Interview Questions for Inhalation Therapy Assessment

Inhalers deliver medication directly to the lungs, treating respiratory conditions like asthma and COPD. Several types exist, each with a unique mechanism:

• Metered-Dose Inhalers (MDIs): These deliver a pre-measured dose of medication as a fine mist with each actuation. They often require coordination between inhaling and pressing the canister. Think of it like a tiny spray bottle for your lungs.
• Dry Powder Inhalers (DPIs): DPIs contain medication as a dry powder. Inhalation triggers the release of the medication; no propellant is needed. They are often preferred for patients who struggle with the coordination needed for MDIs. Imagine it like a tiny, breath-activated medicine dispenser.
• Soft Mist Inhalers (SMIs): These deliver a soft mist of medication, making coordination easier than with MDIs. They’re particularly helpful for patients who have difficulty using other inhalers effectively. Think of it as a gentler, easier-to-use aerosol spray.
• Nebulizers: Nebulizers use compressed air or ultrasonic vibrations to turn liquid medication into a mist, which the patient inhales via a face mask or mouthpiece. They’re often used for patients who cannot effectively use other inhalers, such as young children or those with severe respiratory distress. Think of it as a miniature mist machine that treats respiratory issues.

Each inhaler type utilizes a different method for medication delivery, catering to varying patient needs and abilities.

Administering medication via an MDI with a spacer involves these steps:

1. Shake the MDI: This ensures the medication is evenly distributed.
2. Attach the spacer: The spacer helps trap the medication, allowing for more effective inhalation.
3. Exhale completely: This clears the airways, creating space for the medication.
4. Press the inhaler and inhale slowly and deeply: The spacer will hold the medication, allowing you to inhale it slowly and evenly over a few seconds.
5. Hold your breath for 10 seconds: This allows the medication to reach deeper into the lungs.
6. Remove the inhaler: Take the inhaler away from the spacer.
7. Rinse your mouth (if using corticosteroids): This reduces the risk of thrush.

The spacer acts as a reservoir, allowing the medication to settle and be inhaled more completely, maximizing medication delivery and minimizing side effects. It’s a vital tool, particularly for children and the elderly, who often struggle with inhaler coordination.

Assessing the effectiveness of inhaled medication hinges on both subjective and objective measures:

• Subjective Assessment: This involves asking the patient about their symptoms. Questions focus on symptom frequency, severity (e.g., breathlessness, wheezing, cough), and the impact on daily activities. A patient’s self-reported improvement is crucial.
• Objective Assessment: This relies on measurable data. Peak expiratory flow (PEF) monitoring using a peak flow meter provides a quick measure of lung function. Spirometry is a more comprehensive assessment of lung volumes and flows. Changes in these measures indicate the medication’s efficacy in improving lung function.

Combining both subjective and objective assessments paints a comprehensive picture of treatment effectiveness. If improvement is inadequate, adjustments to medication or treatment plans are essential.

Inhaled medications, while targeted, can have side effects:

• Bronchodilators (e.g., beta-agonists like albuterol): Common side effects include tremor, palpitations, headache, and increased heart rate. These are often mild and transient. Severe reactions are rare.
• Corticosteroids (e.g., fluticasone): Oral thrush (fungal infection in the mouth), hoarseness, and dysphonia (voice change) are possible. Using a spacer and rinsing the mouth after use can help minimize these.

It’s crucial to monitor patients for these side effects and adjust treatment accordingly. If side effects are significant or bothersome, alternative therapies may need to be considered.

Spirometry is a simple, non-invasive test measuring lung function. The procedure involves:

1. Patient Preparation: The patient should avoid smoking, strenuous activity, and bronchodilator use before the test.
2. Technique Demonstration: The technician demonstrates proper breathing techniques.
3. Test Performance: The patient performs a series of forced expiratory maneuvers. The machine records the airflow and lung volumes.
4. Result Interpretation: Key parameters such as FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and FEV1/FVC ratio are analyzed. These values are compared to predicted values based on age, sex, height, and ethnicity. Reduced FEV1 and FEV1/FVC ratio are indicative of obstructive airway disease (e.g., asthma, COPD).

