ANSWER KEYS INCLUDED
WORKBOOK
, Contents
I Foundations of Respiratory Care, 1
Chapter 1: Early History of Respiratory Care, 1
Chapter 2: Delivering Evidence-Based Respiratory Care, 3
Chapter 3: Quality, Patient Safety, Communication, and Recordkeeping, 7
Chapter 4: Principles of Infection Prevention and Control, 12
Chapter 5: Ethical and Legal Implications of Practice, 18
Chapter 6: Physical Principles of Respiratory Care, 25
Chapter 7: E-Medicine in Respiratory Care, 31
Chapter 8: Fundamentals of Respiratory Care Research, 34
II Applied Anatomy and Physiology, 37
Chapter 9: The Respiratory System, 37
Chapter 10: The Cardiovascular System, 47
Chapter 11: Ventilation, 51
Chapter 12: Gas Exchange and Transport, 57
Chapter 13: Solutions, Body Fluids, and Electrolytes, 64
Chapter 14: Acid-Base Balance, 70
Chapter 15: Regulation of Breathing, 78
III Assessment of Respiratory Disorders, 87
Chapter 16: Bedside Assessment of the Patient, 87
Chapter 17: Interpreting Clinical and Laboratory Data, 97
Chapter 18: Interpreting the Electrocardiogram, 102
Chapter 19: Analysis and Monitoring of Gas Exchange, 110
Chapter 20: Pulmonary Function Testing, 120
Chapter 21: Review of Thoracic Imaging, 129
Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist, 139
Chapter 23: Nutrition Assessment, 143
IV Review of Cardiopulmonary Disease, 151
Chapter 24: Pulmonary Infections, 151
Chapter 25: Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease (COPD), Asthma,
and Related Diseases, 160
Chapter 26: Interstitial Lung Disease, 174
Chapter 27: Pleural Diseases, 179
Chapter 28: Pulmonary Vascular Disease, 189
Chapter 29: Acute Respiratory Distress Syndrome (ARDS), 196
Chapter 30: Respiratory Management of Trauma, Obesity, Near Drowning, and Burns, 202
Chapter 31: Heart Failure, 207
Chapter 32: Lung Cancer, 210
Chapter 33: Neuromuscular and Other Diseases of the Chest Wall, 217
Chapter 34: Disorders of Sleep, 224
Chapter 35: Neonatal and Pediatric Respiratory Disorders, 229
V Basic Therapeutics, 239
Chapter 36: Airway Pharmacology, 239
Chapter 37: Airway Management, 250
Chapter 38: Emergency Cardiovascular Life Support, 260
Chapter 39: Humidity and Bland Aerosol Therapy, 269
Chapter 40: Aerosol Drug Therapy, 276
Chapter 41: Storage and Delivery of Medical Gases, 284
Chapter 42: Medical Gas Therapy, 292
vii
Copyright © 2021 by Elsevier, Inc. All rights reserved. Contents
,Chapter 43: Lung Expansion Therapy, 303
Chapter 44: Airway Clearance Therapy, 309
VI Acute and Critical Care, 317
Chapter 45: Respiratory Failure and the Need for Ventilatory Support, 317
Chapter 46: Mechanical Ventilators, 326
Chapter 47: Physiology of Ventilatory Support, 331
Chapter 48: Patient-Ventilator Interactions, 340
Chapter 49: Initiating and Adjusting Invasive Ventilatory Support, 343
Chapter 50: Noninvasive Ventilation, 353
Chapter 51: Extracorporeal Life Support, 359
Chapter 52: Monitoring the Patient in the Intensive Care Unit, 363
Chapter 53: Discontinuing Ventilatory Support, 373
Chapter 54: Neonatal and Pediatric Respiratory Care, 384
VII Patient Education and Long-Term Care, 393
Chapter 55: Patient Education and Health Promotion, 393
Chapter 56: Cardiopulmonary Rehabilitation, 399
Chapter 57: Respiratory Care in Alternative Settings, 406
Chapter 58: Ethics and End of Life, 415
viii
Contents Copyright © 2021 by Elsevier, Inc. All rights reserved.
