Chest treatment in Critical Care Flashcards Preview

PHTH 564 - ICU > Chest treatment in Critical Care > Flashcards

Flashcards in Chest treatment in Critical Care Deck (58)
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1

Donning PPE order?

1. hand hygiene
2. gown
3. mask / respirator
4. eye protection
5. gloves

2

Doffing PPE order?

1. ensure you are 2 m away from pt before beginning
2. gloves
3. hand hygiene
4. gown
5. hand hygiene
6. eye protection
7. hand hygiene
8. mask / respirator
9. hand hygiene

3

3 components of resp ax?

1. pt history
2. physical examination
3. lab tests and investigations

4

In normal lung, ventilation is best is _______ region

dependent

5

For pt on mechanical ventilation, ventilation is best in ________ region of lungs

non-dependent (air follows path of least resistance)

6

Perfusion in normal lung is a _____ pressure system and therefore responds more to _____

low; gravity

7

________ is our best position for V/Q match as it improves overall ventilation

upright

8

Mechanical ventilation can limit _______ due to high pressures in thorax

perfusion

9

______ zone of lung has best V/Q matching

middle

10

Generally place bad lung ___

up (non-dependent position)

11

When someone has and epidural, be aware of ___ changes

BP

12

Who do we prone ?

ARDS or ALI pts

13

Why we prone: 75% of ARDS pt's have decrease in ____ and increase in PaO2

shunt

14

Why we prone: generally allows for decrease in ___ and ______ levels

FiO2; PEEP

15

Why we prone: generally allows for decrease in ______

PaCO2

16

4 precautions to proning?

1. hemodynamic instability
2. active intra abdominal process
3. facial or ocular injuries
4. recent sternotomy or abdominal incisions

17

3 CI's to proning?

1. unstable spina injury
2.uncontrolled cerebral hypertension
3. facial trauma / burns / open chest or abdomen

18

When proning, head and arm position change every ___ hours, and pt is prone for __-___ hours

2; 2-18

19

Lung volume recruitment techniques produce an ____ breath that is larger than the pt or ventilator delivered TV

inspiritory

20

3 indications to perform lung volume recruitment technique?

1. acute lobar collapse
2. sputum clearance
3. maintenance lung compliance and thoracic mobility

21

Lung volume recruitment techniques can be performed only with non-ventilated pts (T/F)

FALSE; ventilated and non ventilated

22

4 lung volume recruitment technique examples ?

1. breath stacking with an ambu bag +/- a one way valve
2. manual hyperinflation
3. mechanical insufflation / exsufflation machine
4. ventilator hyperinflation

23

5 CI's to lung volume recruitment techniques?

1. undrained pneumothorax
2. proximal tumor / obstruction
3. unstable head injury
4. HFOV
5. recent thoracic sx (unless you have surgeons permission)

24

Manual hyperinflation is also known as ______

bagging

25

_____ ______ is usually performed on an intubated / ventilated pt to improve lung volumes and assist with secretion clearance

manual hyperinflation

26

Manual hyperinflation consists of slow _____ phase and a week release stimulating a ____/___

inspiration; cough/huff

27

With MHI, O2 flow rate of __-__ L/min is required to prevent rebreathing of CO2

14-15

28

When doing MHI, pt's PEEP on the ventilator should be at __ or below, otherwise opening the circuit could cause excessive de-recruitment

10

29

4 pieces of equipment needed for MHI?

1. ambu-bag
2. O2 tubing
3. PEEP value
4. Pressure manometer in the circuit for safety

30

Pressure during MHI in circuit should be __-__cmH2O

30-40