RT 246 - Comprehensive Clinical Education

1. Demonstrate, through successful completion of written examination, return demonstration, or clinical performance evaluation completed by clinical instructor, the ability to:
   1. Demonstrate the ability to identify the following abnormal ECG patterns:
      1. Sinus bradycardia
      2. Sinus tachycardia
      3. Premature atrial contractions
      4. Atrial tachycardia
      5. Atrial flutter
      6. Atrial fibrillation
      7. Junctional rhythms
      8. Premature ventricular complexes
      9. Ventricular tachycardia
      10. Ventricular fibrillation
      11. Atrioventricular blocks
      12. Asystole
   2. Explain the functions of an indwelling systemic arterial catheter.
   3. Describe the complications associated with an indwelling arterial catheter and the precautions to avoid those complications.
   4. Demonstrate the proper technique for withdrawing blood from an arterial catheter.
   5. Identify the various parts and explain the functions of a Swan-Ganz or pulmonary artery catheter.
   6. Identify the various pressure waveforms, including wedge pressure, as the pulmonary catheter passes through the chambers of the heart and is positioned in the pulmonary artery.
   7. State the normal values for the following measurements made with the pulmonary artery catheter:
      1. Right atrial pressures
      2. Right ventricle pressures
      3. Pulmonary artery pressures
      4. Mean pulmonary artery pressures
      5. Pulmonary capillary wedge pressures
      6. SVO2
   8. Demonstrate the proper technique for obtaining the above measurements.
   9. Demonstrate the proper technique for withdrawing a mixed venous blood sample from a pulmonary artery catheter.
   10. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
2.  
   1. Demonstrate the proper setup and application to patients of the following mechanical ventilators:
      1. Bennett 7200
      2. Siemens Servo
      3. Bird 8400
   2. Demonstrate the ability to troubleshoot signs of malfunction and make appropriate corrections to the ventilators listed above.
   3. Make appropriate recommendations or modifications in ventilators settings, utilizing the following information:
      1. The physiologic equations from RT 226  
      2. Arterial blood gases
      3. Chest x-rays
      4. The hemodynamic measurements from RT 246, Section I, Unit I
      5. Physical assessment
      6. Patient history
      7. Progress notes
      8. Electrolytes
      9. CBC
      10. Other lab data
   4. Relate the following information to your patient's ability to tolerate ventilator discontinuance:
      1. VD/VT
      2. A-a DO2
      3. VC
      4. NIF
      5. Qs/Qt
      6. VE
      7. RR
   5. Demonstrate proper techniques for administering
      1. IMV
      2. CPAP
      3. PSV
      4. PCV
   6. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
3.  
   1. Identify the generic and/or trade name for the following classes of drugs:
      1. Sympathomimetic bronchodilator
      2. Anticholinergic bronchodilator
      3. Xanthine
      4. Mucolytic
      5. Dilutants
      6. Corticosteroid
      7. Antiasthmatics
      8. Narcotic analgesics
      9. Cardiac glycosides
      10. Antiarrhythmic
      11. Cardiac stimulants
      12. Vasopressor
      13. Vasodilator
      14. Neuromuscular blocking agents
   2. State the indications for the above mentioned drugs.
   3. Explain the effects of the above mentioned drugs.
   4. State the side effects of the above mentioned drugs.
   5. State the proper therapeutic dosage of the above mentioned aerosolized drugs.
   6. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
4.  
   1. Describe the following methods of extracorporeal oxygenation:
      1. Venoarterial (VA)
      2. Venovenous (VV
   2. Explain advantages and disadvantages of each method described above.
   3. Identify and explain the function of the components in an extracorporeal oxygenation circuit.
   4. Identify acceptable