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Respiratory Care > RET2874 Final > Flashcards

RET2874 Final Flashcards

(106 cards)

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1
Q

Alveolar Oxygen Equation

A

PaO2 = (Pb - 47)FiO2 - (PaCO2 x 1.25)

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2
Q

Defibrillation (biphasic) initial, second, and third shock intensities

A

120 J, 150 J, 200 J

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3
Q

Indications for unsynchronized counter shock (defibrillation)

A

V-fib, v-tach, pulseless v-tach

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4
Q

Cardioversion is also known as…

A

Synchronized electric shock

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5
Q

Indications for cardioversions

A

V-tach, SVT, A-fib, A-flutter

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6
Q

Initial and subsequent voltage for cardioversions

A

50 J, 100 J, 200 J, 300 J, 360 J

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7
Q

Pressure which, if exceeded during positive pressure ventilation, can cause esophagus to open and gastric distension

A

20-25 cmH2O

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8
Q

Patients with ______________ can not tolerate BHT procedures even if a secretion clearance problem exists.

A

Acute exacerbations of COPD

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9
Q

Copious sputum production is defined as

A

25-30 mL/day

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10
Q

Supine position with the patient inclined at an angle of 45 degrees so the pelvis is higher than the head.

A

Trendelenberg

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11
Q

Trendelenberg contraindications

A

Gross hemoptysis, icp > 20mmHg, uncontrolled hypertension, distended abdomen, post neurosurgery, uncontrolled airway at risk for aspiration, esophageal surgery

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12
Q

Percussion should be performed for _______.

A

3-5 min

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13
Q

Vibration should be performed _____ percussion.

A

After

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14
Q

MI:E indications

A

Chronic neuromuscular patients

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15
Q

Involves active expiration against variable flow resistance at pressures of 10-20 cmH2O

A

PEP

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16
Q

BHT for infants

A

PDPV

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17
Q

BHT for children

A

Exercise, PEP, PDPV, ACB, HFO

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18
Q

BHT for children > 12 years

A

Exercise, ACB, PEP, PDPV, HFO

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19
Q

BHT for neuro patients

A

PDPV, suction, MI:E

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20
Q

BHT for patients with musculoskeletal weakness

A

PEP, MI:E

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21
Q

Medications for BHT

A

N-acetylcysteine, dornase alfa, hypertonic saline

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22
Q

Incentive spirometry criteria

A

VC > 15 ml/kg or IC > 33%; no difficulty with secretions

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23
Q

In IPPB the __________ and ___________ determine the tidal volume.

A

Set pressure, flow rate

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24
Q

IPPB indications

A

The need to improve lung expansion AND other therapies are unsuccessful, patient cannot cooperate, inability to clear secretions

