Exam 56: Respiratory Care in Alternative Settings

While visiting a home care patient who uses a multidose vial of an expensive bronchodilator, you notice that the expiration date for this medication has passed. Which of the following actions would you recommend at this time?

Which of the following alarm systems is needed for postacute care patients who require only intermittent pressure-limited noninvasive positive pressure ventilation?

Establishing therapeutic objectives for home care is normally the responsibility of which member of the respiratory home care team?

Which of the following are acceptable indicators of hypoxemia for purposes of justifying home O₂ therapy? 1) Resting PaO₂ of 55 mm Hg (room air) 2) Drop in SaO₂ below 89% during ambulation 3) Resting arterial SaO₂ below 88% (room air)

Studies have shown that carefully selected home treatment regimens can play an important role in achieving which of the following? 1) Maintaining patients' lives 2) Improving patients' quality-of-life 3) Increasing patients' functional performance 4) Reducing hospitalization costs

Basic principles of infection control in the home care setting include which of the following? 1) Avoid visits by friends with respiratory infections. 2) Have caregivers follow proper handwashing techniques. 3) Incinerate all disposable equipment and supplies.

Patient- and resident-focused functions addressed in The Joint Commission (formerly Joint Commission on Accreditation of Hospitals Organization [JCAHO]) standards for long-term, subacute care, and home care include which of the following? 1) Patient education 2) Treatment 3) Rights and ethics 4) Infection control

Home care patients requiring continuous ventilatory support for long-term survival include which of the following? 1) Those with high spinal cord injuries 2) Those with late-stage muscular dystrophy 3) Those with bronchogenic carcinoma

The O₂ in the inner reservoir of a home liquid O₂ system is maintained at what temperature?

A home care patient with kyphoscoliosis requires intermittent positive pressure breathing (IPPB) treatments twice per day with O₂. A local charitable organization has given the family a pneumatically powered IPPB device for this purpose. Which of the following gas sources would you recommend to drive this device? 1) Liquid O₂ reservoir 2) O₂ concentrator 3) Compressed gas cylinder

Mechanical ventilation in the home setting can be provided by which of the following methods? 1) Positive pressure through an oral endotracheal tube 2) Positive pressure through an intact upper airway 3) Intermittent abdominal displacement methods 4) Negative pressure through an intact upper airway

For which home care patients requiring mechanical ventilation would you recommend a portable volume-cycled ventilator rather than a pressure-limited device? 1) Those with a neuromuscular or neurologic disorder 2) Those who cannot sustain any spontaneous breathing 3) Those with chronic obstructive pulmonary disease

Postacute care settings include which of the following? 1) Rehabilitation facilities 2) The home 3) Trauma centers 4) Skilled nursing facilities (SNFs)

For which of the following groups would you recommend long-term negative pressure ventilation in an alternative setting? 1) Patients who cannot or will not use noninvasive positive pressure ventilation 2) Patients who need frequent airway access for suctioning 3) Patients with severe nasal congestion or obstruction

What are some major problems with demand-flow O₂ delivery systems? 1) They are cumbersome and unattractive. 2) Equipment and maintenance costs are high. 3) The device valve may have slow response times. 4) Catheter and sensor malfunction is common.

At flows between 1 and 2 L/min, a typical molecular sieve O₂ concentrator provides an O₂ concentration of approximately what level?

Absolute contraindications for using noninvasive positive pressure ventilation include which of the following? 1) Hemodynamic instability 2) Uncooperative patient 3) Copious secretions 4) Need for airway protection

Types of negative pressure ventilators used in postacute care include which of the following? 1) Iron lung (tank ventilator) 2) Chest cuirass (shell ventilator) 3) Body wrap or pneumosuit 4) Abdominal displacement device

A home care patient receiving long-term O₂ therapy at 5 L/min complains that her nondisposable humidifier is not bubbling properly. Upon inspection of the humidifier, you notice hard white deposits in and around the diffusing element. Which of the following would you recommend to this patient?

Relative contraindications for using noninvasive ventilation (NIV) include all of the following except: