RRT Clin Sims- Lindsey Jones Questions

RRT Clin Sims- Lindsey Jones Questions With Complete Solutions

Information Gathering - Emphysema:

(Abnormal condition of the alveoli resulting destruction and loss of elasticity.) - Correct Answers ✅- Cyanosis, Barrel chest, ↑ A-P diameter, Accessory muscle use, Digital clubbing of the nail beds, Significant hz of smoking and/or occupational exposure to smoke or other pulmonary irritant

• Dyspnea, Wheezing breath sounds

Chest X-ray: flattened diaphragms, hyperlucency, diminished

pulmonary vascular markings.

CBC: polycythemia, increased WBC due to possible infection.

ABGs: Compensated respiratory acidosis (high PaCO2, normal

pH), moderate to severe hypoxemia.

Sputum culture: often positive for bacteria.

PFT: flows are ↓ especially middle sized airways (FEF 25-75%)

Fev1 & Fev1/FVC%, reduced DLCO (less than 20).

Descision Making - Emphysema: 1 / 4

RRT Clin Sims- Lindsey Jones Questions With Complete Solutions (Abnormal condition of the alveoli resulting destruction and loss of elasticity.) - Correct Answers ✅- Oxygen therapy— low FIO2 (0.24 to 0.28) or 1 to 2 lpm nasal cannula

• Oxygen conserving devices such as liquid oxygen or trans-

tracheal oxygen

• Home care education on devices and equipment cleaning
• Rehabilitation efforts (specifics not usually required)
• Aids to help quit smoking such as nicotine replacement

therapy

• Bronchodilation medication via MDI or aerosol nebulizers
• Antibiotics for infection
• Smoking cessation products (nicotine replacement therapy).

Information Gathering - Chronic Bronchitis (Condition where the patient has a productive cough 25% of the year for at least two consecutive years.) - Correct Answers ✅- Productive cough, purulent sputum production, Exposure to pulmonary irritants, like hz of smoking, Frequent infections

• Dyspnea

Chest X-ray: could be nx, or may show hyperlucency,

diminished, pulmonary markings. 2 / 4

RRT Clin Sims- Lindsey Jones Questions With Complete Solutions

CBC: possibly ↑ WBC due to possible infection.

ABGs: could be nx or very slight respiratory acidosis and

hypoxemia

PFT: flows are ↓ especially middle sized airways (FEF 25-75%)

FEV1, Normal DLCO Decision Making - Chronic Bronchitis (Condition where the patient has a productive cough 25% of the year for at least two consecutive years.) - Correct Answers ✅- Anything that promotes good pulmonary hygiene such as chest physiotherapy, hydration therapy when sputum is thick.

• Fluid therapy if dehydrated.
• Oxygen therapy for hypoxemia
• Aerosolized bronchodilator therapy, Antibiotic Tetracycline

may be preferable Information Gathering - Bronchiectasis 3 / 4

RRT Clin Sims- Lindsey Jones Questions With Complete Solutions

• Abnormal condition where the bronchi

secrete large volumes of pus during abnormal dilation.) - Correct Answers ✅- Productive cough, often with blood, digital clubbing of the nail beds, significant hz of infections (recurrent)

• Dyspnea

Chest X-ray: generally normal

Sputum culture: gram negative bacteria

Bronchogram is the primary test. Characterized by a "tree in winter pattern" Decision Making - Bronchiectasis

• Abnormal condition where the bronchi

secrete large volumes of pus during abnormal dilation.) - Correct Answers ✅- Anything that promotes good pulmonary hygiene such as CPT, hydration therapy when sputum is thick.

• / 4