Spirometry is a cornerstone of respiratory assessment. It’s used for diagnosis, monitoring disease progression, and evaluating the effectiveness of treatment.

Inhaled medication use depends on the specific condition and patient factors:

• Bronchodilators: Indicated for relieving bronchospasm in asthma and COPD. Contraindicated in patients with hypersensitivity to specific medications.
• Corticosteroids: Indicated for long-term control of inflammation in asthma and COPD. Contraindicated in patients with active tuberculosis or fungal infections without appropriate treatment.
• Combination Inhalers: Contain both a bronchodilator and a corticosteroid, providing both quick relief and long-term control. Contraindications are similar to the individual components.

Careful consideration of a patient’s medical history, current medications, and potential interactions is essential before prescribing inhaled medications. Each medication has a unique profile of indications and contraindications that must be rigorously assessed.

Managing an acute asthma exacerbation requires immediate intervention:

1. Assess the patient: Evaluate respiratory rate, heart rate, oxygen saturation, and level of distress.
2. Administer oxygen: Aim for oxygen saturation above 95%.
3. Inhaled bronchodilators: Administer short-acting beta-agonists (SABAs) via a nebulizer or MDI with spacer, repeated as needed.
4. Systemic corticosteroids: Oral or intravenous corticosteroids may be necessary to control inflammation.
5. Monitor: Continuously monitor vital signs and respiratory status.
6. Hospitalization: Hospitalization may be necessary if the patient’s condition does not improve, or if there are signs of severe respiratory distress.

The goal is to rapidly reverse bronchospasm, reduce inflammation, and improve oxygenation. Timely and appropriate intervention is critical to prevent severe complications.

Respiratory distress manifests differently in adults and children, but some common signs are universal. Think of it like this: your body is shouting ‘I’m struggling to breathe!’

Adults: May exhibit increased respiratory rate (tachypnea), shortness of breath (dyspnea), use of accessory muscles (like the neck and shoulder muscles) to breathe, retractions (indrawing of the skin between the ribs during inhalation), cyanosis (bluish discoloration of the skin and lips due to low oxygen levels), altered mental status (confusion, drowsiness), and wheezing or crackles in the lungs.

Children: Children may show similar symptoms, but they might also exhibit nasal flaring (widening of the nostrils), grunting (a sound made during exhalation to help keep the airways open), and head bobbing. They may also become lethargic or irritable. Because children are smaller, the signs can appear more quickly and dramatically.

• Example: An adult with pneumonia might present with rapid breathing, a productive cough, and chest pain, all indicative of respiratory distress.
• Example: A child with bronchiolitis might have increased work of breathing, wheezing, and nasal flaring.

It’s crucial to remember that the severity of these signs varies, and early recognition is key to effective intervention.

Oxygen therapy aims to increase the oxygen levels in the blood, relieving hypoxia (low oxygen in tissues). The method of delivery depends on the patient’s needs and the severity of their respiratory distress. Think of it like choosing the right tool for a job.

Principles: We aim for adequate oxygen saturation (SpO2), typically above 90%, while minimizing potential risks like oxygen toxicity. The flow rate and concentration of oxygen are adjusted based on the patient’s condition.

Delivery Methods:

• Nasal Cannula: Simple, low-flow device delivering 1-6 liters per minute (LPM). Good for mild hypoxemia.
• Simple Face Mask: Delivers higher oxygen concentrations (up to 40-60%) at 5-10 LPM. Provides more humidified oxygen than a nasal cannula.
• Venturi Mask: Delivers precise oxygen concentrations (24-50%) and is useful for patients with chronic obstructive pulmonary disease (COPD) who need specific oxygen concentrations.
• Non-rebreather Mask: Delivers the highest oxygen concentration (up to 80-90%) via a reservoir bag. Used in emergencies when high oxygen levels are needed quickly.
• High-Flow Nasal Cannula: Delivers heated and humidified oxygen at high flow rates (up to 60 LPM). Provides positive airway pressure, improving oxygenation and ventilation.

