After they had successful tracheostomy cuff deflation, it wa…

After they had successful tracheostomy cuff deflation, it was time to introduce the bias-closed position no-leak Passy Muir Tracheostomy & Ventilator Swallowing and Speaking Valve (PMV). Noah’s ventilator settings were stable, he wanted to eat and speak again, and they had confirmed his upper airway was patent by hearing whispers of speech after his cuff deflation. However, the team met with similar obstacles when using the PMV as they had with cuff deflation. Noah was hesitant and anxious about something new, which would cause a change in his breathing. The first time they placed the PMV in-line with the ventilator, Noah agreed to use it for 10 minutes. Another consideration for success with children is to have them invested in the therapy; have them agree and assist with planning the goals. While there was much hesitation from Noah, having him assist with the plan, understand it, and using distraction while providing encouragement helped to motivate his use for 10 minutes. While it was not the easiest 10 minutes, Noah enjoyed having his voice back and being able to try tastes of Nutella. The therapist monitors the patient and determines PMV tolerance by observing the following characteristics? (Select all that apply) 

Due to the patient’s underlying issues with anxiety, the ini…

Due to the patient’s underlying issues with anxiety, the initial stages of cuff deflation and vent weaning presented a huge challenge. With the cuff still inflated, Noah was unable to vocalize and did not have an easy method to communicate with staff or family, which added to his frustration. Whenever a member of the team would try to work with him, his respiratory rate and heart rate would increase as he would become tearful and anxious with possible change. Given Noah’s current status (physical and respiratory), what might be one method of communication the SLP could implement? 

You are delivering albuterol to your patient in an asthmatic…

You are delivering albuterol to your patient in an asthmatic episode (2 points each).a. What particle sizes are optimal (use units of measure)?b. What generations are involved?c. What mechanism(s) of deposition will be involved where action is needed?d. Name two things that will affect lung deposition.