, SECTION I FOUNDATIONS OF RESPIRATORY CARE
Early History of Respiratory Care
WORD WIZARD
Getting to know the terminology of respiratory care can be a challenge. Each chapter in this workbook starts with some
word work to help you learn to “talk the talk” of a professional respiratory therapist and communicate with all members
of the healthcare team.
Match the following terms to their definitions.
Definitions Terms
1. Caregiver who acts as a physician extender after receiving A. AARC
additional education. B. CoARC
C. NBRC
2. National professional association for respiratory care. D. cardiopulmonary system
3. Healthcare discipline that specializes in the promotion of E. respiratory care
optimum cardiopulmonary health. F. respiratory therapy
G. respiratory therapist(s)
4. Name suggesting increased involvement in disease prevention H. oxygen therapy
and management and promotion of health and wellness. I. aerosol medications
J. mechanical ventilation
5. One of the primary treatments for asthma uses this method of K. airway management
delivery. L. pulmonary function testing
6. Widely prescribed in hospitals by the 1940s and still a mainstay M. physician assistant
of respiratory care. N. respiratory care practitioner(s)
7. Organization responsible for the respiratory care credentialing
examinations.
8. An iron lung is an example of this therapy that helps patients
who cannot breathe.
9. Professional organization that accredits respiratory care schools
and programs.
10. Heart and lungs working together is the “bread and butter” of
our profession.
11. Method to test the ways that height, age, obesity, and disease
alter lung function.
12. Another name for the RT is this more formal term.
13. Individual trained to deliver care to patients with heart and lung
disease.
14. Relieving obstruction is the key to this respiratory procedure.
1
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 1 Early History of Respiratory Care
,MEET THE OBJECTIVES
Chapter 1 presented four main objectives for learning. Test how well you understand these mysteries of history by
providing short answers to these questions.
15. Define the respiratory care profession in your own words. Include at least three main concepts. How did the
profession get started? Why are we here?
16. Describe how RT schools got started. What kinds of programs do they have now? How do these programs differ
from those in the early days?
SUMMARY CHECKLIST
17. Respiratory therapists apply scientific principles to , identify, and
dysfunction of the cardiopulmonary system.
18. The is the professional organization for the field. It was started in
and was called .
19. The iron lung was used extensively during the epidemics of the 1940s and
1950s.
FOOD FOR THOUGHT
20. Describe at least four careers that would become possible for you as a result of baccalaureate or graduate education.
A.
B.
C.
D.
21. Heroes are found in history. Name three important historical figures in respiratory care. Pick one and briefly explain
how this person might inspire you in your career!
2
Chapter 1 Early History of Respiratory Care Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Delivering Evidence-Based
Respiratory Care
WORD WIZARD
The Key Terms in Chapter 2 are more complicated because they describe organizations, methods for disease management,
and outcome monitoring.
Increase your understanding by matching the terms below to the Big Ideas.
Word Big Idea
1. CoARC Develops a worldwide code of ethics within respiratory care
2. The Joint Commission Responsible for quality of schools
3. Evidence-based medicine Uses meta-analyses to find best care
4. NBRC Uses site visits to check quality of care
5. ICRC Responsible for quality of credentialing exams
MEET THE OBJECTIVES
Fill in your answers in the spaces provided.
6. Quality must be monitored to ensure it is being obtained. Give an example of each main monitoring strategy.
A.
B.
7. How can protocols enhance the quality of respiratory care services? Support your answer with evidence from the text.
8. What is the Coalition for Baccalaureate and Graduate Respiratory Therapy Education (CoBGRTE)? List one of their
objectives.
