Basic Clinical Lab Competencies for Respiratory Care

by White, Gary C.

• ISBN13: 9780766825321
• ISBN10: 0766825329
• Edition: 4th
• Format: Paperback
• Copyright: 2002-10-17
• Publisher: CENGAGE Delmar Learning

Summary

This book combines the theoretical knowledge and psychomotor skills required to perform the required to practice the art and science of respiratory care. Other books only present the psychomotor aspects of a skill or procedure (monkey see monkey do). This is the only text that integrates the theory knowledge and the practical skills in one concise manual. By combining both aspects of procedural performance, indications, contraindications, assessment and outcomes may be more thoroughly emphasized. The inclusion of the American Association for Respiratory Care Clinical Practice Guidelines lends credibility to this approach. The clinical practice guidelines emphasize the importance of assessment of need, contraindications, hazards/complications, monitoring and outcomes assessment. Simply providing a "cook book" approach to a skill or procedure negates the importance of the theory required to perform adequate assessment and document outcomes of a given therapeutic intervention.

Table of Contents

List of Performance Evaluations	p. ix
Preface	p. xi
Introduction to the Text	p. xii
Acknowledgments	p. xiii
List of Contributors	p. xiii
Patient Assessment
Basics of Asepsis	p. 1
Microorganism Transmission
Centers for Disease Control and Prevention Guidelines
Handwashing
Aseptic Gowning
Aseptic Application of Surgical Latex Gloves
Double-Bagging of Equipment and Supplies
Aseptic Removal of Isolation Attire
Basic Patient Assessment: Vital Signs and Breath Sounds	p. 15
Body Temperature
Pulse
Respiratory Rate
Blood Pressure
Sound
Measuring Body Temperature
Measuring Oral Temperature
Measuring the Pulse
Measuring Respiratory Rate
Assessing Blood Pressure
Auscultation of Breath Sounds
Advanced Patient Assessment: Inspection, Palpation, and Percussion	p. 33
Chest Landmarks for Assessment
Assessment Techniques and Abnormal Findings
Preexamination and Other Considerations
Inspection of the Chest
Radiologic Assessment	p. 47
Production of a Chest Radiograph
Radiodensity of Common Materials
X-Ray Views of the Chest
The Normal Chest Radiograph
Common Abnormalities on the Chest Radiograph
Ventilation-Perfusion Scanning
Pulmonary Angiography
Computed Tomography of the Chest
Chest Film Orientation
Rotation and Penetration
Viewing the Chest Radiograph
Pulmonary Function Testing	p. 69
Rationale for Bedside Monitoring
Equipment Used in Measuring Bedside Parameters
Bedside Measurements
Basic Spirometry
Capacities and Their Significance
The Forced Vital Capacity Tracing
Maximum Voluntary Ventilation
ATPS to BTPS Conversion
Flow-Volume Loops
Measurement of Functional Residual Capacity and Residual Volume
Diffusion: Single Breath Carbon Monoxide Test
Hazards of Pulmonary Function Testing
Bedside Monitoring: Equipment Assembly and Testing
Preparation of the Collins Water Seal Spirometer
Patient Factors in Spirometry
Measuring the Bedside Pulmonary Function Parameters
Basic Spirometry: Using the Collins Water Seal Spirometer
Pulmonary Function Tests
Measuring and Calculating Components of a Pulmonary Function Testing Tracing
Measuring and Calculating the Forced Vital Capacity
Maximum Voluntary Ventilation
Conversion from ATPS to BTPS
Calculating Predicted Values
Interpretation of the Results
Electrocardiography	p. 101
Electrical Physiology of the Heart
The Normal ECG and the Electrical Activity of the Heart
The Twelve Leads of an ECG
Dangerous and Life-Threatening Arrhythmias
ECG Artifact
Electrocardiograph Equipment
Equipment Required for an Electrocardiogram
Patient Positioning
Lead Placement
Arrhythmia Recognition
Operating the Electrocardiograph Machine
Artifact Recognition
Proper Handling of an Electrocardiographic Tracing
Phlebotomy	p. 115
Obligations Related to Performance of Phlebotomy
Maintaining a Safe Environment
Equipment
Venipuncture Technique
Arterial Blood Gas Sampling	p. 127
Anatomical Locations for Arterial Puncture
Complications of Arterial Puncture
Blood Gas Sampling Errors
