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Module 7 > Mechanical Ventilation > Flashcards

Mechanical Ventilation Flashcards

1
Q

F/RR

A

Frequency /RR (12-20bpm)

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2
Q

fio2

A

Fraction /percent of inspired o2

Anywhere between 21% -100

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3
Q

I:e ratio

A

Inspiration time compared to expiratory time (1:2)

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4
Q

PEEP

A

Positive and expiratory pressure ( 5-10 cm H2O)

Can go all the way up to 15 on high peep but sometimes can be at 5 to keep alveolar open and to keep it from collapsing during expiration

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5
Q

PIP

A

Peak inspiratory pressure ( 15-20 cmh20)

max pressure for inspiration
Resistance pressure From air flowthe ventilator all the way that goes down to bronchi

Can be effected by mucous plugging, bronchospasms, kink in the tubing

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6
Q

VE

A

Minute ventilation /volume ( vtxRR) (6-8l/min)

Amount of air delivered to pt in one minute

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7
Q

VT

A

Tidal volume ( 6-8 L/kg- ideal body weight ) (very sick lungs use to 4-6 ml/kg

How big the breath is .. the volume that is delivered with each breath

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8
Q

S/s of o2 toxicity from ventilated patients

A

Restlessness, Dyspnea, chest discomfort, fatigue , atelectasis

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9
Q

Barotrauma

A

When increased airway pressure distends the lungs and possibly ruptures fragile alveoli or emphysemtous bless ( pt with non compliant lungs such as COPD) at greater risk for this

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10
Q

Ventilator associated pneumonia (VAP)

A

Pneumonia that occurs 48 hours or more after ET intubation

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11
Q

Low pressure alarm

A

Cuff leak
Leak in the ventilator circuit
Patient stops breathing in the pressure support modes of SIMV
Unintentional extubation
Tube disconnected from circuit
Barotrauma

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12
Q

Cuff leak

A

Assess for cuff leak , check cuff pressure , call RT and physician

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13
Q

Leak in the ventilator circuit

A

Assess all connections and tubing call RT and physician , a new ventilator may be needed

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14
Q

Patient stops breathing in the pressure support modes of SIMV

A

Assess the pt notify RT and physician may need to provide manual breathes via BVM

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15
Q

Unintentional extubation

A

Assess pt for need to be reintubated, apply o2, may need to give manual breaths via BVM

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16
Q

Tube disconnects from circuit

A

Reconnect tubing to circuit ; assess pt

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17
Q

Barotrauma

A

Assess subq emphysema - notify RT and physician if present

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18
Q

High pressure alarm

A

Mucous plug or increased secretion
Pt bites ETT
Pneumothorax
Pt anxious and fighting the ventilator
Kink in the tubing
Water collected in the ventilator tubing
Pt coughing
Bronchospasm
Pulmonary edema
Decreased lung compliance

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19
Q

Mucous plug or increased secretions

A

Suction as needed

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20
Q

Pt bites ETT

A

Insert oral airway to prevent biting ( bite block)

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21
Q

Pneumothorax

A

Assess for asymmetrical chest rise , decreased breath sound over pneumothorax site , notify physician

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22
Q

Pt anxious and fighting the ventilator

A

Assess the pt, provide emotional support , reevaluate sedation /analgesic need

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23
Q

Kink in the tube

A

Assess the tubing from ventilator to pt to ensure no kindling of the tube is present

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24
Q

water collected in the ventilator tubing

A

Empty the water from the tubing

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25
Q

Pt is coughing

A

Continue to monitor

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26
Q

Bronchospasm

A

Assess for nonproductive consistent cough , give breathing treatments

27
Q

Pulmonary edema

A

Assess lung sounds and ETT for fluid ; suction needed may need to be placed prone and given diuretics

28
Q

Decreased lung compliance

A

Assess lung sounds RR, BP and sao2 , notify RT and physician , ventilator mode may need to be changed

29
Q

ETT cuff pressure should be at

A

<25

30
Q

If cuff pressure is too low

A

Puts pt at risk for aspiration, unintentional excubation, and pt can talk to us ( we dont want them to)

31
Q

If cuff pressure is too high

A

It can cause tracheal necrosis

32
Q

Chest xray reveals what about ETT

A

3-4 cm above carina

33
Q

What should the capnometer reveal

A

The color yellow to indicate the presence of CO2

But the purple is a no no

34
Q

When we sunction the pt what should we do when it comes to the carina

A

It already sits about 3-4 cm and when you sunction , barely touch it ..it can cause a cough so that’s how we know when we are there

35
Q

What is the obiturator used for?