3
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 2 Delivering Evidence-Based Respiratory Care
,SUMMARY CHECKLIST
Complete the following statements by writing the correct term(s) in the spaces provided.
9. Ordering too many respiratory care services is called and hinders delivery of
quality care.
10. Specific guidelines for delivering appropriate respiratory care services are called .
11. The respiratory therapist is the highest credential in the profession.
12. Respiratory care credentialing examinations are administered by the .
13. An approach to determining optimal patient management based on research is termed -
medicine.
A 25-year-old woman has returned to a medical/surgical nursing unit following an appendectomy.
She has no history of lung disease and is wearing a nasal cannula delivering oxygen at 3 L/min.
She is alert and oriented, with a respiratory rate of 18 breaths/min and a heart rate of 82 beats/min.
Her current SpO2 (pulse oximeter reading) is 99% on the nasal cannula. Her physician orders
“respiratory therapy protocol,” and you are asked to assess this patient.
Use the protocol found in Figure 2-2 in the text to help you answer the following questions.
14. What are the clinical signs of hypoxia/hypoxemia? List at least three.
A.
B.
C.
15. Using the oxygen therapy protocol, determine if the oxygen therapy is appropriate for this patient.
Support your answer with information from the textbook.
16. What action would you recommend at this time?
4
Chapter 2 Delivering Evidence-Based Respiratory Care Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Case 2
A 54-year-old man with a history of asthma and cigarette smoking was admitted to the hospital
for a hernia repair. Following the procedure, his chest radiograph shows an elevated diaphragm
and bilateral atelectasis. Vital capacity is acceptable, but the patient is unable to hold his breath.
The pulse oximeter reading is 95% on room air. His heart rate is 84 beats/min, blood pressure
110/78 mm Hg, respiratory rate 17 breaths/min, and temperature 36.8° C. Breath sounds are
decreased bilaterally with apical wheezes. He has a weak nonproductive cough. The patient is alert
and oriented.
17. Use the algorithm in Figure 2-1 in the text to determine how to give this patient his medications.
If you’ve never used an algorithm before, it may be useful to write out the steps in your path. Start
with “Is the patient alert?” and write your answer in Step 1.
Step 1
Step 2
Step 3
Step 4
WHAT DOES THE NBRC SAY?
Circle the best answer for the following multiple choice questions.
18. A patient with chronic obstructive pulmonary disease complains of difficulty breathing when he is ambulating.
His SpO2 is 88% at rest. Which of the following would you recommend?
A. Oxygen therapy
B. PEEP therapy
C. Antibiotic therapy
D. Aerosolized bronchodilator therapy
19. An alert 18-year-old patient is admitted with difficulty breathing. The patient receives a diagnosis of asthma, and
you are asked to instruct the patient in the use of an MDI. An MDI is a device used for
A. oxygen therapy.
B. PEEP therapy.
C. antibiotic therapy.
D. aerosolized bronchodilator therapy.
20. A patient with pneumonia is receiving oxygen via nasal cannula at 2 L/min. The SpO2 is 89%, heart rate is 110 beats/
min, and respiratory rate is 24 breaths/min. Which of the following would you recommend?
A. Increase the liter per minute flow to the cannula.
B. Intubate and begin mechanical ventilation.
C. Initiate aerosolized bronchodilator therapy.
D. Initiate postural drainage.
5
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 2 Delivering Evidence-Based Respiratory Care
,FOOD FOR THOUGHT
21. Protocol-based therapy and quality assurance efforts do not always work! Discuss some of the reasons you think
these two strategies might fail.
22. Evidence-based medicine (EBM) uses meta-analysis. What does this term mean? Why is meta-analysis different
than standard reviews of literature? Is it better?
23. Now, do a little research outside of the text. What is the entry to licensure credential needed in you state? Do you
need a license to practice in your state?