Selection: The selection process considers the patient’s respiratory status, oxygen saturation, the need for humidification, and the desired oxygen concentration. For instance, a patient with severe pneumonia may require a non-rebreather mask initially, while someone with stable COPD might benefit from a Venturi mask.

Ventilators are life-support machines that assist or replace spontaneous breathing. Different types exist, each suited for specific patient needs. Imagine them as different engines designed for different vehicles.

Types and Applications:

• Volume-cycled ventilators: Deliver a preset tidal volume (the amount of air per breath) regardless of pressure. Used commonly in various settings.
• Pressure-cycled ventilators: Deliver a preset airway pressure for a specific duration. Often used for patients with lung compliance issues.
• Pressure-support ventilators: Provide assistance to the patient’s own breaths by adding pressure during inhalation. Used in weaning patients from mechanical ventilation.
• High-frequency ventilators: Deliver many small breaths per minute at a high frequency. Useful for patients with severe lung injury.
• Inverse ratio ventilation: A mode that increases expiratory time relative to inspiratory time, helping to improve oxygenation in patients with acute respiratory distress syndrome (ARDS).

The choice of ventilator depends on the patient’s respiratory status, diagnosis, and the need for specific ventilation strategies. For example, a patient with ARDS might benefit from inverse ratio ventilation, whereas a patient recovering from surgery might be on a pressure-support ventilator.

Monitoring patients on mechanical ventilation is crucial to ensure effective therapy and early detection of complications. It’s like constantly checking the vital signs of a complex machine.

Key Monitoring Parameters:

• Respiratory rate and rhythm: Observing the ventilator’s settings and the patient’s response.
• Tidal volume and minute ventilation: Assessing the amount of air delivered and removed from the lungs per minute.
• Peak inspiratory pressure (PIP): Measuring the highest pressure during inhalation, indicating airway resistance.
• Mean airway pressure (MAP): The average pressure in the airways, reflecting the overall lung mechanics.
• Oxygen saturation (SpO2): Monitoring the patient’s blood oxygen levels.
• Arterial blood gas (ABG) analysis: Assessing the levels of oxygen, carbon dioxide, and pH in the arterial blood. Provides the most accurate assessment.
• Lung sounds: Auscultating the lungs to detect abnormalities like wheezes or crackles.
• Hemodynamics: Monitoring blood pressure, heart rate, and cardiac output. Changes here can indicate complications.

These parameters are regularly assessed and adjustments made to the ventilator settings as needed to optimize ventilation and oxygenation.

Mechanical ventilation, while life-saving, carries potential risks. It’s like a powerful medicine that needs careful management.

Potential Complications:

• Barotrauma: Lung injury caused by high pressures during ventilation, potentially leading to pneumothorax (collapsed lung).
• Volutrauma: Lung injury caused by large tidal volumes, potentially leading to ARDS.
• Atelectasis: Collapse of a lung or part of a lung, often due to inadequate ventilation.
• Infection: Ventilator-associated pneumonia (VAP) is a common and serious complication.
• Hemodynamic instability: Changes in blood pressure and heart rate due to ventilator-induced effects.
• Muscle weakness: Prolonged mechanical ventilation can lead to diaphragmatic dysfunction.
• Ventilator-associated complications: These can include mucous plugging, bleeding, and ventilator-induced lung injury.

Careful monitoring, proper ventilator settings, and preventative measures are vital to minimize these risks. For example, proper hand hygiene and meticulous suctioning techniques reduce the risk of infection.

Weaning from mechanical ventilation is a gradual process that aims to restore spontaneous breathing. It’s like slowly teaching someone to walk again after a long illness.