Capillary Blood Gas Sampling
Supplies Needed for Arterial Puncture
Puncture Techniques
Postpuncture Care
Indwelling Arterial Catheter Sampling
Supplies for Capillary Sampling
Standard Precautions
Arterialization of the Puncture Site
Site Preparation
Obtaining the Sample
Care of the Sample
Care of the Puncture Site
Hemodynamic monitoring	p. 145
Pascal's Law
Transducers
Central Venous Pressure Catheters
Pulmonary Artery Catheters or Swan-Ganz Catheters
Normal Pressure Ranges
Clinical Applications of the Pulmonary Artery Catheter
Case Studies Illustrating the Application of a Pulmonary Artery Catheter
Arterial Lines
Hazards with Indwelling Vascular Catheters
Equipment Required for Hemodynamic Monitoring
Equipment Setup and Preparation
Zeroing the Transducer
Identification of the Phlebostatic Axis
Wave Form Damping
Obtaining a Pulmonary Artery Wedge Pressure
Overwedging of the Balloon
Cardiac Output Determination
Arterial Line Maintenance
Zeroing an Arterial Line
Noninvasive Monitoring	p. 165
Rationale for Noninvasive Monitoring
Noninvasive Monitoring Equipment
Limitations of Noninvasive Monitoring
Hazards of Noninvasive Monitoring
Assembly, Troubleshooting, and Calibration
Therapeutics
Documentation and Goals Assessment	p. 181
The Medical Record
Goals Assessment and Documentation
Documentation Guidelines and Abbreviations
Oxygen Supply Systems	p. 193
Medical Gas Cylinders
Medical Gas Piping Systems
Using Medical Gas Cylinders
Use of Portable Liquid Oxygen Systems
Use of an Oxygen Concentrator
Use of Air/Oxygen Blenders
Oxygen Administration	p. 219
Indications for Oxygen Therapy
Low-Flow Oxygen Devices
High-Flow Oxygen Delivery Systems
Clinical Applications of Low-Flow and High-Flow Oxygen Systems
Humidification
Enclosures
Hazards of Oxygen Therapy
Introduction to Respiratory Care Pharmacology	p. 239
Receptor Site Theory
Mechanisms of Bronchospasm
Sympathomimetic Drugs
Phosphodiesterase Inhibitors
Anticholinergic Drugs
Corticosteroids in Respiratory Care
Cromolyn Sodium and Asthma Management
Mucokinetic Agents
Use of Bland Aerosols in Respiratory Care
Aerosolized Antimicrobial Agents
Metered Dose Inhalers
Dry Powder Inhalers (DPI)
Metered Dose Inhaler
Use of a Spacer with a Metered Dose Inhaler
Dry Powder Inhalers
Humidity and Aerosol Therapy	p. 255
What Is Humidity and What Is Aerosol?
Equipment for Humidity and Aerosol Therapy
Humidity and Aerosol Therapy
Aerosol/Oxygen Delivery Devices
Bronchial Hygiene Therapy	p. 277
Body Alignment and Stance
General Guidelines for Moving Patients
Safety Devices
Chest Percussion and Postural Drainage
Other Therapies for Bronchial Hygiene
General Guidelines
Patient Positioning
Use of Restraints
Manual Beds
Percussion Technique
Positive Expiratory Pressure Therapy
Flutter Valve Therapy
High-Frequency Chest Wall Oscillation Therapy Administration
Adjunctive Breathing Techniques
Hyperinflation Therapy	p. 317
Hyperventilation Modalities
Goals of and Indications for Hyperinflation Therapy
Hazards and Complications of Hyperventilation Therapy
Incentive Spirometers
The Bird Mark 7 Ventilator
The Bennett PR-2 Ventilator
Bennett AP-5 Ventilator
Percussionaire IPV-1
Incentive Spirometry
IPPB Therapy
Intrapulmonary Percussive Ventilation Therapy
Bronchoscopy Assisting	p. 351
Therapeutic and Diagnostic Bronchoscopy
Indications for Bronchoscopy
Rigid and Flexible Bronchoscopes
Types of Instruments
Types of Sample Testing and Analysis
Solutions Used to Fix or Prepare Samples for Testing
Personal Protective Equipment
Bronchoscopy Room or Suite
Medications Employed for Anesthesia and Analgesia
Patient Monitoring
Hazards and Complications of Bronchoscopy
Equipment Preparation
Documentation Preparation
Patient Preparation
Supplemental Oxygen
Bronchoscopy Assisting
Specimen Preparation
Bronchoalveolar Lavage
Patient Monitoring
Bronchoscopy During Mechanical Ventilation
Documentation
Cleaning the Bronchoscope
Sample Delivery
Equipment Processing and Surveillance	p. 369
Related Microbiology
Equipment Processing Terms
Equipment Processing Methods
Facility Design for Equipment Processing
Bacteriological Surveillance Programs
Data Utilization