6
Chapter 2 Delivering Evidence-Based Respiratory Care Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Quality, Patient Safety, Communication,
and Recordkeeping
WORD WIZARD
Read Chapter 3 in your textbook and see if you can fill in the missing words.
Healthcare settings are filled with electrical equipment. The flow of electricity is called .
Everything should have a three-prong plug. The third prong is the neutral wire, or , which
helps prevent electrocution. For this reason, no outside electrical devices are allowed in the hospital unless the
biomedical staff checks them. Electrocution can occur in the form of a(n) shock. This might
happen if you are standing on a wet floor and a power cord falls onto the floor. Many power cords are detachable, so this
is a potential hazard. Always clean up spills.
A small shock, or shock, is a hazard to patients who have pacemakers, ECG leads, and
indwelling heart catheters. These shocks may result in ventricular fibrillation and death! This could happen if the
wire gets broken, so don’t ever roll beds or other equipment over electrical power cords.
Report frayed cords and take suspect equipment out of use.
Because high oxygen concentrations are used in respiratory care, fire is a real hazard.
Even though oxygen is categorized as a(n) gas and does not burn, it greatly speeds up an
existing fire. In fact, oxygen is necessary for fires to exist. For a fire to start, you also need ,
material, and heat. Remove any of these three, and the fire will go out. You must make sure that ignition sources such as
are not allowed when oxygen is in use. Most hospitals will call a “Code Red” if a fire exists,
and you must respond. One of the respiratory therapist’s responsibilities in a fire is to shut off the zone valve to the af-
fected area if the fire is near a patient using oxygen. (See Chapter 41, Storage and Delivery of Medical Gases.)
KEEP IT MOVING!
The following are some guidelines for safe ambulation. Number them 1 through 7 in the right order.
Dangle the patient.
Sit the patient up.
Assist to a standing position.
Encourage slow, easy breathing.
Lower the bed and lock the wheels.
Move the IV pole close to the patient.
Provide support while walking.
7
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 3 Quality, Patient Safety, Communication, and Recordkeeping
WORKBOOK
, Contents
I Foundations of Respiratory Care, 1
Chapter 1: Early History of Respiratory Care, 1
Chapter 2: Delivering Evidence-Based Respiratory Care, 3
Chapter 3: Quality, Patient Safety, Communication, and Recordkeeping, 7
Chapter 4: Principles of Infection Prevention and Control, 12
Chapter 5: Ethical and Legal Implications of Practice, 18
Chapter 6: Physical Principles of Respiratory Care, 25
Chapter 7: E-Medicine in Respiratory Care, 31
Chapter 8: Fundamentals of Respiratory Care Research, 34
II Applied Anatomy and Physiology, 37
Chapter 9: The Respiratory System, 37
Chapter 10: The Cardiovascular System, 47
Chapter 11: Ventilation, 51
Chapter 12: Gas Exchange and Transport, 57
Chapter 13: Solutions, Body Fluids, and Electrolytes, 64
Chapter 14: Acid-Base Balance, 70
Chapter 15: Regulation of Breathing, 78
III Assessment of Respiratory Disorders, 87
Chapter 16: Bedside Assessment of the Patient, 87
Chapter 17: Interpreting Clinical and Laboratory Data, 97
Chapter 18: Interpreting the Electrocardiogram, 102
Chapter 19: Analysis and Monitoring of Gas Exchange, 110
Chapter 20: Pulmonary Function Testing, 120
Chapter 21: Review of Thoracic Imaging, 129
Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist, 139
Chapter 23: Nutrition Assessment, 143
IV Review of Cardiopulmonary Disease, 151
Chapter 24: Pulmonary Infections, 151
Chapter 25: Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease (COPD), Asthma,
and Related Diseases, 160
Chapter 26: Interstitial Lung Disease, 174
Chapter 27: Pleural Diseases, 179