Process: Weaning begins when the patient shows clinical signs of improvement and respiratory muscle strength. A common approach involves a trial of spontaneous breathing, often using pressure support or synchronized intermittent mandatory ventilation (SIMV). We progressively reduce ventilator support as the patient’s respiratory function improves. During the process, the patient’s respiratory rate, tidal volume, oxygen saturation, and arterial blood gases are closely monitored.

Assessment: Several clinical parameters guide the weaning process:

• Respiratory rate: Below 30 breaths per minute at rest.
• Tidal volume: Adequate to maintain ventilation.
• Minute ventilation: Within normal limits.
• SpO2: Above 90% on room air or with minimal supplemental oxygen.
• pH and blood gas values: Within normal limits.
• Patient’s ability to cough and clear secretions: Essential to prevent complications.

The process can be challenging, and setbacks are possible. Patients are carefully observed for signs of respiratory distress, and support may need to be increased temporarily if needed.

Non-invasive ventilation (NIV) techniques provide respiratory support without the need for an endotracheal tube or tracheostomy. It’s like providing respiratory assistance with less invasive measures.

Role in Respiratory Care: NIV is used to treat various conditions, such as acute exacerbations of COPD, pulmonary edema, and neuromuscular weakness. It can improve oxygenation, reduce work of breathing, and prevent intubation in appropriate patients. NIV often involves the use of masks that deliver positive pressure, supporting the patient’s breathing efforts.

Common NIV Methods:

• Continuous positive airway pressure (CPAP): Delivers a constant level of positive pressure throughout the respiratory cycle.
• Bi-level positive airway pressure (BiPAP): Delivers two different levels of pressure: one during inhalation (IPAP) and one during exhalation (EPAP).

The choice of NIV method depends on the patient’s clinical condition and response to therapy. NIV is associated with improved outcomes and reduced mortality in many situations and often prevents the need for more invasive mechanical ventilation.

High-flow nasal cannula (HFNC) oxygen therapy delivers heated and humidified oxygen at high flow rates, typically exceeding 6 L/min. Its benefits stem from its ability to provide several supportive mechanisms.

• Improved Oxygenation: HFNC delivers a higher FiO2 (fraction of inspired oxygen) compared to conventional oxygen delivery methods, improving oxygen saturation, especially in patients with hypoxemia.
• Reduced Work of Breathing: The high flow washes out dead space air, reducing the work of breathing and potentially improving respiratory mechanics. Think of it like clearing a clogged pipe – the high flow helps to clear the airway of stagnant air.
• Positive End-Expiratory Pressure (PEEP) effect: HFNC can provide some level of PEEP, which helps to keep the alveoli open and improve gas exchange. This is particularly beneficial in patients with atelectasis (collapsed lung).
• Improved comfort: The heated and humidified oxygen is generally more comfortable for patients than dry oxygen delivered via mask or cannula.

However, HFNC also has limitations:

• Increased risk of complications: While less common than with invasive ventilation, complications such as nasal trauma, skin breakdown, and even hyperoxia are possible.
• Not a replacement for mechanical ventilation: HFNC is supportive therapy; it’s not a replacement for mechanical ventilation in patients requiring more aggressive respiratory support.
• Requires careful monitoring: Close monitoring of oxygen saturation, respiratory rate, and clinical status is essential to ensure efficacy and safety.
• Cost and resource intensive: HFNC systems can be expensive to purchase and maintain.

For example, I’ve used HFNC successfully in patients with COPD exacerbations to improve their oxygenation and reduce their work of breathing, allowing them to rest and improve their overall condition before progressing to other interventions. However, I’ve also had cases where despite HFNC, the patient required intubation and mechanical ventilation due to worsening respiratory failure. The decision to use HFNC should always be made on a case-by-case basis, considering the patient’s overall condition and the availability of resources.

Assessing and managing airway secretions is crucial in patients with respiratory conditions. It involves a multi-pronged approach.

