Deck 15: Humidity and Aerosol Therapy

Question 1

Which of the following defines body humidity?

A)37°C,100 mmHg partial press [H₂O],and 47% saturation
B)37°C,44 mmHg partial press [H₂O],and 100% saturation
C)37°C,47 mmHg partial press [H₂O],and 100% saturation
D)47°C,37 mmHg partial press [H₂O],and 100% saturation

Answer 1

37°C,47 mmHg partial press [H₂O],and 100% saturation

Question 2

The presence of which one or more of the following may be an indication for administration of a water,isotonic,or hypotonic saline aerosol?

A)Stridor
B)Diagnosis of laryngotracheobronchitis
C)Clinical history suggesting upper airway irritation and increased work of breathing,such as smoke inhalation
D)a,b,and c

Answer 2

a,b,and c

Question 3

Which part of the ultrasonic nebulizer has the ability to convert electrical energy into mechanical energy?

A)Amplitude
B)Frequency
C)Piezoelectric crystal
D)Couplant

Answer 3

Piezoelectric crystal

Question 4

Which of the following should be monitored while the patient is receiving bland aerosol therapy?
I.Patient subjective response
II.Heart rate and rhythm,blood pressure
III.Respiratory rate,pattern,mechanics,accessory muscle use
IV.Sputum production quantity,color,consistency,odor
V.Breath sounds

A)I,III,and V
B)II and IV only
C)I,II,III,and IV
D)All of these

Question 5

Which of the following is NOT an indication for bland aerosol administration?

A)The need for sputum specimens
B)The need to deliver bronchodilators
C)The presence of upper airway edema
D)The presence of a bypassed upper airway

Question 6

Which of the following hazards or complications can occur with bland aerosol administration?

A)Wheezing
B)Bronchodilation
C)Tachycardia
D)Tremors

Question 7

Which type of humidifier is described as a small hygroscopic device placed proximal to a patient's artificial airway,where it absorbs water vapor from the patient's exhaled gas.When the patient breathes or the mechanical ventilator delivers the next breath,moisture in the device evaporates,humidifying the airway?

A)Bubble humidifier
B)Conventional humidifier
C)Wick humidifier
D)Heat and moisture exchanger (HME)

Question 8

What is the relative humidity of a gas that has the capacity to hold 40 mg/L of humidity,but only has an absolute humidity of 30 mg/L?

A)100%
B)75%
C)14 mg/L
D)133%

Question 9

How do Wick-type humidifiers increase the absolute humidity of a gas delivered to the patient?

A)By increasing the temperature
B)By increasing the surface area of contact between the water and the gas
C)By incorporating an HME into the system
D)a and b

Question 10

Which of the following statements is true concerning a heat and moisture exchanger (HME)humidifier?

A)The patient should be carefully monitored for increases in airway resistance and increased work of breathing.
B)It absorbs water vapor from the inhaled gas and delivers it to the patient.
C)The relative humidity of these devices is 100% at temperatures of 30 to 31°C.
D)They are indicated for patients that have a minute volume of greater than 15 LPM

Question 11

When monitoring the effectiveness of bronchodilator administration,which of the following pulmonary function tests would indicate the airway responsiveness the best?

A)Residual volume
B)Functional residual capacity
C)Tidal volume
D)Peak flow

Question 12

What is the purpose of a baffle in a large volume nebulizer?

A)Entrains air into the nebulizer to achieve various FIO₂.
B)Serves to stabilize particle size.
C)Regulates total gas flow to ensure a high-flow device.
D)It controls the output of the aerosol.

Question 13

The Centers for Disease Control and Prevention (CDC)recommends addressing exposure control issues when delivering an aerosol to the lung parenchyma by (1)administrative policy,(2)engineering controls,and (3)personal protective equipment,in that order.Which of the following is NOT a CDC recommendation for engineering controls?

A)Booths or stalls for sputum induction and aerosolized medication administration in areas in which multiple patients are treated.
B)Frequent air exchanges to dilute concentration of aerosol in room to eliminate 99% of aerosol before the next patient enters and receives treatment in the area.
C)Filters or filtered scavenger systems to remove aerosols that cannot be contained.
D)Rinsing filters,nebulizers,and other contaminated components of the aerosol delivery system used with suspect agents as hazardous waste after each use.