Chapter 28: Pulmonary Vascular Disease, 189
Chapter 29: Acute Respiratory Distress Syndrome (ARDS), 196
Chapter 30: Respiratory Management of Trauma, Obesity, Near Drowning, and Burns, 202
Chapter 31: Heart Failure, 207
Chapter 32: Lung Cancer, 210
Chapter 33: Neuromuscular and Other Diseases of the Chest Wall, 217
Chapter 34: Disorders of Sleep, 224
Chapter 35: Neonatal and Pediatric Respiratory Disorders, 229
V Basic Therapeutics, 239
Chapter 36: Airway Pharmacology, 239
Chapter 37: Airway Management, 250
Chapter 38: Emergency Cardiovascular Life Support, 260
Chapter 39: Humidity and Bland Aerosol Therapy, 269
Chapter 40: Aerosol Drug Therapy, 276
Chapter 41: Storage and Delivery of Medical Gases, 284
Chapter 42: Medical Gas Therapy, 292
vii
Copyright © 2021 by Elsevier, Inc. All rights reserved. Contents
,Chapter 43: Lung Expansion Therapy, 303
Chapter 44: Airway Clearance Therapy, 309
VI Acute and Critical Care, 317
Chapter 45: Respiratory Failure and the Need for Ventilatory Support, 317
Chapter 46: Mechanical Ventilators, 326
Chapter 47: Physiology of Ventilatory Support, 331
Chapter 48: Patient-Ventilator Interactions, 340
Chapter 49: Initiating and Adjusting Invasive Ventilatory Support, 343
Chapter 50: Noninvasive Ventilation, 353
Chapter 51: Extracorporeal Life Support, 359
Chapter 52: Monitoring the Patient in the Intensive Care Unit, 363
Chapter 53: Discontinuing Ventilatory Support, 373
Chapter 54: Neonatal and Pediatric Respiratory Care, 384
VII Patient Education and Long-Term Care, 393
Chapter 55: Patient Education and Health Promotion, 393
Chapter 56: Cardiopulmonary Rehabilitation, 399
Chapter 57: Respiratory Care in Alternative Settings, 406
Chapter 58: Ethics and End of Life, 415
viii
Contents Copyright © 2021 by Elsevier, Inc. All rights reserved.
, SECTION I FOUNDATIONS OF RESPIRATORY CARE
Early History of Respiratory Care
WORD WIZARD
Getting to know the terminology of respiratory care can be a challenge. Each chapter in this workbook starts with some
word work to help you learn to “talk the talk” of a professional respiratory therapist and communicate with all members
of the healthcare team.
Match the following terms to their definitions.
Definitions Terms
1. Caregiver who acts as a physician extender after receiving A. AARC
additional education. B. CoARC
C. NBRC
2. National professional association for respiratory care. D. cardiopulmonary system
3. Healthcare discipline that specializes in the promotion of E. respiratory care
optimum cardiopulmonary health. F. respiratory therapy
G. respiratory therapist(s)
4. Name suggesting increased involvement in disease prevention H. oxygen therapy
and management and promotion of health and wellness. I. aerosol medications
J. mechanical ventilation
5. One of the primary treatments for asthma uses this method of K. airway management
delivery. L. pulmonary function testing
6. Widely prescribed in hospitals by the 1940s and still a mainstay M. physician assistant
of respiratory care. N. respiratory care practitioner(s)
7. Organization responsible for the respiratory care credentialing
examinations.
8. An iron lung is an example of this therapy that helps patients
who cannot breathe.
9. Professional organization that accredits respiratory care schools
and programs.
10. Heart and lungs working together is the “bread and butter” of
our profession.
11. Method to test the ways that height, age, obesity, and disease
alter lung function.
12. Another name for the RT is this more formal term.
13. Individual trained to deliver care to patients with heart and lung
disease.
14. Relieving obstruction is the key to this respiratory procedure.
1
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 1 Early History of Respiratory Care
,MEET THE OBJECTIVES
Chapter 1 presented four main objectives for learning. Test how well you understand these mysteries of history by
providing short answers to these questions.