• Assessment: This includes auscultation to identify adventitious breath sounds (e.g., crackles, wheezes) indicative of secretions, reviewing the patient’s chart for history of mucus production, and directly observing the sputum (color, consistency, amount).
• Non-invasive techniques: These are preferred first-line methods. They include:
• Hydration: Ensuring adequate fluid intake thins secretions.
• Chest physiotherapy: This can include postural drainage, percussion, and vibration to mobilize secretions.
• Incentive spirometry: Helps patients to take deep breaths, promoting alveolar expansion and improving cough effectiveness.
• Humidification: Providing moist air, especially with dry gas therapy.
• Invasive techniques: When non-invasive methods are insufficient:
• Suctioning (endotracheal or tracheal): Removes secretions from the airway.
• Bronchoscopy: A more invasive procedure which allows direct visualization and removal of secretions.

For instance, I recently managed a patient with cystic fibrosis whose chronic mucus accumulation required a combined approach. We started with increased hydration, chest physiotherapy sessions twice daily, and aerosolized hypertonic saline to thin the secretions. When these measures were insufficient, we used suctioning to clear thick mucus plugging and improve gas exchange. The treatment plan was individualized and adjusted based on the patient’s response and ongoing assessments.

Respiratory hygiene and infection control are paramount in preventing the spread of respiratory infections, particularly in healthcare settings. Respiratory hygiene practices focus on minimizing the spread of respiratory pathogens through coughing, sneezing, and talking. Infection control targets preventing the transmission of infections between patients and healthcare workers.

• Respiratory hygiene: This involves educating patients and staff on proper cough etiquette (coughing into the elbow), hand hygiene, and the importance of covering the mouth and nose when sneezing or coughing.
• Infection control: This encompasses a range of measures, including:
• Standard precautions: These are basic infection control measures applied to all patients, such as handwashing, using personal protective equipment (PPE) such as gloves and masks, and proper handling of contaminated materials.
• Transmission-based precautions: These are implemented based on the mode of transmission of a specific pathogen. For airborne pathogens, negative pressure rooms are employed. For droplet precautions, masks and spatial separation are used. Contact precautions focus on preventing direct contact transmission.
• Environmental cleaning and disinfection: Regular cleaning and disinfection of equipment and surfaces reduces the risk of transmission.

For example, I’ve worked in units where meticulous adherence to respiratory hygiene and infection control protocols resulted in a significant reduction in the incidence of hospital-acquired pneumonia. Conversely, neglecting these practices can lead to outbreaks and increased morbidity and mortality.

My experience encompasses a broad range of respiratory assessment tools and technologies. I’m proficient in using:

• Spirometry: A fundamental test for assessing lung function, measuring forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and other parameters crucial for diagnosing and managing obstructive and restrictive lung diseases.
• Pulse oximetry: A non-invasive method for monitoring blood oxygen saturation (SpO2), providing essential information about the patient’s oxygenation status.
• Arterial blood gas analysis: Measures blood pH, partial pressures of oxygen and carbon dioxide, and bicarbonate levels providing comprehensive assessment of gas exchange and acid-base balance.
• Peak expiratory flow (PEF) meters: Used for monitoring airflow in patients with asthma or other conditions leading to bronchospasm.
• Capnography: Monitors end-tidal carbon dioxide (EtCO2), a valuable indicator of ventilation and circulation.
• Electrocardiogram (ECG): Essential for monitoring cardiac function, especially in patients with underlying cardiovascular comorbidities.
• Advanced technologies: I’m familiar with advanced respiratory support devices like mechanical ventilators (volume-cycled, pressure-cycled, etc.), HFNC systems, and various monitoring equipment like impedance pneumography and esophageal manometry.

I’ve utilized these tools to diagnose various respiratory conditions such as asthma, COPD, pneumonia, and pulmonary embolism and to monitor patients undergoing treatment. The selection of the tools depends on the clinical scenario and patient presentation, ensuring efficient assessment and appropriate treatment.

