Kacmarek: Egan's Fundamentals of Respiratory Care, 11th Edition

Kacmarek: Egan's Fundamentals of Respiratory Care, 11th EditionCHAPTER OBJECTIVES 1. Define respiratory care. (Q: 4, 15) 2. Summarize some of the major events in the history of science and medicine. (Q: 18) 3. Explain how the respiratory care profession got started. (Q: 20) 4. Describe the historical development of the major clinical areas of respiratory care. (Q: 21) 5. Name some of the important historical figures in respiratory care. (Q: 24) 6. Describe the major respiratory care educational, credentialing, and professional associations. (Q: 16) 7. Explain how the important respiratory care organizations got started. (Q: 16) 8. Describe the development of respiratory care education. (Q: 17) 9. Predict future trends for the respiratory care profession. (Q: 23) WORD WIZARD Reference: Glossary 1. M. physician assistant 2. A. AARC 3. F. respiratory therapy 4. E. respiratory care (Number 3 and 4 are often interchanged.) 5. I. aerosol medications 6. H. oxygen (O2) therapy 7. C. NBRC 8. J. mechanical ventilation 9. B. CoARC 10. D. cardiopulmonary system 11. L. pulmonary function testing 12. N. respiratory care practitioner(s) 13. G. respiratory therapist(s) (The terms in 13 and 14 are often interchanged.) 14. K. airway management MEET THE OBJECTIVES 15. References: Pages 4, 11 The actual definition of respiratory therapy is “the health care discipline that specializes in the promotion of optimal cardiopulmonary function and health.” Main concepts may include the assessment, treatment, management, control, diagnostic evaluation, education, and care of patients with deficiencies and abnormalities of the Answer Key for the Workbook 1-2Copyright © 2017 Elsevier Inc. All Rights Reserved. cardiopulmonary system. Respiratory care is increasingly involved in the prevention of respiratory disease, the management of patients with chronic respiratory disease, and the promotion of health and wellness. The Inhalation Therapy Association (ITA) was the first professional association in respiratory care. The ITA became the American Association for Inhalation Therapists (AAIT) in 1954, the American Association for Respiratory Therapy (ARRT) in 1973, andthe American Association for Respiratory Care (AARC) in 1982. 16. Reference: Page 14 The first course in inhalation therapy was offered in 1950. Programs in the 1960s focusedon teaching students the proper application of O2 therapy, O2 delivery systems, humidifiers, and nebulizers and the use of various IPPB devices. The new standard requires an associate degree for entry into the profession. There will be a need for individuals with more education so more baccalaureate and graduate education is needed. Technician programs no longer exist. SUMMARY CHECKLIST 17. Reference: Page 4 Prevent; treat 18. Reference: Page 11 AARC; 1947; the Inhalation Therapy Association 19. Reference: Page 9 Polio FOOD FOR THOUGHT 20. The general answer is management, supervision, research, and education. You can also become a case manager, a drug representative, or go on for graduate education in anesthesia or as a physician assistant. 21. This question is a simple classic that has many possible answers. Dr. David Pierson promoted the science of respiratory care and the use of protocols. He helped us elevate our practice. Joseph Priestley discovered O2, and Thomas Beddoes first used it. I would like to be a therapist who becomes a pioneer of a new and vital technique. Kacmarek: Egan's Fundamentals of Respiratory Care, 11th EditionChapter 02: Delivering Evidence-Based Respiratory Care Answer Key for the Workbook Copyright © 2017 Elsevier Inc. All Rights Reserved. CHAPTER OBJECTIVES 1. Understand the elements for delivering quality respiratory care. (Q: 5) 2. Explain how respiratory care protocols improve the quality of respiratory care services. (Q: 6, 7) 3. Understand the evidence-based medicine. (Q: 9) WORD WIZARD 1. CoARC Responsible for quality of schools 2. The Joint Commission Uses site visits to check quality of care 3. Evidence-based medicine Uses meta-analyses to find best care 4. NBRC Responsible for quality of credentialing exams MEET THE OBJECTIVES 5. Reference: Page 20 A. Equipment B. Personnel C. Method of delivery of services 6. Reference: Page 31 A. Institutional: Skills check-offs and classes and competencies B. Governmental: Monitors like CMS or The Joint Commission accredits institutions based on quality monitoring standards over nine or more areas. 7. Reference: Tables 2-1, 2-2, 2-3, and 2-5 Protocols improve the allocation of respiratory resources by reducing misallocations suchas over-ordering. Protocols also reduce costs. Care may be enhanced. 8. Reference: Pages 36-38 The ARDSNet studies produced scientific evidence. When analyzed, they showed that you could decrease patient mortality by following specific guidelines for volume ventilation. Using 4 to 8 ml/kg as the breath size saved lives. SUMMARY CHECKLIST Reference: Page 38 9. Misallocation Answer Key for the Workbook 2-2Copyright © 2017 Elsevier Inc. All Rights Reserved. 10. Protocols 11. Registered (RRT) 12. National Board for Respiratory Care (NBRC) 13. Evidence-based CASE STUDIES Case 1 Reference: Page 26, Figure 2-2 14. A. SOB B. Tachycardia C. Diaphoresis, confusion, etc. 15. The pulse oximeter shows a good saturation. The patient has no clinical signs of hypoxemia and no history that suggests heart or lung disease. Respiratory rate and heart rate are normal. Oxygen (O2) therapy is not indicated. 16. Place the patient on room air and recheck the saturation. The history of abdominal surgery suggests starting the patient on postoperative protocol like incentive spirometry. Discontinue the O2 if the saturations are good. Case 2 Reference: Page 25, Figure 2-1 17. He has a history of smoking, lung disease, and has had surgery. His x-ray shows atelectasis. He is wheezing, so he needs a bronchodilator. Step 1: Patient is alert Step 2: Can take a deep breath Step 3: Does not meet MDI criteria Step 4: Select SVN WHAT DOES THE NBRC SAY? 18. Reference: Page 26, Figure 2-2 A. O2 therapy 19. Reference: Page 27, Mini Clini D. Aerosolized bronchodilator therapy 20. Reference: Page 26, Figure 2-2 A. Increase the liter per minute flow to the cannulas. Answer Key for the Workbook 2-3Copyright © 2017 Elsevier Inc. All Rights Reserved. FOOD FOR THOUGHT 21. Reference: Pages 24, 27; Boxes 2-2, 2-5, and 2-6 Successful protocol programs involve many elements, including collaboration with physicians and nurses, trained therapists, committed medical direction, and active qualitymonitoring. Failure to take all of these actions could result in poor outcomes. Protocols themselves must be well designed. Quality assurance efforts are also complex. Timely audits must be conducted, and follow-up actions to resolve problem areas must be taken. 22. Reference: Page 38 Meta-analysis analyzes and summarizes all the research findings on a topic into one result using the best studies (weighted). A standard literature search cannot combine the various studies. Meta-analysis is better, but you need enough quality studies to performthe analysis, making it limited, for example, in evaluating new therapies.