15. Define the respiratory care profession in your own words. Include at least three main concepts. How did the
profession get started? Why are we here?
16. Describe how RT schools got started. What kinds of programs do they have now? How do these programs differ
from those in the early days?
SUMMARY CHECKLIST
17. Respiratory therapists apply scientific principles to , identify, and
dysfunction of the cardiopulmonary system.
18. The is the professional organization for the field. It was started in
and was called .
19. The iron lung was used extensively during the epidemics of the 1940s and
1950s.
FOOD FOR THOUGHT
20. Describe at least four careers that would become possible for you as a result of baccalaureate or graduate education.
A.
B.
C.
D.
21. Heroes are found in history. Name three important historical figures in respiratory care. Pick one and briefly explain
how this person might inspire you in your career!
2
Chapter 1 Early History of Respiratory Care Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Delivering Evidence-Based
Respiratory Care
WORD WIZARD
The Key Terms in Chapter 2 are more complicated because they describe organizations, methods for disease management,
and outcome monitoring.
Increase your understanding by matching the terms below to the Big Ideas.
Word Big Idea
1. CoARC Develops a worldwide code of ethics within respiratory care
2. The Joint Commission Responsible for quality of schools
3. Evidence-based medicine Uses meta-analyses to find best care
4. NBRC Uses site visits to check quality of care
5. ICRC Responsible for quality of credentialing exams
MEET THE OBJECTIVES
Fill in your answers in the spaces provided.
6. Quality must be monitored to ensure it is being obtained. Give an example of each main monitoring strategy.
A.
B.
7. How can protocols enhance the quality of respiratory care services? Support your answer with evidence from the text.
8. What is the Coalition for Baccalaureate and Graduate Respiratory Therapy Education (CoBGRTE)? List one of their
objectives.
3
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 2 Delivering Evidence-Based Respiratory Care
,SUMMARY CHECKLIST
Complete the following statements by writing the correct term(s) in the spaces provided.
9. Ordering too many respiratory care services is called and hinders delivery of
quality care.
10. Specific guidelines for delivering appropriate respiratory care services are called .
11. The respiratory therapist is the highest credential in the profession.
12. Respiratory care credentialing examinations are administered by the .
13. An approach to determining optimal patient management based on research is termed -
medicine.
A 25-year-old woman has returned to a medical/surgical nursing unit following an appendectomy.
She has no history of lung disease and is wearing a nasal cannula delivering oxygen at 3 L/min.
She is alert and oriented, with a respiratory rate of 18 breaths/min and a heart rate of 82 beats/min.
Her current SpO2 (pulse oximeter reading) is 99% on the nasal cannula. Her physician orders
“respiratory therapy protocol,” and you are asked to assess this patient.
Use the protocol found in Figure 2-2 in the text to help you answer the following questions.
14. What are the clinical signs of hypoxia/hypoxemia? List at least three.
A.
B.
C.
15. Using the oxygen therapy protocol, determine if the oxygen therapy is appropriate for this patient.
Support your answer with information from the textbook.
16. What action would you recommend at this time?
4
Chapter 2 Delivering Evidence-Based Respiratory Care Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Case 2
A 54-year-old man with a history of asthma and cigarette smoking was admitted to the hospital
for a hernia repair. Following the procedure, his chest radiograph shows an elevated diaphragm
and bilateral atelectasis. Vital capacity is acceptable, but the patient is unable to hold his breath.
The pulse oximeter reading is 95% on room air. His heart rate is 84 beats/min, blood pressure
110/78 mm Hg, respiratory rate 17 breaths/min, and temperature 36.8° C. Breath sounds are
decreased bilaterally with apical wheezes. He has a weak nonproductive cough. The patient is alert
and oriented.