Prioritizing patient care in a busy respiratory care unit necessitates efficient triage and resource allocation. I use a systematic approach:

• Prioritization based on urgency and acuity: Patients with acute respiratory distress, impending respiratory failure, or unstable vital signs are always prioritized. This often involves using a clinical acuity system to quickly assess and classify patients.
• Efficient workflow: Streamlining tasks, delegating appropriately, and ensuring efficient communication amongst the team are essential.
• Time management: Utilizing organizational techniques such as task lists and prioritizing based on patient needs.
• Effective communication: Clear and prompt communication with physicians, nurses, and other healthcare professionals is vital for ensuring seamless patient care.
• Collaboration: Working as part of a multidisciplinary team allows for better resource allocation and shared decision-making. For example, I communicate closely with nurses regarding medication administration and the response to treatments.

In practice, I might manage a patient with severe asthma exacerbation simultaneously with a post-operative patient requiring airway clearance. The critical nature of the asthma exacerbation dictates immediate intervention (e.g., administering nebulized bronchodilators, assessing oxygen saturation, and initiating further treatment as necessary). While addressing the post-operative patient, I focus on preventing complications like atelectasis through incentive spirometry and airway clearance techniques.

Patient education is a crucial aspect of respiratory care. I strive to empower patients to actively participate in their management.

• Tailoring education: I adapt my teaching methods to the individual patient’s learning style, health literacy level, and cultural background. For example, I’d use visual aids for a patient with limited literacy.
• Focus on practical skills: I instruct patients on essential techniques like using inhalers correctly, performing chest physiotherapy, and recognizing signs of worsening respiratory symptoms.
• Providing written materials: I supplement verbal instructions with clear, concise written information.
• Reinforcement and follow-up: Regular check-ins and follow-up visits reinforce learning and address any questions or concerns.
• Empowering patients: I encourage patient participation in decision-making by explaining their condition, treatment options, and potential risks and benefits.

I remember educating a patient with COPD on the importance of medication adherence, recognizing early warning signs of an exacerbation, and the necessity of pulmonary rehabilitation. By providing clear, concise instructions and actively involving the patient in the decision-making process, we improved their understanding and their ability to self-manage their condition, leading to fewer hospital readmissions.

Handling difficult or challenging patients or situations requires patience, empathy, and a structured approach.

• Active listening: Understanding the patient’s perspective and concerns is paramount. This builds trust and facilitates effective communication.
• Empathy and respect: Treating each patient with dignity and respect, even when dealing with challenging behaviors.
• Clear communication: Using clear, concise language and avoiding medical jargon to ensure mutual understanding.
• Problem-solving: Working collaboratively with the healthcare team to address patient-specific needs and resolve conflicts.
• Seeking support: Don’t hesitate to seek guidance from supervisors or colleagues when facing complex situations. It’s important to recognize personal limitations and seek support when necessary.
• De-escalation techniques: In cases of agitated or aggressive behavior, I employ de-escalation techniques to calm the patient and create a safe environment.

For example, I once encountered a patient who was resistant to receiving treatment. By actively listening to his concerns, empathizing with his frustration, and explaining the treatment rationale patiently, I was able to build trust, address his concerns, and ensure that he received the necessary care. It’s about finding a balance between firm adherence to medical necessity and compassionate understanding of the patient’s perspective.

My greatest strengths as a respiratory therapist lie in my critical thinking skills, my ability to quickly assess and respond to rapidly changing patient conditions, and my commitment to providing patient-centered care. I excel at troubleshooting complex respiratory equipment and adapting treatment plans to individual patient needs. For example, I recently managed a patient experiencing acute respiratory distress. By carefully analyzing their arterial blood gas results and physical assessment, I quickly identified the need for immediate ventilator adjustments, preventing further deterioration. My weakness is occasionally taking on too much responsibility, striving for perfection. I am actively working on delegating tasks more effectively and prioritizing workload to maintain a healthy work-life balance and ensure optimal patient care.

