Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio Unit 3 - Week 9 > Monitoring, Life Support And Respiratory Care > Flashcards

Monitoring, Life Support And Respiratory Care Flashcards

1
Q

Noninvasive monitoring - Electrocardiogram (ECG/EKG)

A

10 electrodes to give 12 leads
Usual display has all vitals and lead II (temp, BP, O2 and RR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Top of machine monitoring vitals

A

EKG lead 2 or V5
O2 saturation wave
Respiratory wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

On the right of the monitor for vitals

A

Heart rate
O2 saturation
Respiratory rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

EKG - What are emergencies to look out for?

A

ST segment changes
Multiple PVCs or change in foci
Onset of ventricular tachycardia or ventricular fibrilation
Progression/worsening of heart block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What would you do with a patient if the EKG showed A-fib and/or occasional PVC’s?

A

Note them in their chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the pulse oximetry measure and how is it expressed?

A

Measurement of arterial oxygen saturation - SpO2
Expressed as a percentage of oxygen bound to hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Principles of pulse oximetry

A

Threshold level = above 90%
Orders for titrations/adjustment during activity
Reasons for inaccuracies - can’t depend on this for HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Limitations of the pulse oximeter

A

Low perfusion or circulation
Anemia
Nail polish
Fluorescent lighting
Dark skin
Jaundice
Arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Heart rate normal range

A

50 - 100 beats per minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Systolic BP normal range

A

85 to 140 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diastolic BP normal range

A

40 to 90 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Respiratory rate normal range

A

12 to 20 breaths per minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Oxygen saturation normal range

A

> 95% of FiO2 (fraction of inspired oxygen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reasons for using arterial lines

A

For more unstable patient
Continuous BP management or frequent access to arterial system
Hemodynamic monitoring (fluid)
Frequent ABGs taken
Drug administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Precautions for arterial lines

A

Avoid dislodging - large blood loss
Radial - limit or avoid WB on wrist
Femoral - monitor closely and avoid dislodging (mobility encouraged)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Potential arterial line placements in order from most to least common place to put it

A

Radial artery
Femoral artery
Brachial artery
Axillary artery
Ulnar artery
Dorsalis pedis artery
Posterior tibial artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Noninvasive monitoring

A

Heart rate
Systolic and Diastolic BP
Respiratory rate
Oxygen saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Invasive monitoring

A

Arterial line
Central (venous- like
Swan Ganz - Pulmonary Artery Catheter
Temperature
Intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Central (venous) line

A

Measures central venous pressure (CVP) or R atrial pressure
Allows IV access for medication administration
Tunneled (long term) or non tunneled (short term)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does it mean for a line to be tunneled?

A

Short distance that the line is burrowed under the skin prior to entering the actual vein
Decrease infection risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What line is used for long term placement?

A

PICC line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is the PICC line placed?

A

Cephalic, basilic or brachial vein using sterile techniques
Still runs up to superior vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is the R subclavian or internal jugular vein used for a central line?

A

Quick access to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a port?

A

Central line implanted under the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CVP or PICC Precautions

A

Need to remain sterile
Usually well covered near skin insertion
Secure ends well before mobilizing
Be aware of location and avoid dislodging
Use precautions when femoral PICC used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Swan Ganz-Pulmonary artery catheter

A

Surgically inserted catheter —> through a central vein —> threaded through R atrium and ventricle into pulmonary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can the Swan Ganz- Pulmonary Artery catheter measure?

A

Central venous pressure (CVP)
R atrial pressure
Pulmonary artery pressure
Pulmonary capillary wedge pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is a Swan Ganz - Pulmonary artery catheter?

A

Measurement of blood pressure to locate/monitor heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What can pulmonary capillary wedge pressure calculate/measure?

A

Measure and estimate L side filling pressure and calculate vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What else can the Swan Ganz - Pulmonary artery catheter help with?

A

Calculation of vascular resistance
SvO2 and temporary pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does pulmonary artery pressure help determine?

A

Problems like pulmonary HTN or resistance to flow through the lungs

32
Q

Why is the Swan Ganz Catheter so important?

A

Measurement of left sided heart failure

33
Q

Pulmonary capillary wedge pressure and left sided heart function

A

(Indirect) LEFT side heart filling pressure
Because it’s a closed system, it can determine status of pulmonary circulation, detect pulmonary HTN, and estimate filling pressure of the L atrium?

34
Q

What happens if there’s pressure in the pulmonary vessels?

A

It pushes the fluid into the interstitial tissue and causes problems w CO2 and O2 exchange

35
Q

What does issues with CO2 and O2 exchange cause?

A

Congestion in the lungs

36
Q

What else can the Swan Ganz catheter help with due to its location?

A

Guide fluid management in critically ill and dosing of diuretics

37
Q

Elevated PCWP

A

Pulmonary HTN
Indicates resistance to flow into the L ventricle

38
Q

Uses of Swan Ganz Catheter

A

Monitoring heart function (post op)
Diagnosing chronic heart failure
Differentiating causes of pulmonary edema
Guiding diuretic dosing to manage fluid overload

39
Q

Complications of dislodgment of Swan Ganz

A

Serious arrhythmias
Pulmonary artery rupture
Pulmonary valve damage because it goes through it
Infection - heart

40
Q

Invasive ways to monitor temperature

A

Swan Ganz
Urinary catheter
Nasopharyngeal
Rectal probe

41
Q

When are the only times you’d use a rectal probe?

