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LIFE Support Test 3 > TEST 3 > Flashcards

TEST 3 Flashcards

(108 cards)

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1
Q

assessment for readiness to wean includes what?

A

reversal of condition that caused need for ventilation, control fever, assess nutritional status (keep RQ 0.8), assess cardio status, assess renal function, acceptable CNS function (cough/gag)

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2
Q

What is RQ equation

A

CO2 produced/O2 consumed

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3
Q

value of heart rate that is not good for weaning

A

less than 60 and greater than 120

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4
Q

value of cardiac index that is not good for weaning

A

<2.1

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5
Q

RSBI f/ Vt weaning measure

A

<80 is a very successful

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6
Q

PaO2/FiO2 weaning measure

A

> 150-200 good wean

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7
Q

What is the most predictive measurement used to wean?

A

RSBI

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8
Q

What is Bispectral Index Monitoring

A

non invasive means of monitoring the effects of sedation on the brain

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9
Q

What numbers do you want on the RASS scale to wean

A

1 to -2

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10
Q

What is the most used method of weaning?

A

t tube weaning is best but mostly use PSV

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11
Q

What is porportional assist ventilation

A

prevents asynchrony by randomly calculating lung mechanics, the mode will adjust the ventilatory flows and sensitivity to changes in resistance and compliance

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12
Q

What is VAPS?

A

only operates on mandatory breaths, a preset pressure is set along with a minimum Vt

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13
Q

What is automode?

A

the ventilator switch b/w mandatory and spontaneous breathing modes

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14
Q

What should you do when doing a terminal wean

A

want to suction really well, and shut off alarms

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15
Q

Servo 300 is driven by what?

A

minute ventilation

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16
Q

How is the servo 300 powered?

A

pneumatically and electric

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17
Q

what triggers does the servo 300 have?

A

pressure, flow, manual, time

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18
Q

equation for insp. flow

A

Vi= VE/TI%

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19
Q

how does the servo 300 cycle?

A

vol, time, pressure, flow

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20
Q

PRVC on the servo 300

A

vent gives breaths at 10 cmH2O, calc system compliance, then delievers 3 more test breaths and calcs compliance again readjusts PIP to achieve targeted Vt

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21
Q

what are some adv of PRVC

A

maintain alveolar recruitment, decelerating flow pattern, maintains VT despite changes in compliance and resistance

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22
Q

Who is PRVC good for

A

patients with lung injury, asthma, COPD, peds, post op

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23
Q

Minute ventilation is based on what 2 things

A

rate and tidal volume

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24
Q

what is volume support on servo 300

A

vent adjusts PS levels to achieve targeted Ve and then calcs compliance and adjusts PS to maintain set volume