17. Use the algorithm in Figure 2-1 in the text to determine how to give this patient his medications.
If you’ve never used an algorithm before, it may be useful to write out the steps in your path. Start
with “Is the patient alert?” and write your answer in Step 1.
Step 1
Step 2
Step 3
Step 4
WHAT DOES THE NBRC SAY?
Circle the best answer for the following multiple choice questions.
18. A patient with chronic obstructive pulmonary disease complains of difficulty breathing when he is ambulating.
His SpO2 is 88% at rest. Which of the following would you recommend?
A. Oxygen therapy
B. PEEP therapy
C. Antibiotic therapy
D. Aerosolized bronchodilator therapy
19. An alert 18-year-old patient is admitted with difficulty breathing. The patient receives a diagnosis of asthma, and
you are asked to instruct the patient in the use of an MDI. An MDI is a device used for
A. oxygen therapy.
B. PEEP therapy.
C. antibiotic therapy.
D. aerosolized bronchodilator therapy.
20. A patient with pneumonia is receiving oxygen via nasal cannula at 2 L/min. The SpO2 is 89%, heart rate is 110 beats/
min, and respiratory rate is 24 breaths/min. Which of the following would you recommend?
A. Increase the liter per minute flow to the cannula.
B. Intubate and begin mechanical ventilation.
C. Initiate aerosolized bronchodilator therapy.
D. Initiate postural drainage.
5
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 2 Delivering Evidence-Based Respiratory Care
,FOOD FOR THOUGHT
21. Protocol-based therapy and quality assurance efforts do not always work! Discuss some of the reasons you think
these two strategies might fail.
22. Evidence-based medicine (EBM) uses meta-analysis. What does this term mean? Why is meta-analysis different
than standard reviews of literature? Is it better?
23. Now, do a little research outside of the text. What is the entry to licensure credential needed in you state? Do you
need a license to practice in your state?
6
Chapter 2 Delivering Evidence-Based Respiratory Care Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Quality, Patient Safety, Communication,
and Recordkeeping
WORD WIZARD
Read Chapter 3 in your textbook and see if you can fill in the missing words.
Healthcare settings are filled with electrical equipment. The flow of electricity is called .
Everything should have a three-prong plug. The third prong is the neutral wire, or , which
helps prevent electrocution. For this reason, no outside electrical devices are allowed in the hospital unless the
biomedical staff checks them. Electrocution can occur in the form of a(n) shock. This might
happen if you are standing on a wet floor and a power cord falls onto the floor. Many power cords are detachable, so this
is a potential hazard. Always clean up spills.
A small shock, or shock, is a hazard to patients who have pacemakers, ECG leads, and
indwelling heart catheters. These shocks may result in ventricular fibrillation and death! This could happen if the
wire gets broken, so don’t ever roll beds or other equipment over electrical power cords.
Report frayed cords and take suspect equipment out of use.
Because high oxygen concentrations are used in respiratory care, fire is a real hazard.
Even though oxygen is categorized as a(n) gas and does not burn, it greatly speeds up an
existing fire. In fact, oxygen is necessary for fires to exist. For a fire to start, you also need ,
material, and heat. Remove any of these three, and the fire will go out. You must make sure that ignition sources such as
are not allowed when oxygen is in use. Most hospitals will call a “Code Red” if a fire exists,
and you must respond. One of the respiratory therapist’s responsibilities in a fire is to shut off the zone valve to the af-
fected area if the fire is near a patient using oxygen. (See Chapter 41, Storage and Delivery of Medical Gases.)
KEEP IT MOVING!
The following are some guidelines for safe ambulation. Number them 1 through 7 in the right order.
Dangle the patient.
Sit the patient up.
Assist to a standing position.
Encourage slow, easy breathing.
Lower the bed and lock the wheels.
Move the IV pole close to the patient.
Provide support while walking.
7
Copyright © 2021 by Elsevier, Inc. All rights reserved. Chapter 3 Quality, Patient Safety, Communication, and Recordkeeping