Question 14

If a gas is fully saturated with water vapor (100% saturated),what can be stated about the gas?

A)It is at body humidity.
B)It is at maximum humidity.
C)The relative humidity is 50%.
D)The temperature of the gas is 37°C.

Question 15

Which of the following FIO₂ settings would provide the highest total flow output of an aerosol device?

A)24%
B)28%
C)35%
D)40%

Question 16

What controls the particle size generated by an ultrasonic nebulizer?

A)Amplitude
B)Frequency
C)Piezoelectric crystal
D)Couplant

Question 17

With the administration of water,hypotonic,or isotonic saline,an improved outcome is indicated by the presence of which of the following?

A)Heart rate increasing with more PVCs
B)Decreased work of breathing
C)Increasing PaCO₂ with decreasing pH
D)Increased audible stridor

Question 18

Which of the following situations would be a contraindication for Heat-Moisture Exchanger (HME)use to provide humidification to a mechanically ventilated patient?

A)Body temperature of 34°C
B)Inspired Vt 600ml,expired Vt 400 ml
C)Spontaneous minute volume of 8 LPM
D)a and b

Question 19

When the temperature of a gas is increased,its capacity will ________________

A)remain the same.
B)exert a barometric pressure of 47 mmHg.
C)decrease.
D)increase.

Question 20

What is defined as is water in gaseous form,or vapor?

A)Humidity
B)Aerosol
C)Humidity deficit
D)Barometric pressure

Question 21

When administering a medication via a small volume nebulizer to a patient,instruct the patient to take slow,deep breaths with a slight pause before exhaling.What is the purpose of the pause before exhaling?

A)Allow deeper penetration of the medication into the lungs.
B)Decrease the risk of medication side effects.
C)Help the aerosol to deposit in the lungs.
D)Increase the delivered FI02 from the small volume nebulizer.

Question 22

Back pressure exerted downstream from the nebulizer will cause ______________

A)the aerosol output to increase.
B)the total flow output of the unit to increase.
C)the delivered FIO₂ to increase.
D)the amount of air entrained through the entrainment ports to increase.

Question 23

Which of the following is NOT part of the preparation of a bubble humidifier for use on a patient?

A)Filling the reservoir with sterile,distilled water and testing to make sure there is no bacterial growth.
B)Testing can be accomplished by observing for bubbling and checking for flow at the outlet.
C)The outlet should also be occluded to test the safety popoff for function.
D)If the device is a prefilled disposable unit,make sure all seals have been appropriately broken on assembly.

Question 24

Despite having the flowrate set on 15 LPM on a 30% aerosol to a T-piece,there is very little aerosol seen coming out of the aerosol tubing.What should the practitioner check?

Question 25

Connection of a large-volume nebulizer to the correct type flowmeter is ensured because the connection incorporates a:

A)PISS fitting at the top of the unit.
B)ASSS fitting at the top of the unit.
C)DISS fitting at the top of the unit.
D)15 mmID fitting at the top of the unit

Question 26

A patient has an ultrasonic nebulizer ordered every 4 hours to help with secretion mobilization.After the treatment the patient complains of chest tightness and wheezing is heard upon auscultating the chest.What could be done to alleviate this problem?

Question 27

A patient with a tracheostomy is receiving oxygen via T-piece.The physician orders 70% oxygen to be delivered by heated aerosol.The patient's inspiratory flowrate is 35 LPM.How should this oxygen therapy be set up on the patient?

Question 28

When utilizing a Brigg's adaptor to connect the aerosol unit to a tracheostomy tube,a 6 inch piece of wide-bore tubing should be attached to the adaptor opposite the aerosol tubing coming from the nebulizer.What is the purpose of this tubing?

A)To maintain a constant FIO₂
B)To collect expectorated secretions from the patient
C)To act as a reservoir for the couplant
D)To decrease the risk of contamination from aerosolized droplets