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25
What is the apnea time in automode of servo 300 in adult
12 seconds
26
how do you know what parameters need to be set in what modes in servo 300
place finger over 2 dots next to standby button, place finger over the 2 dots next to mode set, lights will illuminate the parameters that need to be set
27
What are the special functions on the servo 300 (Tt, Vi in LPM and I:E)
to find touch standby pad, and immediately touch pad next to patient mode and touch standby to return to normal screen
28
What configurations are on the Servo I
infant only, adult only, and universal
29
What are optional modes on Servo I
automode and Bi vent (APRV)
30
Phigh for APRV setting on Servo I
use current Pplat and use previous MAP
31
Plow for APRV setting on Servo I
0-5 cmH2O
32
Time high for APRV setting on Servo I
5 sec
33
Time low for APRV setting on Servo I
0.5-1.0 sec
34
typical high:low APRV setting on Servo I
inverse I:E 6:1-10:1
35
How is heliox used in the Servo I
available for neonates and adults in all modes, mixture includes 80/20 usually, requires upgrade, high pressure hose and DISS adapter
36
NAVA can be used on what vent?
SERVO I
37
What is NAVA?
neurally adjusted vent assist, a long cath is advanced from the mouth/nose to the stomach around to the level of the diaphragm, the electrical activity of the diaphragm is captured, primary used in neonates
38
how many rechargeable batteries does the SERVO I hold?
6 each lasts for 30 minutes
39
How do you figure out volume that is lost in the tubing on SERVO I?
jj
40
What neb is usually used for SERVO I
ultra sonic neb
41
What is trigger time out on SERVO I
variable setting in automode, pts who trigger serveral consecutive breaths are allowed longer apnea periods than those who dont
42
what is the open lung tool on the SERVO I
feature available during PCV, increased level of PC until opening pressure is found and decreases PEED until closing pressure is found
43
What special tubing is used for SERVO I during the pre check of the ventilator
MAQUET blue test tube
44
indications for at home MV
vent muscle disorders such as ALS, alveolar hypoventilation sydrome (Kyphoscoliosis), COPD, obstructive lung disease (end stage COPD), restrictive lung disease (sarcoid, interstitial lung disease), cardiac disorders (peds)
45
contraindications for at home MV
FIO2>40%, PEEP>10, lack of mature trach, patients choice not to receive care at home, lack of a discharge plan, unsafe home enviro, inadequate home resources ($, personnel)
46
medical hazards for at home MV
hypocapnia/hyper, hypoxemia, barotrauma, seizures, respiratory infection, hemodynamic instability
47
contraindications for in hospital MV transport
inability to provide adequate oxygenation, inability to maintain stable hemodynamics, cant monitor cardiopulmonary status, cant maintain airway control, all transport team members must be present
48
hazards for in hospital MV transport
hyperventilation, loss of PEEP, hypotenstion, tachycardia, equipment failure, disconnection of venous access, accidental extubation, hypoxemia, VAP
49
LTV 1200 internal battery lasts how long
1 hour
50
LTV can run off of what in a car
cig lighter outlet
51
in NPPV mode on LTV 1200 what does it deactivate
low pressure and low vol. alarms
52
in CPAP/PS mode on LTV 1200 what do you set the rate to?
dashes or 0, cycles at 25% of peak flow
53
how do you access extended features on LTV 1200
push select button and hold 3 secs, turn knob, and select item
54
What items are included in extended features on the LTV 1200
rise time, flow termination, apnea, NPPV mode
55
How does a flow trigger work on the LTV 1200
requires a special patient circuit, a puff of gas is sent through every minute to keep line clear
56
How many circuits does the trilogy vent use?
3
57
What are the 3 breathing circuits on the trilogy
active exhalation with PAP, passive exhalation, and active exhalation valve/flow sensor circuit(exhalation porting block)
58
what special device does the passive exhalation port use?
whisper swivel 2
59
how do you select the right circuit type on the trilogy
press down and alarm silence, select alarms and settings, and choose circuit type (active PAP, active flow, or passive)
60
the trilogy can be used on what patients
peds thru adults (>5kg)
61
how long does internal battery last on trilogy
3-5 hours
62
what type of battery is the trilogy compatible with
lead acid batteries
63
battery capacity of 5 LEDS are all lit means what
80-100% capacity
64
4 LEDS are lit on trilogy means what
60-79% capacity
65
1 LED flashes means what
1-9 % capacity
66
0 LEDS are lit means what
no capacity
67
what is auto TRAK sensitivy on the trilogy
only used with passive exhalation port, device that contin. tracks patients breathing patterns and automatically adjusts sensitivity
68
what is a dual prescription option on the trilogy 202
day and nighttime settings (full and partial support)
69
What is AVAPS on trilogy 202
average vol. assured pressure support, helps patient maintain TV equal or greater to target TV by controlling PS
70
When is Cflex not available on trilogy 202
if CPAP is set to 4
71
What does the trilogy 202 not calculate
Cstat or Auto PEEP
72
what is the number 1 goal of MV in peds and neonates
dec the WOB (1), re-establish an FRC, prevent auto peep
73
equation for diameter of cuffed tubed in PEDS
3 + age in years/4
74
equation for diameter of uncuffed tubed in PEDS
4 + age in years/4
75
<1000 g what is tube size
2.5
76
1000-2000 g is what size tube
3.0
77
2000-3000g is what size tube
3.5
78
>3000 g is what size tube
3.5-4
79
depth of insertion equation for ages 1-12
ETT size X 3
80
where do you want flow sensor in PEDS pts
beginning of ETT, close to patient
81
tidal volumes for premie
4-6ml/kg
82
tidal volume for infant
5-8ml/kg
83
tidal volume for toddler
5-8ml/kg
84
tidal volume for preschool age
6-9ml/kg
85
tidal volume for child/adolescent
7-10
86
rates for premie
40-60
87
rates for infant
25-40 (1 month-1yr)
88
rates for toddler
20-35 (1-3)
89
rates for preschool
20-30 (3,4,5)
90
rates for child
18-25 (6-12yo)
91
rates for adolescent
12-20
92
PEEP for NICU and PEDS
2-5 cmH2O
93
when size 3-3.5 ETT tube what should PS be set at
10 cmH2O
94
when size 4-4.5 ETT tube what should PS be set at
8 cmH2O
95
when size 5 and larger ETT tube what should PS be set at
6 cmH2O
96
what is the number 1 effect wanted in the use of CPAP in NICU
inc. FRC
97
CPAP was introduced by who for the treatment of what?
Gregory Etal for treatment of hyaline membrane disease
98
what is SiPAP
assists in infants who are spontaneously breathing but need some assistance, FRC is cycled b/w two levels of CPAP
99
What are the 4 parameters adjusted during the use of SIPAP
baseline CPAP level, SiPAP pressure, duration of sigh, and frequency of sighn
100
What are the benefits of SiPAP
recruit unstable alveoli, off load some of resp. work, stimulate surfactant release, stimulate resp. center drive
101
SiPAP pressure should be set to what?
1-3 above baseline CPAP level
102
initial SiPAP duration should be set to what
1 second and frequency set to 6 cycles per minute
103
what is set in the TCPL mode
have to set flow, PIP (10-25 NICU), PEEP (2-15NICU) insp time (0.2-0.4 sec for premies and 0.3-0.5 for term infants), Rates (full:40-60, partial:10-30)
104
What is most powerful influence on oxygenation
MAP
105
equation for MAP
PIP X insp time + PEEP X exp time/total breath duration
106
VIP ventilator bias flow infant sensor is set to what
3LPM
107
VIP vent bias flow peds sensor is set to what
5LMP but can be turned off
108
VIP vent demand flow is what?
available in any mode or with any sensor (-1cmH2O)

LIFE Support Test 3 (1 decks)

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