Ch.18 Flashcards
Minute ventilation
The movement of air in and out of the lungs within a minute
What does fighting the vent mean?
An individual who is apparently doing well while receiving mechanical ventilation but suddenly develops acute respiratory distress.
What is asynchrony?
When the pts inspiratory efforts and flow demands are not accommodated by the vent. *Can be very uncomfortable for pt because WOB is inc & cost of breathing O2 effort is inc.
Why is “fighting the vent” challenging for clinicians?
Because pt cannot verbalize their discomfort so clinician doesn’t know what going on.
What will occur with fighting the vent?
The sudden onset of dyspnea
What is the number in obligation of a clinician?
Ensuring pt safety
How can a clinician gain valuable info while pt is on a vent?
Asking direct (yes or no) questions
What are some signs of physical distress?
Tachypnea, nasal flaring, diaphoresis, accessory muscle use, retraction of the suprasternal, Supra a ocular and intercostal spaces, abdominal paradox (belly breathing).
What are some patient related causes?
• Artificial airway problems
• Brochospasm
• Secretions
• pulmonary edema
• pulmonary embolus
• dynamic hyperinflation
• abdominal respiratory drive
• alteration in body posture (change in body position)
• drug induced problems
• abdominal distention
• pneumothorax
• anxiety
What are some vent related causes?
• system leak
• circuit malfunction or disconnection
• inadequate FiO2
• pt-vent asynchrony (manually bag disconnect from vent)
• inappropriate vent support mode
• inappropriate trigger sensitivity
• inappropriate inspiratory flow setting
• inappropriate cycle variable
• inappropriate PEEP setting
• problems with closed loop ventilation
What should happen when an alarm activates on a vent?
The clinician should first make sure that the pt is receiving adequate ventilation and O2.
T or F; During the initial assessment the alarm should be checked and silenced?
True
T or F; When a serious problem is detected, the pt should be disconnected from the vent and receive manual resuscitation with and ambu-bag?
True
T or F; Manual resuscitation must be performed cautiously to avoid inappropriate patterns of ventilation excessive pressures ( above 40cmH2O) and barotrauma.
True
T or F;disconnection of the pt from the vent can cause contamination of the pts airway, which can inc the pts risk for developing VAP.
True
