Ventilation

Question 1

What is VT?

Answer 1

Tidal Volume - volume of gas moved in and out of the lungs in a single inspiration and expiration

Question 2

What is RV?

Answer 2

Residual Volume - the volume of gas remaining in the lungs after maximum expiration

Question 3

What is IRV?

Answer 3

Inspiratory Reserve Volume- the maximum volume of additional air that can be inspired after normal inspiration

Question 4

What is ERV?

Answer 4

Expiratory Reserve Volume - The maximum amount of gas that can be forcibly exhaled after a normal expiration

Question 5

What is FRC?

Answer 5

Functional Residual Capacity - the volume of air present in the lungs at the end of passive expiration

Question 6

What is IC?

Answer 6

Inspiratory capacity - the total volume of gas that can be inspired after a normal exhalation

Question 7

What is Total Lung Capacity ?

Answer 7

The maximum volume of gas contained in the lungs after maximum inspiration

Question 8

What is VC?

Answer 8

Vital Capacity - the greatest volume of gas that can be forcibly inhaled after maximal exhalation

Question 9

What is FiO2?

Answer 9

Fraction of Inspired Oxygen - sets the oxygen percentage and controls the mixture of gases

Question 10

What is the Fset?

Answer 10

Relates to the number of breaths that the ventilator is set to deliver in one minute

Question 11

What is VT?

Answer 11

The amount of gas , in millilitres that is inhaled and exhaled in each breath

Question 12

What is MV?

Answer 12

Minute Volume - the total volume of gas delivered to the pt in one minute

Question 13

What is PEEP?

Answer 13

Positive End Expiratory Pressure - the Positive pressure in the lungs (above atmospheric pressure) that exists at the end of expiration and prevents the closure of alveoli

Question 14

What is P.insp?

Answer 14

Peak Inspiratory Pressure - the highest level of pressure generated in the lungs during inspiration when the pt is ventilated

Question 15

What is P.peak?

Answer 15

Peak Airway Pressure - the highest pressure during the previous breath

Question 16

What is ETS?

Answer 16

Expiratory Trigger Sensitivity- a setting that defines the percentage (%) of peak inspiratory flow that will cycle the ventilator into exhalation

Question 17

What is C.stat?

Answer 17

Static Compliance- it represents pulmonary compliance during periods without gas flow, such as during an inspiratory pause.

Question 18

What is R.Insp?

Answer 18

Resistance- primarily derived from the resistance in the airways and ETT

Question 19

What is RCexp?

Answer 19

Expiratory time constant- a dynamic measurement of respiratory function in both mandatory ventilated or spontaneously breathing patients. The rate at which the lung empties

Question 20

How do you work out Tidal Volume (VT)?

Answer 20

5-8mL x pt weight

Question 21

How do you work out (FRC) Functional Residual Capacity?

Answer 21

(ERV + RV) - Expiratory reserve volume + Reserve Volume

Question 22

How do you work out Total lung capacity?

Answer 22

(IC + FRC) Inspiratory capacity + Functional Residual Capacity

Question 23

How do you work out vital capacity (VC)?

Answer 23

(IRV +VT+ERV) Inspiratory reserve volume + Tidal volume + Expiratory reserve volume

Question 24

what are the indications associated with mechanical ventilation?

Answer 24

• airway management
• management of respiratory distress
• to enable sedation or paralysis
• post op management
• increase lung volumes and reduce WOB
• prevention or reversal of alveolar trauma

Question 25

what are the indications for the use of PEEp?

Answer 25

used when a patient requires assistance with ventilation in order to improve the ventilation and perfusion of the lungs and increase arterial oxygen tension

Question 26

what causes high peak airway pressure and how would you troubleshoot this?

Answer 26

Ppeak is influenced by airway resistance and compliance - check the ventilator and settings - look listen and feel patient - check endotracheal tube - suction for patentcy - CRX for positioning - check for kinks or obstructions -

Question 27

what is PS (pressure Support) and how does it work?

Answer 27

the patient has control over the respiratory frequency and the depth and length and flow of each breath. -PS ventilation can also compensate for the increased work imposed by the resistance of the ETT and the ventilator.

Question 28

what happens to the tidal volume when pressure support is manipulated?

Answer 28

Pressure support can have an effect on the tidal volume, as it can assist with the expansion of the lungs

Question 29

what are some of the advantages Spontaneous Mode?

Answer 29

- ensures adequate lung expansion - ensure adequate gas exchange - will support a patients spontaneous inspiratory effort (making inspiration easier) - pt controls inspiratory time, flow rate, frequency and expiratory time

Question 30

what is the pre-requisite for a patient receiving Spontaneous Mode?

Answer 30

- pt RASS is -2 to 0 - pt 8 breaths a minute or is greater than ventilators set RR - pt is able to initiate inspiration for every breath

Question 31

what does SIMV stand for and briefly define this mode of ventilation

Answer 31

Synchonised Intermittent Mandatory Ventilation | -ensures a set number of breaths are delivered at a set volume every minute

Question 32

what does DuoPAP mean and breifly define this mode of ventilation.

Answer 32

Duo Positive Airway Pressure -the ventilator will deliver the number of breaths set, to the pressure set (Phigh), for the set amount of time (T-high), it will then release the breath to PEEP and offer the patient support for any breath taken in that time

Question 33

what are the signs that a patient f not tolerating the ventilator?

Answer 33

- biting/coughing on the tube - swallowing - trying to remove the airway piece

Question 34

describe your actions if you were having problems ventilating your patient

Answer 34

- review pt - check your cuff - check O2 + Co2 + RR - check for kinks - check equipment - listen to chest

Question 35

what is the function of the cuff on an ETT or Tracheostomy tube?

Answer 35

Provide a seal between the ETT and the tracheal wall to enable accurate delivery of tidal volumes during mechanical ventilation

Question 36

what is a normal cuff pressure and how often should it be checked?

Answer 36

- cuff pressure should be maintained between 20-30cm H2O (as per the green section on the cuff manometer) - it should be checked at the commencement of each shift or when cuff leak is suspected

Question 37

Name a possible complication if the cuff pressure is too high

Answer 37

Too high- tissue ischemia, ulceration and necrosis of the tracheal wall

Question 38

Name a possible complication if the cuff pressure is too low

Answer 38

Too low- leak of air, oropharygeal secretions around the ETT cuff, predisposing the pt to inadequate ventilation, de-recruitment, aspirational pneumonia and ETT migration

Question 39

You are caring for a pt with an ETT. While performing a face shave, you accidentally sever the pilot line. What are your nursing actions?

Answer 39

- inform Drs immediately - assist pt breathing - get intubation trolley

Question 40

your intubated patient suddenly starts making gurgling noises and their minute volume has decreased from 7L/min to 2L/min. What would you suspect has happened?

Answer 40

-pt may have built up secretions and require suctioning.

Question 41

your agitated pt has self extubated, what are your immediate nursing actions?

Answer 41

- CODE BLUE - place either a NRM or commence on manual rebreather bag with O2 runninig - monitor airway and breathing - sedation?