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ARTP > ARTP 10 > Flashcards

ARTP 10 Flashcards

1
Q

Where do you place the circuit after a circuit change?

A

Needs to be treated as a biohazard and put in biohazard bag

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2
Q

When is a circuit change done?

A

It is no longer done routinely because it increases the chance of germs getting inside the system. Instead it is changed as needed (when soiled).

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3
Q

Three things that a ventilator pre check ensures

A
  1. Ensures there is no leak
  2. Determines tube compression- makes sure patient receives all the volume of air they are supposed to
  3. Ensures machine is running correctly.
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4
Q

What are the 4 settings that can affect the i:e ratio

A

Flow, Ti, TV, RR

***If in VC- you CANT change Ti. And in PC you cannot change flow

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5
Q

If flow increases, i:e does what?

A

i decreases, e increases

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6
Q

If you increase TV, i:e does what?

A

i increases, e decreases

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7
Q

If you increase the Ti, i:e does what?

A

increases the i time, decreases the e time

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8
Q

If RR is increased the i:e does what?

A

As RR increases, BOTH the i AND e time will decrease

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9
Q

What will cause a sudden spike in RR?

A

Auto-cycling, which is usually due to the sensitivity being too low

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10
Q

Where is the HME placed?

A

Placed between the Y and the artificial airway of the pt

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11
Q

Disadvantage to using an HME

A

Adds additional dead space to the system

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12
Q

Disadvantage to using an HME

A

Adds additional dead space** to the system and you have to remove it in order to give a SVN.

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13
Q

PS of 7 or less does what?

A

compensates for the increased WOB due to the increased airway resistance from the ETT tube

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14
Q

What are the most important alarms in CPAP and PS ventilation

A

Low TV, RR, Pressure, apnea

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15
Q

What do you do if your pt is air trapping?

A

Want to increase the flow rate

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16
Q

If there is a leak in your system, what two values would you compare?

A

Their would be a big difference between the VTi and the VTe.

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17
Q

***Which vital sign will help you best evaluate the unwanted cardiac side effects from changing PEEP?

A

Whenever you are adding additional PEEP, you increase the chance of increasing the pressure set on the heart, decreasing CO. You can best monitor this by looking at the BP*

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18
Q

What does a PS of 8 or more do?

A

It will help AUGMENT the breath

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19
Q

***If a patient appears to be in distress or asynchronus with the ventilator, what value could you change to improve the situation?

A

Change the flow….by increasing it?

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20
Q

What temperature is the WICK set at?

A

35-37

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21
Q

What will increasing the temperature of the heater do?

A

It will increase the humidity level in the circuit which can help with thick secretions.

22
Q

***Correlation between expiration time and increased lung compliance

A

Diseases that increase lung compliance will require a longer expiration time in order to fully exhale the entire volume in their lungs. (Think COPD patients)

23
Q

***What are your main goals you shoot for as far as initial FiO2 setting?

A

You want to achieve an SpO2 of 92% and PaO2 of 60-70mmHg

24
Q

If your patient has auto PEEP, what is likely causing the problem?

A

If they have auto PEEP, they are probably ‘air trapping’

25
Q

What is extrinsic PEEP?

A

This is the initial PEEP setting you input, which is usually 5cmH2O

26
Q

Initial TV setting

A

Preferred TV is 6-8ml/Kg. Start at 8mL/Kg.

27
Q

Initial flow rate setting

A

60-80Lpm

28
Q

Initial setting for inspiratory time

A

0.8 seconds (0.6 to 1 second)

29
Q

FiO2 setting for someone with COPD

A

Don’t want to go above FiO2 40%

30
Q

Flow Trigger setting

A

1-2Lpm

31
Q

Pressure trigger setting

A

-0.5 to -2.0 cmH2O

32
Q

High Pressure

A

+15cmH2O (10-15)

33
Q

Low pressure

A

5-10cmH2O below

34
Q

Apnea

A

20-30 seconds

35
Q

High RR alarm

A

set at double the set RR

36
Q

Low RR alarm

A

2 below the set RR

37
Q

High minute ventilation alarm and low minute ventilation alarm

A

10-15% above or 2L

10-15% below or 2L

38
Q

TV alarm (high and low)

A

100-200mL above and below the set TV

39
Q

Low PEEP alarm

A

2-3 cmH2O below set PEEP

40
Q

What happens when you trip over the ventilator plug and disconnect it?

A

The vent will alarm and will go into backup ventilation via the battery back-up

41
Q

What is included in a vent order

A

Mode, set rate, FiO2, TV, PEEP

42
Q

What two settings are typically not included in a vent order?

A

Flow & i:e ratio

43
Q

Which mode is pressure limited and time cycled?

A

PC

44
Q

Where is dead space found in the ventilator circuit?

A

Anything after the ‘Y” is considered dead space

45
Q

When changing PEEP, what do you need to do?

A

Change in increments of 2, and monitor BP whenever adding additional PEEP. Also reassess your alarms!

46
Q

What two things does PS do?

A

Compensate for extra WOB (from ETT tube) and increase your TV

47
Q

**What are the 5 contraindications for using an HME?

A 
1 low body temp
2 bloody secretions
3 copious thick secretions
4 increased minute ventilation
5 has a leak greater than 70%
48
Q

what alarm causes bradypnea?

A

low minute ventilation alarm

49
Q

normal LC

A

60-100

50
Q

***Low pressure alarm is most important for which mode?

A

CPAP

ARTP (13 decks)

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