Throughout my career, I’ve consistently worked within collaborative interdisciplinary teams, including physicians, nurses, physical therapists, and occupational therapists. Effective teamwork is crucial in respiratory care, especially with critically ill patients. For instance, in managing a patient with cystic fibrosis, I collaborated closely with the pulmonologist to optimize their medication regimen, the dietician to ensure adequate nutritional intake, and the physical therapist to improve their respiratory muscle strength. This multidisciplinary approach ensured holistic patient care and better outcomes. I actively participate in team meetings, contribute my expertise, and listen respectfully to the contributions of others, fostering a climate of shared decision-making and mutual respect.

Staying current in respiratory care requires ongoing professional development. I actively participate in continuing education courses, workshops, and conferences offered by professional organizations like the American Association for Respiratory Care (AARC). I subscribe to relevant journals such as Respiratory Care and Chest, and I regularly review research articles and clinical guidelines to stay informed about the latest evidence-based practices and technological advancements. I am also a member of professional online communities and forums where I engage in discussions and learn from colleagues’ experiences. This multifaceted approach ensures I maintain a high level of competency and apply the most up-to-date knowledge and skills in my clinical practice.

Evidence-based practice (EBP) is fundamental to respiratory care. It involves integrating the best available research evidence with clinical expertise and patient values to make informed clinical decisions. I utilize EBP by critically appraising research studies, using systematic reviews and meta-analyses to guide my practice. For example, when deciding on the optimal method of weaning a patient from mechanical ventilation, I consider the latest research on weaning protocols, alongside my own clinical judgment based on the patient’s specific condition and preferences. I also ensure that any interventions I use are supported by strong evidence and have been shown to improve patient outcomes. EBP allows me to provide the most effective and safe care possible, while continually striving to improve my practice based on the latest evidence.

Managing a patient with a tracheostomy requires meticulous attention to detail and a thorough understanding of airway management. My approach involves initial assessment of the tracheostomy tube (size, type, presence of secretions), ensuring secure placement and patency. I regularly monitor the patient for signs of respiratory distress, such as increased work of breathing, decreased oxygen saturation, or changes in lung sounds. I diligently suction the tracheostomy tube as needed to remove secretions, employing sterile technique to prevent infection. I also provide tracheostomy care, including cleaning the stoma site and changing the dressing to prevent infection and skin breakdown. Patient education is crucial; I teach patients and their caregivers about tracheostomy care, suctioning techniques, and signs and symptoms requiring immediate medical attention.

I have extensive experience with various aerosol drug delivery systems, including metered-dose inhalers (MDIs), dry powder inhalers (DPIs), nebulizers (both jet and ultrasonic), and high-flow nasal cannula systems. I am proficient in selecting the most appropriate device based on the patient’s specific needs and respiratory condition, considering factors such as their coordination abilities, medication type, and disease severity. I thoroughly instruct patients on the correct technique for using each device, ensuring optimal medication delivery and minimizing adverse effects. For example, when teaching a patient how to use a DPI, I emphasize the importance of proper inhalation technique to maximize drug deposition in the lungs. I also regularly assess the effectiveness of the chosen delivery system, making adjustments as needed to ensure the patient is receiving their medication appropriately.

My experience in the assessment and management of sleep-disordered breathing includes conducting polysomnography interpretations, titrating positive airway pressure (PAP) therapy, and educating patients on CPAP/BiPAP use. I am skilled in identifying patients at risk for sleep apnea through thorough history taking and physical examination, paying particular attention to risk factors such as obesity, hypertension, and daytime sleepiness. I’m comfortable performing diagnostic sleep studies and interpreting the results to determine the severity and type of sleep-disordered breathing. Once a diagnosis is established, I work with patients to optimize their PAP therapy, adjusting settings as needed based on their response and ensuring comfort and compliance. Patient education is paramount; I ensure patients understand the importance of adhering to their treatment plan to improve their sleep quality and overall health.