Medsurg Respiratory Training Courses Questions And Answers

MEDSURG RESPIRATORY TRAINING COURSES QUESTIONS AND ANSWERS what does spirometry testing do? -Answer-confirms airflow obstruction and determines the severity of COPD what does the chest x ray of a COPD patient usually show? -Answer-flat diaphragm due to hyperinflated lungs (decreased/increased) serum alpha 1 antitrypsin levels are indicative of lung disease -Answer-decreased patients with an O2 sat of ___% or less at rest qualify for supplemental O2 -Answer-88 true or false: ABGs alone can be used to diagnose COPD -Answer-false typically, in the late stages of COPD, the patient has __________ pH, __________ PaCO2, and ____________ HCO2 -Answer-low to normal pH above normal PaCO2 high to normal HCO3 (compensated) total lung capacity -Answer-the sum of vital capacity and residual volume vital capacity -Answer-The total volume of air that can be exhaled after maximal inhalation. residual volume -Answer-Amount of air remaining in the lungs after a FORCED exhalation when the __________ ratio is less than _____ along with the appropriate symptoms, a diagnosis of COPD is made -Answer-when the FEV1/FVC ratio less than 70% FEV1 -Answer-forced expiratory volume in 1 second FVC -Answer-forced vital capacity (amount of gas that can be forcibly and rapidly exhaled after a full inspiration) The value of _____ as a percentage compared with normal provides a guideline for the degree of severity in the pt's lung disease and stage of the disease -Answer-FEV1 the (lower/higher) the FEV1, the more obstructed the airways are -Answer-lower (obstructive/restrictive) disease is characterized by an increase in the resistance to airflow through the airways -Answer-obstructive restrictive lung disease is characterized by (reduced/increased) expansion/elasticity of the lung parenchyma with (decreased/increased) total lung capacity -Answer-reduced, decreased chest wall disorders -Answer-rib fractures, flail chest, etc chest wall disorders are considered (restrictive/obstructive) -Answer-restrictive acute/chronic interstitial and infiltrative diseases are considered (restrictive/obstructive) -Answer-restrictive asthma is considered (restrictive/obstructive) -Answer-obstructive patients with COPD will have a(n) (increased/decreased) total lung capacity -Answer-increased what are some airway clearance techniques that COPD patients can use? -Answer-huff coughing, chest physiotherapy (postural drainage, percussion, vibration) how often can postural drainage be done? -Answer-q4 hours COPD patients should practice (diaphragmatic/chest) breathing with pursed lips -Answer-diaphragmatic how much fluid intake is recommended for a COPD patient? -Answer-3L/day unless contraindicated surgical interventions for COPD (3) -Answer-1. lung volume reduction surgery (LVRS) 2. bullectomy 3. lung transplant Lung volume reduction surgery (LVRS) -Answer-decreases the size of hyperinflated lungs and decreases airway obstruction, increasing room for remaining alveoli to function improves chest wall mechanics bullectomy surgery is done for -Answer-emphysematous COPD bullae -Answer-large air pockets within the lung parenchyma lung transplants are done in cases of -Answer-severe COPD normally, (O2/CO2) is what stimulates the chemoreceptors and causes us to ventilate with COPD, people are driven to breathe by ___________ -Answer-normally, increased CO2 levels stimulate ventilation chronic COPD leads to hypoxemia being the only thing stimulating a person to breathe true or false: all pts with COPD retain CO2 -Answer-false oxygen goal for COPD -Answer-SPO2 of at least 90% OR PaO2 of at least 60 mmHg most COPD patients can tolerate __ L of oxygen via _________ -Answer-2 L via nasal cannula or venturi mask what is especially helpful for giving low, constant O2 concentrations to patients with COPD? -Answer-venturi mask acapella device -Answer-small handheld device that uses Positive Expiratory Pressure (PEP) and vibrations to mobilize secretions High-frequency chest wall oscillation -Answer-inflatable vest with high frequency airwaves that dislodge mucus from airways true or false: aggressive respiratory toilet is good for COPD patients -Answer-true what type of diet is recommended for COPD patients? -Answer-high in calories and protein, moderate in carbs, moderate to high in fats how many meals/day should COPD pts eat? -Answer-5-6 small meals why should oral care be offered to COPD patients before meals? -Answer-to reduce the taste of sputum COPD pts should drink liquids (with/between) meals -Answer-between what should COPD pts do before mealtimes? -Answer-rest for 30 min and use a bronchodilator 1 hour before COPD pts should eat (cold/hot) foods. why? -Answer-cold; give less 'full sensation' and they can eat more which meal is best for a COPD patient? A. a tossed salad with roasted cauliflower and chickpeas B. bean and cheese burrito C. beef stew with cabbage and potatoes D. turkey sandwich and protein shake -Answer-D (light meal high enough in proteins and calories) cauliflower, beans, and cabbage cause gas buildup smoking cessation drugs include -Answer-bupropion hydrochloride (Zyban) and varenicline (Chantix) what types of drugs may be given for COPD? (6) -Answer-smoking cessation drugs anti-inflammatory agents (corticosteroids, PDE4 inhibitors) bronchodilators long acting anticholinergics mucolytics (ex: Mucomyst, NS) Methylxanthines (mild bronchodilator, improves diaphragm contractility. Ex: theophylline) which drugs are short acting beta-2 agonists? what do they do? -Answer-Albuterol and Atrovent are short acting bronchodilators