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Flashcards in ventilated patient Deck (52)
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1

what 2 ABG parameters indicate respiratory status

pH and PaCO2

2

what are indicators a pt can not ventilate or oxygenate

hypercapnia (high CO2)
respiratory failure
low PO2
RR >35
nasal flaring
tri podding
use of accessory and intercostal muscles
paradoxical breathing

3

what are late signs of respiratory failure

confusion, stupor, cyanosis, bradypnea, bradycardia, hypotension, dysrhythmias

4

what is indicative of respiratory failure

CO2 greater than 50 and low pH

5

if a pt is retaining CO2 we want to ______ the ______ volume and ________ rate

increase; tidal; respiratory

6

If their O2 sats are within normal limits but showing respiratory acidosis it an oxygenation or ventilation problem

ventilation

7

where should the ET tube be placed

3-4cm right above the carina
*pt will be coughing if ETT is on the carina and if you go in with suction and hit it it will cause damage

8

what is the gold standard when ETT is placed

capnometer
*when intubated you will put this at the end of the tube and when pt exhales and it turns yellow its good (auscultate too)

9

after using the capnometer and its successful what is next

secure the ET tube

10

what should the ETT balloon measure and why does it have to be that certain measurement

25mmHg
if overinflated it will cause tissue necrosis
if under inflated pt could aspirate whatever was sitting on top of balloon

11

what is minimal leak technique?

when you hear noises coming from where the ETT balloon is you get a 3cc syringe and inflate slowly until you hear nothing

12

when suctioning how long can you take

no longer than 10

13

when a pt has an ETT in what should the HOB be at all times

up

14

static compliance is

how stiff your lungs are

15

how can lungs be stiff?

every time pt has bronchitis or pneumonia for example it scars the lung tissue therefore decreasing static compliance (from coughing and damaging tissue)

16

f/RR (normal is 12-22)

frequency/ respiratory rate

17

fraction of inspired oxygen necessary to meet oxygenation goals (RA 21%)

FIO2

18

what is the I:E ratio

inspiratory time to expiratory time. normal 1:2 indicating exhalation time is twice as long as inhalation time

19

positive end-expiratory pressure. generally added to mitigate end- expiratory alveolar collapse (keep alveoli open) can decrease venous return to the heart

PEEP

20

why do we increase peep

when pt has really bad atelectasis we want to open up the alveoli and if we increase peep and pt inhaled it expands and when they exhale they deflate a little but don't collapse

21

how can PEEP decrease venous return

if its increased pressure in thoracic it presses against vessels therefore decreasing venous return

22

peak inspiratory pressure shows the greatest airway pressure at the end of the inspiratory cycle on the ventilator

PIP
*normal is 15-20 cmH2O

23

minute ventilation/volume is the amount of air delivered to the lungs in one minute

Ve
*Vt x f = Ve
normal is 6-8L/min

24

tidal volume is the amount of air delivered with each breath.

Vt norm is 8-10 mL/kg

25

what ventilator is a FULL support mod and controls all the work of breathing
*requires least amount of pt effort

Assist control AC/ACV
* pt is guaranteed the preset Vt, RR, FIO2, and PEEP
*pt can only spontaneously trigger the ventilator to initiate a breath. Vt will remain the same can't draw in anymore only what its set at

26

is a set airway pressure to assist the patient with spontaneous breaths
*it decreases work of breathing by giving the patient a little boost on the breaths they initiate on their own

pressure support PS/PSV
*decreases respiratory rate and increases spontaneous Vt

pressure support is decreased as the patient improves

27

what other ventilator can PS/PSV be activated with

CPAP

28

same as PS/PSV this one just means that a preset pressure is present in the circuit and lungs throughout both the inspiratory and expiratory phases of the breath
*patient does ALL the work

CPAP
*serves to keep alveoli from collapsing resulting in better oxygenation and less work of breathing
*blows continuous air
*apnea parameters are always set

29

for a pt on CPAP who starts breathing fast or shallow what can be added

PS/PSV to give them a boost to slow RR and increase their own Vt

30

_____ can be used non invasively on a non intubated pt using a face mask

CPAP