet for the TMC Exam with Verified Solutions 2023
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Review Sheet for the TMC Exam with Verified Solutions 2023
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Review Sheet for the TMC Exam with Verified Solutions 2023 TABLE OF CONTENTS Key Terminology page 1 New Items for 2021 page 3 I. Patient Data A. Evaluate Data in the Patient Record page 22 B. Perform Clinical Assessment page 29 C. Perform Procedures to Gather Clinical Information page 69 D. Evaluate Procedure Results page 83 E. Recommend Diagnostic Procedures page 105 II. Troubleshooting and Quality Control of Devices, and Infection Control A. Assemble / Troubleshoot Devices page 109 B. Ensure Infection Prevention page 112 C. Perform Quality Control Procedures page 116 III. Initiation and Modification of Interventions A. Maintain a Patent Airway Including the Care of Artificial Airways page 120 B. Perform Airway Clearance and Lung Expansion Techniques page 125 C. Support Oxygenation and Ventilation page 131 D. Administer Medications and Specialty Gases E. Ensure Modifications are Made to the Respiratory Care Plan page 149 F. Utilize Evidence Based Practice page 168 G. Provide Respiratory Care in High -Risk Situations page 170 TMC Review Sheet H. Assist a Physician / Provider in Performing Procedures page 172 I. Conduct Patient and Family Education page 177 Resources, References, Learning Tools page 179 KEY TERMINOLOGY Chocolate Brown Blood indicates Methemoglobinemia So do hemoximetry to see how much of the various types of hemoglobin are present. One common cause of methemoglobinemia is nitrite. Also, Nitric Oxide Therapy. Treatment of methemoglobinemia is Methylene Blue! Hemoximetry is the same thing as CO-Oximetry To measure carboxyhemoglobin and other types of hemoglobin. Crucial test in Carbon Monoxide poisoning! Oxyhemoglobin, Fetal Hemoglobin, Methemoglobin, Carboxyhemoglobin Empyema Some students have confused this term with emphysema, so let’s explain. Empyema is usually caused by an infection that spreads from the lung. It leads to a buildup of pus in the pleural space . There can be a pint or more of infected fluid. This fluid puts pressure on the lungs. Risk factors include pneumonia, Tuberculosis , Chest surgery, Lung abscess , Trauma, or injury to the chest. The health care provider may note decreased breath sounds or an abnormal sound (friction rub) when listening to the chest with a stethoscope. Tests that may be ordered include Chest x-ray, CT scan of the chest, Pleural fluid analysis , Thoracentesis . The goal of treatment is to cure the infection. This involves the following placing a chest tube to drain the pus and giving antibiotics to control the infection. Phosphotidylglycerol (PG) This is obtained by amniocentesis, when it is present , it indicates that the baby’s lungs are mature L/S Ratio – Lecithin/Sphyngomyelin Ratio – 2:1 – babies – happens at about 34-35 weeks of gestation “Thorpe Tube” – standard oxygen flowmeter, plugs into a wall outlet – not good for transport “Bourdon Gauge” – regulator, good for transport “Eupnea” – normal breathing, no distress “Eu” – Eu – good BiPAP is called NPPV (Noninvasive Positive Pressure Ventilation) or NIV (Noninvasive Ventilation) for testing purposes revsd: October 2020 TMC Review Sheet “Marked” Means very severe – so do something quickly – patient has marked stridor after extubation – reintubate! Marked hypoxemia – oxygen immediately “Oscilloscope” – an older term for a cardiac monitor or other monitoring electronic monitoring device. “Adventitious” lung sounds are abnormal lung sounds. If your patient has abnormal lung sounds, you are in for an “adventure.” Which adventitious sound clears with coughing……rhonchi “Oxygenation Index” OI = (FIO2 X Mean Airway Pressure) / PaO2 The oxygenation index (OI) is used to assess the intensity of ventilatory support required to maintain oxygenation. It is used in neonates/pediatrics to assess the need for potential ECMO therapy. NEW ITEMS FOR 2021 Nasopharyngeal vs. Oropharyngeal airways , how to size: NPA - From the patient’s nostril to the angle of the jaw or to the earlobe OPA – From the corner of the patient’s mouth fo the angle of the jaw Unconscious patient: oropharyngeal airway . I a patient has a gag reflex, DO NOT insert an oropharyngeal airway! Conscious patient: Nasopharyngeal airway ! Macintosh : blade lifts the vallecula Miller blade : goes straight to the epiglottis Subcutaneous emphysema and trach patients: If you have inserted a trach tube and you bag the patient and feel resistance, what would you do if subcutaneous emphysema develops? Take the trach tube out. revsd: October 2020 TMC Review Sheet 10 mL of a 1% albuterol solution , how much do you give? You would give 0.5 mL which is 2.5 mg of albuterol, because every 1 mL of the 1% solution contains 5 mg of albuterol. Underexposure or over exposure ? “The vertebrae could be seen through the heart”…overexposure. X- ray CHF: engorged pulmonary vessels, fine crackles on auscultation, heart is huge! Apnea monitor alarms were intermittent sounding, what was wrong/how do you fix it? apnea interval set at 20. Were the monitor wires disconnected, increase the interval, electrode is not adhered properly. Administration of surfactant : (could be called Bovine Surfactant) Child with an APGAR of 8, 5 minutes after birth. Child had a Dubowitz or Ballard of 42 weeks Gestational age under 28 weeks A patient on CPAP nasal mask , pressure set at 12 cm H2O, pressure dips down to 5 cm H2O. Blood pressure hypotensive. Choice of answers: a. Increase the pressure to 15 cm H2O b. Change to nasal pillows c. Change to a full face mask Patient transport: What would you use to monitor the patient’s ventilatory status: a. Capnography (ventilation) b. Co-Oximetry c. Pulse Oximeter (Oxygenation) revsd: October 2020The benefits of buying summaries with Stuvia:
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