Output Sampling With the Aerotest
Swab Sampling
Surveillance Records
Processing Respiratory Care Equipment
Emergency Management
Emergency Airway Management	p. 383
Anatomy of the Upper Airway
Reflexes of the Upper Airway
Upper Airway Obstruction
Resuscitators
Importance of Inspiratory-Expiratory Ratio During Resuscitation
Intubation: What Is It?
Complications of Intubation
Patient Positioning to Relieve Upper Airway Obstruction
Airway Insertion
Preparation of Manual Resuscitators
Ventilation with a Manual Resuscitator
Equipment Preparation and Assembly for Intubation
Intubation Techniques
Extubation
Artificial Airway Care	p. 415
Suctioning
Cuff Pressure Monitoring
Tracheostomy and Stoma Care
Suctioning Procedure
Cuff Pressure Measurement
Tracheostomy Care Procedure
Stoma Care Procedure
Chest Tubes	p. 443
Chest Tubes: Basic Principles
Chest Drainage System
Assisting with Chest Tube Placement
Setup and Maintenance of the Chest Drainage System
Insertion and Maintenance of Intravenous Lines	p. 453
The Principles of Intravenous Therapy
Intravenous Fluid Properties
Locating Acceptable Sites for Intravenous Needle Placement
Complications of Intravenous Therapy
Maintenance of Intravenous Infusions
Drip Rate Calculations
Supplies Needed for Intravenous Cannulation
Venipuncture Procedure
Maintenance of Intravenous Infusions
Discontinuing Intravenous Therapy
Intra-Aortic Balloon Pumping	p. 471
Cardiac Anatomy
Cardiac Physiology
Cardiac Pathology
Fundamental Principles of IABP Therapy
Ventilation
Noninvasive Positive-Pressure Ventilation	p. 495
Definition of Noninvasive Positive-Pressure Ventilation
Indications for Noninvasive Positive-Pressure Ventilation
Assessment of the Patient for Noninvasive Positive-Pressure Ventilation
Patient-Ventilator Interface In Noninvasive Positive-Pressure Ventilation
Hazards and Complications of Noninvasive Positive-Pressure Ventilation
How Resistance and Compliance Affect Noninvasive Positive-Pressure Ventilation
Modes of Noninvasive Positive-Pressure Ventilation
Supplemental Oxygen Delivery
Patient Monitoring
Patient Assessment for NPPV
Assembly and Testing of the Ventilator
Mask Selection
Ventilator Settings
Patient Monitoring
Patient Charting
Continuous Mechanical Ventilation	p. 513
What is Continuous Mechanical Ventilation?
Indications for Mechanical Ventilation
Criteria for Mechanical Ventilation
Modes of Mechanical Ventilation
Hazards and Complications of Mechanical Ventilation
Assessing the Patient for Mechanical Ventilation
Equipment Requirements
Establishing Ordered Ventilator Settings
Special Ventilatory Functions
Alarms
Monitoring the Patient-Ventilator System
Documentation of Ventilator Settings
Documentation of Patient Values
Changing a Ventilator Circuit
Special Ventilatory Procedures	p. 581
PEEP and CPAP
Physiological Effects of PEEP and CPAP
Weaning Methods and Modes of Mechanical Ventilation
Specialized Monitoring Procedures
Static and Dynamic Pressure-Volume Curves
Criteria for Weaning
Physiological Effects of Weaning
Positive End-Expiratory Pressure
Continuous Positive Airway Pressure
Initiation of CPAP and PEEP
PEEP Trial
Intermittent Mandatory Ventilation
Initiation of IMV or of IMV with CPAP
Pressure Support
AMV and EMMV
Flow Triggering
Measurement of V[subscript D]/V[subscript T]
Measurement of Static and Dynamic Pressure-Volume Curves
Measurement of Spontaneous Parameters
Wave form Analysis	p. 643
Common Wave Forms
Wave Form Morphologies
Analysis of Specific Wave Forms
Wave Form Interpretation
Clinical Criteria for Appropriate Wave Form Selection
Newborn Mechanical Ventilation	p. 657
Basics of Newborn Mechanical Ventilation
Indications for Mechanical Ventilation in the Newborn
Underlying Conditions That May Contribute to Respiratory Failure
Newborn Ventilatory Support Concepts
Hazards and Complications of Newborn Mechanical Ventilation
Assessing the Need for Mechanical Ventilation
Equipment Requirements
Establishing Ordered Ventilator Settings
Alarms
Patient Monitoring and Assessment
Ventilator Monitoring
Answers to Self-Evaluation Post Tests	p. 681
Glossary	p. 683
Index	p. 695
Table of Contents provided by Syndetics. All Rights Reserved.