A

If the trache falls out , we can emergently place this to maintain airway..
it is emergency and cold blue situation

36
Q

What is the first thing we do when there is a change in the condition in the pt

A

Assess the patient

37
Q

What can we trouble shoot if pt seems like they are having a hard time breathing with a trache

A

May have mucous plugs in inner cannula and suction .. then sit and watch to see if it worsens

38
Q

How often to change inner cannula for the trache

A

Every shift or PRN

39
Q

How long should you sunction?

A

10-15 seconds*** at most 10 seconds

40
Q

How often to do oral care?

A

Every 4 hours

41
Q

What indications for suctioning

A

Coughing, increase resp, o2 sat down , tachycardia, restless, seeing plegm or hear it when auscultation

42
Q

Restraints for safety

A

Restraint release q2 hours and skin assessment

Do you have an order? Are you doing ROM ? Are you keeping up with the order?

43
Q

Pharm surround mechanical ventilation

A

Vasopressors
Additional fluid
Bronchodilator
Paralytics
Sedatives

44
Q

LEAN drugs

A

Lidocaine
Epinephrine
Atropine
Narcan

45
Q

Patient safety ETT or trach

A

Ensure tube is secured
Keep tube patent
Verify maintain placement
Monitor resp status
Bag valve mask in the room
Keep scissors airway from external balloon

46
Q

How do we make sure air way is what it needs to be with trach

A

Auscultation , and cuff pressure less than 25

47
Q

What should you always have at the bedside or when you take the pt anywhere

A

BVM

48
Q

Why should we restraint be placed?

A

Danger to self and combatitive

49
Q

What should we ensure before suction?

A

Validate and make sure sunction is working (80 -100 ml of pressure)
And you have pre oxygenated the patient with 100%

50
Q

Suction order

A

Check suction make sure its working
Pre oxygenate pt
Insert Catheter suction
And clear for the next use

51
Q

What should we keep in mind with someone with intracranial pressure if you need to turn them and suction

A

Give them a break in between

52
Q

Suction can be seen in

A

Ventilator , trach , ETT

53
Q

Oxygenation toxicity

A

Chest pain Dyspnea , uncontrolled coughing long period

54
Q

How can we decrease co2?

A

Increase RR and or tidal volume

55
Q

What if we are having trouble with pao2?

A

Increase fio2 ( amount of o2)
Or increase the peep

56
Q

Important for the nurse in positive pressure ventilation

A

Verify setting
Assess pt
Ensure pt safety
Trouble shoot as needed
Monitor for ABGs

57
Q

A/C ventilation

A

Pt can’t breath slower than what is set
If it is set at 500 ml and they take a spontaneous breath it will sense and make sure breath goes to 500 ml

If pt is doing good they may bring down the breaths per min to see if they can do more breaths on their own

58
Q

What is an art line used for

A

ABGs lab work , blood sugar, vasopressor

NEVERRRR for medications

59
Q

The inflated cuff of an ETT

A

When inflated produces a seal between the trachea and the cuff to prevent aspiration and ensure delivery of a set tidal volume when mechanical ventilation is used.

60
Q

Medications ETT intubations

A

Paralytic, sedative,
( propofol , medazalam versed)

61
Q

What patient is not for bipap

A

Shock
Altered loc
Increase airway secretion

62
Q

Fio2 >50% for more than 24-48 hours

A

Can cause oxygen toxicity

63
Q

S/s of o2 toxicity

A

Restlessness, Dyspnea, chest discomfort , fatigue , atelectasis

Module 7 (25 decks)

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