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You are the respiratory therapist working in the Pediatric Clinic
at a 500-bed urban hospital. The nurse manager asks you to
assist in the care of a recently admitted 5 year-old girl who has
trouble breathing. The patient's mother reports that her
daughter was born premature and required mechanical
ventilation for a prolonged period after birth. She also reports
that she brought her daughter to
the hospital several times previously for respiratory
problems. - ANSWER-
Initiate oxygen therapy via nasal
cannula
You should now - ANSWER-Administer albuterol via small
volume nebulizer
You are now asked to assist in the care of a 12-year-old girl
with a history of cystic fibrosis. She was admitted to the
Pediatric Floor from the Emergency Department one hour ago. -
ANSWER-ABG/ CBC/ vital signs/ cardiac monitor/ serum
electrolytes/ sputum culture/ general appearance/ chest
auscultation/ respiratory pattern
,What therapy should you initiate at this time? - ANSWER-
Oxygen by nasal
cannula
What additional therapy would you now recommend? -
ANSWER-tobramycin/
albuterol/ dornase
alpha/ cpt
You are the respiratory therapist working at a 200-bed
community hospital. You are assigned to provide care for a 67-
year-old female patient who was admitted two days ago for a
viral infection she has had for several weeks. She complains of
general weakness which began in the lower extremities. The
patient is 157 cm (5' 2") tall and weighs 61 kg (134 lb). -
ANSWER-level of consciousness/ spontaneous VT, VC, MIP/
pulse oximetry/ breath sounds/ symptoms/ respiratory pattern
Based on your assessment, you would now: - ANSWER-
Measure VT, VC, and
MIP
Q4H
The patient is unable to take a deep breath and complains of
shortness of breath. The hospitalist asks for your conclusion
about a diagnosis for this patient. You should suggest that the
patient most likely has - ANSWER-Guillain
Barré Syndrome
, The hospitalist agrees and asks for your recommendation for
monitoring and care. Based on your assessment, you should
now recommend – ANSWER-Transfer the patient to ICU
Four hours later, the patient's vital signs are: temperature 38.1°
C (100.6° F), pulse 99/min, respirations 22/min, BP 136/87 mm
Hg. SpO2 is 95% on nasal cannula at 4 L/min. Spontaneous
tidal volume is 400 mL, vital capacity is 1.2 L, and MIP is -20 cm
H2O. What would you recommend to the hospitalist at this
time? - ANSWER-Continue to monitor the patient
Two hours later, the patient's vital signs are: temperature 38.4°
C (101.2° F), pulse 108/min, respirations 44/min, BP 156/87 mm
Hg. SpO2 is 92% on nasal cannula at 4 L/min. Spontaneous
tidal volume is 200 mL, vital capacity is 0.5 L, and MIP is -17 cm
H2O. What would you recommend to the hospitalist at this
time? - ANSWER-Initiate mechanical ventilation
You are the respiratory therapist working at a 400-bed urban
medical center.
You are asked to assist in the care of a 68 year-old man who
was recently
admitted. The patient appears pale and tachypneic. He is
complaining of a persistent cough and fever for the past
several days. The patient is 175 cm (5' 9") tall and weighs 53 kg
(117 lb). - ANSWER-general appearance/ diagnostic chest
percussion/ capillary refill/ vital signs/ hx of present illness/
pulse oximetry/ chest auscultation/ respiratory pattern/ past
medical hx/ sensorium