Vent Assistance

Question 1

Respiration stimulated by

Answer 1

elevated CO2

Question 2

Compliance

Answer 2

ability to distend or stretch

Question 3

Compliance types

Answer 3

static - not breathing
dynamic - breathing

Question 4

resistance is determined by

Answer 4

airway length
airway diameter
flow rate of gases

Question 5

VT (tidal volume)

Answer 5

500 mL OR 5-7 mL/kg

Question 6

functional residual capacity (FRC)

Answer 6

volume of gas left in lungs after expiration
average 2300 mL

Question 7

Vital Capacity

Answer 7

big breath in
average: 4600 mL

Question 8

cheyne stokes

Answer 8

cyclical with apneic

Question 9

Biots

Answer 9

cluster breathing

Question 10

Kussmauls

Answer 10

deep regular and rapid (DKA)

Question 11

Apneustic

Answer 11

gasping inspirations with short expirations

Question 12

Hypoxemia

Answer 12

decreased oxygenation of arterial blood

Question 13

Hypoxia

Answer 13

decreased oxygenation at tissue level

Question 14

Compensation

Answer 14

partial - mechanisms occurring ; pH abnormal
complete - mechanisms occurring ; pH normal range

Question 15

Oxygen Delivery Devices

Answer 15

NC - .24-.44 Fi02
High flow cannula -
.6 - .9
simple face mask - .3-.6
Partial Rebreather - .35-.6
Nonrebreather - .6-.8

Question 16

ET tube size

Answer 16

7.5-8 female
8-9 male

Question 17

Verify ET tube placement

Answer 17

auscultate epigastric area
auscultate breath sounds
Esophageal detector
Chest X ray

Question 18

NT tube provide

Answer 18

more pt comfort

Question 19

Hypoxemia ABGs

Answer 19

PaCo2 < 60
on FiO2 > .5
LOW OXYGEN IN BLOOD

Question 20

Hypercapnea

Answer 20

PaCo2 > 50 mm Hg with pH < 7.25

Question 21

PEEP

Answer 21

5-20 cm H20

improves oxygenation
can reduces cardiac output
Increases FRC
Increases surface area of capillaries and alveoli

Question 22

Exhaled Tidal Volume during ventilation

Answer 22

SHOULD NOT BE 50+ SET VT

Question 23

Modes of mechanical vent

Answer 23

volume
pressure

Question 24

Volume Assist / Control Vent

Answer 24

Preset number of breaths at preset VT
CONTROLLED
risk for hyperventilation and respiratory alkalosis
pt can trigger additional breaths

Question 25

Volume intermittent

Answer 25

present number of breaths at preset VT similar to volume assist but patient may trigger additional breaths and the volume of the spontaneous breath is whatever the pt generates

Question 26

High Frequency Oscillatory Vent

Answer 26

Low volume high rate

Question 27

NPPV

Answer 27

noninvasive positive pressure vent face mask, nasal pillow, tight seal reduces complications with mechanical vent for COPD, ♡ failure, palliative

Question 28

Ventilator Bundle

Answer 28

Mouth Care (2-3 Hours) Hob (30 degrees) Weaning Stress ulcers PPI DVT prevention

Question 29

Lungs are fine but difficult weaning.. check

Answer 29

HEMOGLOBIN

Question 30

Chest tubes

Answer 30

Bubbles in suction No bubbles in water chamber can be tidaling

Question 31

Mechanical Vent Complications / Treatment

Answer 31

ETT displaced (R bronchus or esophagus): assess lung sounds, CXR, secure tape and assess marking Laryngeal/Tracheal Injury: ↓ movement with neuromuscular blockade, check cuff pressure (30 cm H2O max) Oral/nasal Injury: assess regularly Barotrauma (pneumothorax/tension pneumothorax): Assess for S&S: high PAP (positive airway pressure), high mean pressure, ↓ lung sounds, tracheal shift to unaffected side, subcutaneous emphysema/crepitus, and hypoxemia (↓ PaO2) Volutrauma (overdistension of alveoli): Keep PIP (Peak Inspiratory Pressure) below 40 cm H2O Oxygen Toxicity (due to length of time on O2 and FiO2, not PaO2; Fi0@ of 1.0 OK for 24 hours): Assess S&S for tracheobronchitis, atelectasis Infection (VAP): Ventilator Bundle, remove condensation from tubing, hand hygiene, subglottic suctioning, non-invasive ventilation when possible