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25
Absolute contraindication for IPPB
Tension pneumothorax
26
Initial pressure setting for IPPB
10-20 cmH2O
27
Initial sensitivity setting for IPPB
1-2 cmH2O
28
The goal of IPPB is _____ ml/kg of IBW or at least ___ of the patient's predicted inspiratory capacity.
10-15, 30%
29
Inspiration occurs at ambient pressure and expiration generates an increased pressure that gradually decreases as expiratory flow decelerates.
PEP
30
Inspiration occurs as ambient pressure and maintains positive pressure throughout expiration.
EPAP
31
Maintains positive airway pressure throughout both inspiration and expiration.
CPAP
32
PEP preset pressures
10-20 cmH2O
33
EPAP preset pressures
10-20 cmH2O
34
CPAP preset pressures
5-20 cmH2O
35
CPAP indications
Unresponsive atelectasis with hypoxemia, cardiogenic pulmonary edema
36
IPPB is ________ cycled.
Pressure
37
The sensitivity setting is __________ on a Bird IPPB.
Pressure
38
With IPPB, PIP should initially be set at ____________, with _____________ flow.
10-15 cmH2O, moderate
39
For an alert patient at high risk for atelectasis or has atelectasis and VC > 15 ml/kg or IC > 33% predicted use...
IS along with deep breathing, frequent repositioning, and early ambulation
40
For patients with minimal risk of post op atelectasis use...
Deep breathing exercises, frequent repositioning, and early ambulation
41
For patients who are high risk for post op atelectasis or has atelectasis AND secretion retention and a VC > 15 ml/kg or IC > 33% predicted use...
PEP or EPAP with bronchodilators, deep breathing exercises, frequent repositioning, early ambulation, and directed cough
42
High risk of post op atelectasis AND unable to use IS, PEP or EPAP with VC
IPPB
43
Acute hypercapnic respiratory failure critical values
PaCO2 > 55 mmhg and rising, pH 0.6
44
Acute hypoxic respiratory failure critical values
PaO2 450 on O2, PaO2/PAO2
45
Additional critical values for ventilatory support
MIP -20 to 0 cmH2O, VC 35,
46
How to manage sudden distress in a ventilator-supported patient
Remove patient from ventilator, initiate manual resuscitation, perform rapid physical assessment, check potency of airway; if death is imminent treat for airway obstruction or pneumothorax
47
Application and maintenance of pressure above atmospheric level at the airway throughout the expiratory phase of positive pressure mechanical ventilation.
PEEP
48
The goal of PEEP is to...
Improve oxygenation
49
Method of ventilatory support where the patient breathes spontaneously without mechanical assistance against threshold resistance with pressure maintained above atmospheric throughout the breathing cycle.
CPAP
50
CPAP is the appropriate therapy for patients in CHF along with _____________________ and ____________.
Positive inotropic agents, diuretics
51
Noninvasive mode of ventilatory support that allows separate regulation of inspiratory and expiratory pressures.
BiPAP
52
IPAP controls...
Removal of CO2
53
EPAP controls...
Oxygenation and increases FRC
54
If maxed out FIO2, increase the ________ but compensate for increased EPAP or PS will decrease, thus decreasing _____________.
Baseline, ventilation
55
Increasing the pressure support...
Decreases the CO2
56
Indications for BiPAP
CHF/COPD exacerbation, hypercapnic respiratory failure, central sleep apnea, increased WOB, OSA, hypoventilation due to neuromuscular disorder, palliative care
57
Exclusion criteria for BiPAP
Cardiac/respiratory arrest, need for immediate intubation, hemodynamics instability, uncooperative patient, and inability to protect the airway
58
Spontaneous mode on BiPAP
Patient triggers all breaths
59
Spontaneous/timed mode on BiPAP
Backup in case inspiration is not triggered
60
Timed mode on BiPAP
No possibility of patient triggered inspiration.
61
Initial settings on BiPAP
IPAP 10-15 cmH2O, EPAP 4-8 cmH2O
62
Additional settings on BiPAP
Rate, backup rate, %IPAP (basically I time), rise time
63
Alarms on BiPAP
High and low pressure, low minute ventilation, high and low rate
64
Total leak on BiPAP should be...
7-25 L/min
65
In TCPL ventilation, the breath ends after the set ______ has been reached and _________ regulates flow during breath.
I-time, pressure
66
Pressure support modes are ____ cycled.
Flow
67
What determines the VT in TCPL ventilation?
PIP, I-time
68
The most powerful influence on oxygenation is...
MAP
69
What contributes to the MAP?
I-time, PIP, PEEP, rate
70
____ is the greatest contributed to the MAP.
PEEP
71
Initial vent settings for neonate
PIP 15-20 cmH2O, PEEP 3-5 cmH2O, rate 20-40 bpm, flow 6-8 l/sec, I-time .3-.5 (lbw) or .5-.8 (larger infants)
72
Indications for neonatal CPAP
Spontaneously breathing babies with respiratory distress at birth (following surfactant)
73
When to intubate a neonate
PaO2 50-60 mmHg, provide/protect an airway, cardiorespiratory instability, me onion, surfactant therapy
74
Placement of ETT under 2 years old
Depth at lip = size of tube x 3
75
Placement of ETT over 2 years old
Depth at lip = (age/2) + 12
76
Determining ETT size neonates
1/10 GA rounded down to nearest size
77
Determining ETT size 1 year old or greater
(Age/4) + 4
78
Pediatric hypoxemia
PaO2
79
Neonatal hypoxemia
PaO2
80
Cstat formula
Returned Vt/(Pplat - PEEP)
81
Raw formula
(PIP - Pplat)/flow
82
Tc formula
Cstat x Raw
83
TCT
60/rate
84
In volume control ventilation, the _______ and _____ remain constant while the ______ varies with lung characteristics.
Volume delivery, inspiratory flow, PIP
85
In pressure control ventilation the ______ is constant and the _____________ and ___________ varies.
PIP, volume delivery, inspiratory flow
86
Modes of ventilation
Assist/control (CMV), SIMV, Spontaneous
87
Mode of ventilation which can provide full support and is either volume or pressure controlled; patient controls the rate.
Assist/Control (CMV)
88
Mode of ventilation in which synchronized breaths improve patient comfort; can be volume or pressure controlled.
SIMV
89
Mode of ventilation which requires active, spontaneous respiratory drive; includes pressure support or CPAP.
Spontaneous
90
Application of set positive pressure to a spontaneous inspiratory effort; flow is decelerating.
Pressure support
91
Volume control mandatory breath
Volume limited, volume cycled
92
Pressure control mandatory breath
Pressure limited, time cycled
93
Spontaneous breath
Flow triggered, flow limited
94
Oxygen Content Formula
CaO2 = (Hb x SaO2 x 1.34) + (PaO2 x 0.003)
95
Volume control assisted breath
Volume limited, volume cycled
96
Pressure control assisted breath
Pressure limited, time cycled
97
Volume control ventilation is used in ______ and ______ modes.
A/C, SIMV
98
In volume control ventilation, the Vt should be set at ________ for normal lungs.
10 ml/kg
99
In volume control ventilation, the Vt should be set at_______ for patients with COPD.
8 ml/kg
100
In volume control ventilation, the Vt should be set at _________ for patients with ARDS.
4-6 ml/kg
101
Pressure control ventilation is used in _____ and _____ modes.
A/C, SIMV
102
Normal airway resistance is _____________.
1 cmH2O/L/sec
103
Normal compliance is ___________.
0.1 L/cmH2O
104
Normal Tc is _______.
0.1 sec
105
Ti
Incomplete delivery of Vt
106
Te
Incomplete emptying of the lungs

Respiratory Care (1 decks)

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