A

Comatose
Intubated
Confused

42
Q

What is intracranial pressure monitoring used for?

A

Neurological trauma - head injury, brain surgery, hemorrhage, tumor meningitis

43
Q

What does increased ICP cause?

A

Decreased perfusion of brain

44
Q

What can low CO2 levels help control?

A

Increased ICP

45
Q

What can be placed to help control ICP?

A

Drain (Temporary)
Shunt (Permanent)

46
Q

Most supportive respiratory support

A

Mechanical Ventilation via tracheostomy

47
Q

Respiratory support in order from least to greatest support

A

Nasal cannula, face make, trach color
Non-rebreather mask, Venturi mask
CPAP

48
Q

Nasal cannula

A

Most common device for O2 delivery
Lowest level of support

49
Q

Flow rates for nasal cannula

A

Between 1 and 6 L/min

50
Q

When will a nasal cannula supply humidity?

A

When rate is > 4L/min

51
Q

What is FiO2?

A

Fraction of inspired air that is oxygen

52
Q

Face mask/trach mask flow rate

A

5-10 L/min

53
Q

FiO2 for face mask/trach mask

A

About 35-56%

54
Q

Humidification for face mask/trach mask

A

Face mask: common at about 4 L/min
Trach mask: ALWAYS humidified

55
Q

Why must a trach mask always be humidified?

A

Humidification of air happens in the upper airways and the trach is a bypass of all the upper airways

56
Q

Venturi Mask

A

Much more specific/precise FiO2 delivery; order for FiO2
Dictates the L/min setting on the O2 supply
Provides more support
Used to ensure a specific saturation is achieved

57
Q

Non-Rebreather Mask

A

Can provide up to 100% oxygen
Bag fills from wall w/ O2 > 15 L/min
Breathe in air from bag
Breathe out - air goes into room
One way valve (green) prevents air from mixing
Due to high flow rate: need to start w full tank and bring a spare

58
Q

High flow nasal cannula

A

Important to decrease dead space in upper airways, increase O2 reserve in system and help pt maintain O2 levels
Provides flow rate for 25-60 L/min

59
Q

CPAP

A

Constant positive pressure during both inhalation and exhalation
Common use in sleep apnea

60
Q

BiPAP

A

2 levels of pressure, one for inhalation and one for exhalation
Used to wean off ventilator or prior to invasive ventilation

61
Q

Why would you use invasive mechanical ventilation?

A

Failure to oxygenate
Failure to ventilate
Combo of both
Airway protection and

62
Q

Why would you have failure to oxygenate?

A

Inadequate exchange of gas at the alveolar level
Pulmonary disease impacting the alveoli

63
Q

Why would there be failure to ventilate?

A

Pt w decreased mental status or where compliance of the lung has decreased so much that it’s very difficult and patients can’t ventilate on their own because they’re expending too much energy

64
Q

Why would you need airway protection?

A

Trauma —> When they’re trying to protect pts airway b/c they see things going bad
During surgical procedures because of sedation

65
Q

What types of invasive mechanical ventilation are there?

A

Endotracheal tube (Short term)
Tracheostomy tube (Long term)

66
Q

Ventilator Settings

A

Total volume
PEEP —> Positive Expiratory End Pressure
Respiratory Rate
FiO2
Mode

67
Q

What is the mode on ventilator settings?

A

The amount of assist

68
Q

What is the tidal volume on a ventilator?

A

Amount of air delivered per breath
Ensures certain volume is delivered

69
Q

What is PEEP (Positive Expiratory End Pressure) on ventilator settings?

A

Pressure used to keep airway from collapsing (splints open airways) —> better O2 exchange

70
Q

What is Respiratory Rate on a ventilator?

A

Breaths per minute machine delivers

71
Q

What is the FiO2 on a ventilator setting?

A

Percent of O2 in delivered air
Try to keep below 50% if it’s going to be used long term

72
Q

What are the 4 levels of assist from most to least support?

A

Control Mode
Assist Control - Volume Control (AC-VC)
Synchronized Intermittent Mandatory Ventilation (SIMV-VC)
Spontaneous or Pressure Support

73
Q

Control Mode aka Ventilation Control

A

Ventilator has complete control —> machine does all the work to control volume and rate of breaths
Preset tidal volume and respiratory rate that blocks all spontaneous breaths —> no pt initiation

74
Q

Assist Control-Volume Control (AC-VC)

A

Set number of breaths (RR)
Every breath has set volume
Pt can initiate more breaths - machine still gives the set volume

Some patient involvement with initiating when breaths will occur over the base rate
Ventilator will ALWAYS give set volume

75
Q

Synchronized Intermittent Mandatory Ventilation (SIMV-VC)

A

Set number of breaths w/ set volume given
When pt takes more breaths than set RR
Tidal volume is NOT controlled —> when pt initiates extra breaths

76
Q

Spontaneous or Pressure Support

A

Set pressure, PEEP and FiO2 to help make it easier
Pt dictates tidal volume and RR

Use own force to generate how much air will go in
Pt initiates breath, vent delivers preset pressure to help overcome airway resistance
Set amount of FiO2 is supplied but pt is responsible for how much volume of air they’ll inhale

Cardio Unit 3 - Week 9 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions