RT 146 - Clinical Education II

1. Demonstrate an understanding of aerosolized medications.
   1. Explain the indications, effects, side effects, concentrations, and dosage of the following aerosolized medications.
      1. Mucolytics
      2. Sympathomimetics
      3. Anticholinergics
      4. Prophylactic antiasthmatics
      5. Antiviral agents
      6. Corticosteriods
   2. Explain the indications, effects, and side effects of the following system bronchodilators:
      1. Theophylline
      2. Aminophylline
   3. State the therapeutic serum level for theophylline
   4. Identify the medications listed in 1 and 2 above by both generic and trade names.
   5. Demonstrate the ability to administer medicated aerosols.
   6. Display the appropriate professional mannerisms, as described in the clinical performance evaluation while performing the clinical duties associated with this unit.
2. Demonstrate an understanding of incentive spirometry.
   1. Explain the goals of SMI/IS and the criteria for its use.
   2. Demonstrate the proper procedure for administering SMI/IS therapy.
   3. Demonstrate the ability to modify SMI/IS therapy to meet the individual needs of the patient.
   4. Identify an inspiratory volume that may act as a goal for SMI/IS therapy.
   5. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
3. Demonstrate an understanding of chest physiotherapy.
   1. Define the goals and explain the clinical indications of chest physical therapy.
   2. Describe the precautions and contraindications to postural drainage.
   3. Describe the precautions and contraindications to chest percussion.
   4. Demonstrate the proper procedure for administering and modifying postural drainage, chest percussion, and vibration based on the patient's response to therapy.
   5. Modify the above techniques for pediatric patients.
   6. Demonstrate the proper procedure for instructing patients in the following techniques:
      1. Effective cough
      2. Diaphragmatic breathing
      3. Pursed lip breathing
   7. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
4. Demonstrate an understanding of the use of manual resuscitators.
   1. Explain those factors that affect the O2 concentration delivered by a manual resuscitator.
   2. Identify the individual components of a manual resuscitator and explain their function.
   3. Demonstrate the ability to assemble and disassemble manual resuscitators currently in use.
   4. Demonstrate the proper technique for ventilating a patient with a manual resuscitator via:
      1. Bag and mask
      2. Bag and e-t tube
   5. Explain methods to determine the effectiveness of manual ventilation.
   6. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
5. Demonstrate an understanding of artificial airways.
   1. Identify and explain the function of the following:
      1. Oropharyngeal airway
      2. Nasopharyngeal airway
      3. Tracheotomy tube
      4. Endotracheal tube - both oral and nasal
   2. Identify the equipment necessary to perform an endotracheal intubation - both oral and nasal
   3. Demonstrate proper procedure for all of the following:
      1. Oral intubation
      2. Extubation
      3. Endotracheal tube stabilization
      4. Inflating cuff via minimal leak technique
      5. Measuring cuff volume and pressure
   4. Select a specific tube from the following, identify its various markings, and discuss the characteristics of tracheostomy tubes currently in use.
   5. Give an appropriate rationale for recommending tracheostomy tube vs. endotracheal tube.
   6. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
6. Identify landmarks and structures in a chest x-ray.
   1. Describe the indications for suctioning:
      1. Oral
      2. Endotracheal/trach tube
      3. Nasotracheal
   2. Explain the possible complications of suctioning and recognize their clinical signs.
   3. Demonstrate proper technique when performing the above mentioned suctioning procedures.
   4. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
7. Safely draw an arterial blood gas and interpret the laboratory results.
   1. Identify the following on a standard chest x-ray:
      1. Heart shadow
      2. Carina
      3. Ribs
      4. Spine
      5. Endotracheal tube position
      6. Mediastinal shift
      7. ECG leads
      8. Left and right hemi-thorax
   2. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
8. Demonstrate an understanding of basic pulmonary function volumes, capacities, and other results.
   1. Describe the complications associated with arterial puncture and precautions to avoid these complications.
   2. Demonstrate proper technique for drawing an arterial blood gas sample.
   3. Demonstrate proper technique for analysis of arterial blood.
   4. Describe those factors which can contribute to inaccurate blood gas values.
   5. Demonstrate the ability to perform appropriate quality control measures on blood gas analyzers.
   6. Interpret acid-base abnormalities.
   7. Give examples of the various types of hypoxia.
   8. Calculate arterial O2 content.
   9. Describe common causes of abnormal blood gases.
   10. Identify acute on chronic acid-base imbalances.
   11. Describe the effect of electrolytes on acid-base status.
   12. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.
9. 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 perform a complete pulmonary function test, including:
      1. Simple spirometry (lung volumes)
      2. Forced vital capacity (FVC)
      3. Flow-volume loops
      4. Maximum voluntary ventilation (MVV)
      5. Airway resistance (RAW)
      6. Airway conductance (GAW)
      7. Thoracic gas volume (VTG)
      8. Total lung capacity (TLC)
      9. Single breath nitrogen elimination (SBN2)
      10. Nitrogen washout
      11. Carbon monoxide diffusion capacity (DLco)
   2. Demonstrate the ability to calibrate the pulmonary function testing equipment.
   3. Given the information from a pulmonary function test, differentiate:     
      1. Obstructive disorders (a. Intrathoracic, b. Extrathoracic, c. Fixed, d. Variable)
      2. Restrictive disorders
   4. Display the appropriate professional mannerisms, as described in the clinical performance evaluation, while performing the clinical duties associated with this unit.