Mechanical Ventilation (S.G) Flashcards

(42 cards)

1
Q

INCR. PaCO2 __ RR/TV

A

INCR.

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2
Q

DECR PaCO2 ____ RR/TV

A

DECR

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3
Q

INCR PaO2 ____ FiO2/PEEP

A

DECR,

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4
Q

DECR. PaO2____FiO2/PEEP

A

INCR.

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5
Q

which airway follows the normal curvature of the tonue and extends past the base?

A

Oropharyngeal

CANNOT have gag reflex, must be sedated

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6
Q

which airway limits gag reflex

A

nasopharyngeal

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7
Q

which art. airway allows eating/talking and is long term

A

Tracheostomy

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8
Q

which art. airway is fast, easy, and done in the ER

A

Endotracheal tube

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9
Q

how long should an ETT be in place?

A

7-10 days

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10
Q

When intubating:

what position

A

sedated in SNIFF position :hyperextend neck

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11
Q

limit intubation to how many seconds

A

30

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12
Q

where does ETT sit anatomically?

A

3-4 cm above carina

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13
Q

Indications of ventilator support

A
  • relief of upper airway obstruction
  • PaO2 45
  • remove secretions
  • prevent massive aspiration of stomach contents
  • GCS
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14
Q

What must you do before suctioning? And how long do you suction for?

A

Give 3 100% breaths

suction no more that 10-15 sec

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15
Q

Soft cuff effect of pressure and volume

A

DECR pressure

INCR volume

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16
Q

Hard cuff effect of pressure and volume

A

INCR pressure

DECR volume

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17
Q

Types of ventilators:

1) NEGATIVE pressure

A

decreases atmospheric pressure to initiate respirations

18
Q

Types of ventilators:

2) POSITIVE pressure

A

fills lungs with gas to expand lungs

* more common

19
Q
Initial Ventilator Settings
FiO2-
Mode
f
Tv
A

FiO2- 0.5-1 (50%-100%)
Mode- AC (assisted control)
f- 8-12/min
Tv- 6-10 (4-8 if compromised)

20
Q

Vent Modes:

AC/CMV

A

continued mandatory volume

-delivers a preset tidal volume always

21
Q

Vent Modes:

SIMV

A

spontaneous and mechanical breathing

* used for weaning

22
Q

Vent Modes:

PEEP

A

opens alveoli at end of exhale

23
Q

PEEP normal values

24
Q

PEEP indications

A

if FiO2 >50 for >24 hours- oxygen toxicity

25
Complications of PEEP
Barotrauma---> pneumothorax--> Decr. C.O
26
Neuromuscular Blockade
Paralyzes skeletal muscles
27
Neuromuscular Blockade
Eyelids and face--> tongue--->neck--->shoulders-->respiratory system ** Recovery from meds is reversed
28
What must you give with a neuromuscular blockade
PAIN MEDS AND SEDATION | they are fully concious
29
Paralytic: | Pavulon
takes 4-6 min, lasts 2-3 hours
30
Paralytic: | Nocuron
takes 2-4 min, lasts 30-40 miN
31
Nursing care of patient of paralytics
- patent airway - Ambu bag - Consider ABGs - Position/passive ROM - protect eyes with lube and eyepatch
32
is Versed a paralytic?
NOO do not choose this answer, it is a SEDATIVE
33
Complications of Mechanical ventilators
- oral, dental, nasal damage - subcutaneous emphysema - infection
34
Complications of Mechanical ventilators | -cardiovascular
decreased C.O
35
Complications of Mechanical ventilators | -Pulmonoary
Barotrauma-pnuemothorax
36
Complications of Mechanical ventilators | -Renal
decreased UO d/t kidneys not being perfused from decreased C.O
37
Respiratory Failure | TYPE 1
low PaO2 and normal CaO2
38
Respiratory Failure | TYPE 2
low PaO2 and high CaO2
39
Acute Lung Injury/ARDS | -non cardiogenic pulmonary edema ( not heart related)
normal PaOP | not a result of heart injury
40
Acute Lung Injury/ARDS | Direct
near drowning aspiration of gastric content penumonia
41
Acute Lung Injury/ARDS | Indirect
``` sepsis shock/trauma DIC pancreatitis multiple blood transfusions ```
42
Position to put a patient with Acute Lung Injury
PRONE!- improves perfusion and decreases shunting | **always assess their stability before putting them prone