CHT Patient Assessment & Clinical Evaluation 2 — Questions and Answers
Question 1: A patient with a history of spontaneous pneumothorax presents for hyperbaric oxygen therapy. Which action is MOST appropriate before initiating treatment?
- Proceed with treatment at reduced pressure
- Obtain physician clearance and verify resolution of the pneumothorax (Correct answer)
- Administer bronchodilators prior to compression
- Limit treatment to 1.5 ATA only
Correct answer: Obtain physician clearance and verify resolution of the pneumothorax
A history of spontaneous pneumothorax is a relative contraindication; confirmed resolution and physician clearance are required before HBO therapy.
Question 2: During the pre-treatment assessment, a patient reports taking bleomycin. This is significant because bleomycin combined with HBO therapy increases the risk of:
- Oxygen toxicity seizures
- Pulmonary fibrosis and oxygen toxicity (Correct answer)
- Middle ear barotrauma
- Nitrogen narcosis
Correct answer: Pulmonary fibrosis and oxygen toxicity
Bleomycin potentiates pulmonary oxygen toxicity, and HBO therapy in patients who have received bleomycin can precipitate severe pulmonary fibrosis.
Question 3: Which vital sign parameter is MOST critical to assess before a patient enters a hyperbaric chamber for wound care treatment?
- Body temperature
- Blood glucose level (Correct answer)
- Blood pressure
- Respiratory rate
Correct answer: Blood glucose level
Blood glucose must be checked because HBO therapy lowers blood glucose, and hypoglycemia during a treatment session can be dangerous and difficult to treat inside the chamber.
Question 4: A patient scheduled for hyperbaric therapy reports consuming alcohol within the past 4 hours. The BEST course of action is to:
- Proceed with treatment at a lower pressure
- Postpone the treatment session (Correct answer)
- Administer antiemetics and proceed
- Reduce the treatment duration by half
Correct answer: Postpone the treatment session
Alcohol intoxication is a contraindication to HBO therapy because it increases seizure risk and impairs the patient's ability to equalize ear pressure.
Question 5: When assessing claustrophobia risk before hyperbaric treatment, which assessment tool is MOST commonly used?
- Hamilton Anxiety Scale
- Modified Claustrophobia Questionnaire (MCQ) (Correct answer)
- Glasgow Coma Scale
- Epworth Sleepiness Scale
Correct answer: Modified Claustrophobia Questionnaire (MCQ)
The Modified Claustrophobia Questionnaire helps screen patients who may have difficulty tolerating enclosed chamber environments.
Question 6: A patient has a central venous catheter in place. Before hyperbaric treatment, the technician should verify that the catheter port is:
- Clamped and taped securely
- Flushed with heparinized saline immediately before entry
- Free of air-filled components that could compress under pressure (Correct answer)
- Removed prior to entering the chamber
Correct answer: Free of air-filled components that could compress under pressure
Air-containing IV lines and catheter reservoirs can compress during pressurization, potentially causing air embolism or infusion errors.
Question 7: Which finding in a patient's ophthalmic history would be a contraindication to monoplace hyperbaric oxygen therapy?
- Wearing corrective contact lenses
- Recent retinal detachment repair with intraocular gas tamponade (Correct answer)
- History of cataract surgery without intraocular lens
- Mild diabetic retinopathy
Correct answer: Recent retinal detachment repair with intraocular gas tamponade
Intraocular gas (e.g., SF6, C3F8) used in retinal surgery can expand during decompression, causing catastrophic intraocular pressure elevation.
CHT Patient Assessment & Clinical Evaluation 2
A patient with a history of spontaneous pneumothorax presents for hyperbaric oxygen therapy.
Which action is MOST appropriate before initiating treatment?