A patient is on a ventilator when you go into see them. There is the letter A on the top left corner referring to “Assist Control” and the monitor reads: FIO2: 30%, PEEP of 6, respirations of 29. 1. What does assist control mean?
Applies peep PEEP to a spontaneously breathing patient
Sets a minimum number of assisted breaths, controlled by either volume or pressure. Patient is able to take breaths on their own alone with the breaths from the ventilator
The ventilator helps by making up the difference in pressure that the patient doesn't produce on their own, but has a set rate
The ventilator is controlling the amount of breaths and volume they take
A patient is on a ventilator when you go into see them. There is the letter A on the top left corner referring to “Assist Control” and the monitor reads: FIO2: 30%, PEEP of 6, respirations of 29. 2. In reference to the FIO2, what does that mean for the amount of oxygen concentration they are getting?
The patient has a respiration of 29 because they are getting and FiO2 of 30%
The patient is getting 30% oxygenation during each breath. Normal value is 21%
The patient is receiving oxygen 30% of the time
30% FiO2 is the normal concentration level, therefore the patient isn't getting any additional supplemental O2
A patient is on a ventilator when you go into see them. There is the letter A on the top left corner referring to “Assist Control” and the monitor reads: FIO2: 30%, PEEP of 6, respirations of 29. 3. According to the PEEP, are they safe to work with? And what does the PEEP mean in terms of, what is it doing for the patient?
No--PEEP is preventing early expiration pressures meaning the machine controls when the patient expires allowing enough time for gas exchange. You can't work with them because 6 is too high of a PEEP to be working with them, they are too critical
No--PEEP is positive end expiratory pressure meaning the amount of pressure necessary to keep their alveoli and air sacs open for ventilation. You can't work with them because 6 is too high of a PEEP to be working with them, they are too critical
Yes--PEEP is preventing early expiration pressures meaning the machine controls when the patient expires allowing enough time for gas exchange. You can work with them because they aren't at a PEEP of 10.
Yes--PEEP is positive end expiratory pressure meaning the amount of pressure necessary to keep their alveoli and air sacs open for ventilation. You can work with them because they aren't at a PEEP of 10.
Your 64 year old patient, Milly, is 400 lbs. with a history of heart failure, respiratory failure (8L O2 via Nasal Cannula), obesity, diabetes, and a wound on left lower leg. She is on Coumadin, Lexapro, and Ativan. You have been working with patient on getting out of bed, transferring to commode, and ambulation. You review her chart prior to working with her and her INR is 3.2. It is safe to work with her. True or false?
Your 73 year old patient, Henry, is in the hospital for respiratory failure, septic shock, hospital deconditioning, and an open sacral wound. You have been working on walking to the bathroom, balance activities, and moving around obstacles. Before you enter his room to treat him, you notice that his hemoglobin in 6.4 and he is receiving 2L of blood currently. What is the best treatment option at this point?
Come back and check with him in the afternoon to do bed exercises
Do AROM/PROM while he lays in bed
Have him walk to the therapy room 50 feet
Stand him up and work on marching, lunges, and squats
Rose is a 76 year old female that is in the hospital recovering from acute respiratory failure and cardiac arrest during a bronchoscopy. You are walking with Rose down the hall way and she tells you that she needs to sit down and take a rest. What are the most common signs and symptoms that her oxygen saturation may be low?
Bradycardia, sleepiness, coughing, agitated
Tachycardia, clear thinking, no rest breaks, dry/flakey skin
Tachycardia, shortness of breath, diaphoresis, tachypnea
Use of accessory breathing muscles, shakey hands, bradycardia
Dusty, a 38 year old patient is in the hospital for respiratory failure, lung empyemas, and acute stages of heart failure, obesity, and AKI. Dusty has been weaned off the ventilator and is now on trach collar at 35% oxygen. The patient has had trials with the Passy Muir Valve (PMV) to try and speak while on the trach collar. How does the Passy Muir Valve affect the air flow into his lungs?
Air can be inhaled and exhaled through the valve to allow for air to travel anywhere it’s needed
Air is only inhaled into the trach, but not exhaled, to allow for air to exit the upper airway for speech
Air is inhaled and then exhaled through the PMV during the patient’s speech
Air is inhaled through the mouth and then exhaled through the PMV during speech
Dusty, a 38 year old patient is in the hospital for respiratory failure, lung empyemas, and acute stages of heart failure, obesity, and AKI. Dusty has been weaned off the ventilator and is now on trach collar at 35% oxygen. The patient has had trials with the Passy Muir Valve (PMV) to try and speak while on the trach collar. What kind of trach tube does he need?
Cuff and fenestrated
Cuff and non-fenestrated
Cuffless/cuff deflated and fenestrated
Cuffless/cuff deflated and non-fenestrated
You are treating Claire, a 81 year old patient who is currently on a nasogastric (NG) feeding tube for her nutrition. Claire is on continuous feedings while in bed. After you are doing working with her for the day and you get her back to bed, what do you need to make sure you do when you are done with the patient?
Ask the patient if they are hungry and want the tube feeding to run
Elevate the head to at least 30 degrees
Hook the tube feeding back up
Keep the patient flat in the supine position
Keep the tube feeding off and tell a nurse
Start the tube feeding
What is the process by which by which a man-made membrane helps clear wastes from the blood, eliminating extra fluid and restoring the proper balance of electrolytes. The catheter can be inserted in internal jugular, subclavian, or forearm for a fistula and can last 3-5 hours.
Hemodialysis
Hemodiafiltration
Hemofiltration
Peritoneal Dialysis
What hemodynamic monitoring device has restrictions of ambulation and only allows you to help transfer your patient from the bed to bedside chair due to high risk for thrombosis, arterial rupture, hemorrhage, or sepsis?
Arterial Lines
Central Venous Catheter
Intracranial Pressure Monitoring
Pulmonary Artery Catheter (Swan Ganz)
A patient has a PICC line in medial cutibal fossa when you go into work with them. What motion precautions/motions should you avoid while you work with them to avoid arrhythmias or dislodging?
>90 shoulder flexion
>90 elbow flexion
forearm supination and pronation
shoulder external rotation
full elbow extension
full shoulder extension
