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From Flashcardlet > Ventilation Part 2 > Flashcards

Ventilation Part 2 Flashcards

1
Q

Does ventilation facilitate gas exchange?

A

NO – it does not help cellular response to oxygen - it ONLY delivers oxygen

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2
Q

What pressures are changed with mechanical ventilation?

A

Intra and extra-thoracic pressures

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3
Q

How can oxygen be delivered with mechanical ventilation?

A

Under time or volume or pressure

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4
Q

How is oxygen usually delivered with mechanical ventilation?

A

Pressure driven so that we can control the pressure and not hurt their lungs

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5
Q

Why do we often try and use a combination of pressure and volume ventilation?

A

To deliver a set volume of oxygen without exceeding a set pressure

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6
Q

What is the mechanism that ends expiration and signals beginning of inspiration in a ventilator?

A

The Mode in which the ventilator is set at

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7
Q

What does SIMV stand for?

A

Synchronized intermittent mandatory ventilation

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8
Q

What does SIMV do?

A

Synchronizes a set amount of breaths with patient’s inhaled breaths

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9
Q

What mode that has a set amount of oxygen and pressure, along with a SET RATE?

A

SIMV

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10
Q

If the SIMV is set for 10 bpm, and the patient breaths 12 bpm, what will the ventilator do?

A

It will be synchronized with 10 of the pt’s breaths and then the pt will breathe twice by themselves

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11
Q

If the SIMV is set for 10 bpm and the patient doesn’t breathe at all, what will the ventilator do?

A

Give 10 bpm

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12
Q

What mode is very similar to SIMV?

A

Assist Control

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13
Q

How is Assist Control similar to SIMV?

A

it has a set rate of mandatory breaths that can be synchronized with patient’s breaths

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14
Q

How is Assist Control different from SIMV?

A

it helps ALL breaths - if the patient breathes more breaths than the set rate, it will continue to assist the patient

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15
Q

Why is Assist Control helpful?

A

because it is hard for them to breathe on their own through the vent so if patient tires out it will help

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16
Q

What mode does NOT initiate a breath but does deliver oxygen under pressure?

A

CPAP

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17
Q

What does CPAP helpful with?

A

it overcomes the dead space created by the tubes

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18
Q

What is CPAP often used for?

A

a trial period before extubation

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19
Q

Why is CPAP often used as a trial period before extubation?

A

to make sure the pt can breath on their own, by only overcoming the resistance created by the tube, the pt has to initiate all breaths

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20
Q

What is the setting for the percent of inspired oxygen delivered by the ventilator?

A

FiO2

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21
Q

What is FiO2 set at right before we suction a patient?

A

100%

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22
Q

What will increased if FiO2 is at too high of a dose?

A

PaO2

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23
Q

How is the Tidal Volume set on a ventilator?

A

mL of air based on body weight

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24
Q

What is the average equation to figure out what Tidal Volume to give?

A

10-12 ml/kg

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25
Q

What are most patient’s Tidal Volume set at, especially long term be ventilation?

A

400-600

26
Q

What is the Tidal Volume set at allot of fresh surgical patients (short term ventilation)?

A

800-900

27
Q

Why is the Tidal Volume for fresh surgical patients set so high?

A

because their lungs are healthy and this way we know they are getting the max amount, while knowing they are going to be extubated soon

28
Q

Do we use SIGH anymore?

A

not anymore really

29
Q

If SIGH is used, what is it usually set at?

A

1 1/2 times the tidal volume

30
Q

What does SIGH give you?

A

an occasional really deep breath

31
Q

What is the setting on a ventilator for how many cycles you want the ventilator to give the patent?

A

rate

32
Q

What does PEEP stand for?

A

Positive End Expiratory Pressure

33
Q

What does PEEP do?

A

keeps alveoli open when patient exhales (prevent atelectasis)

34
Q

What is PEEP expressed as?

A

+5, +6,+7… etc.

35
Q

What will PEEP increase?

A

functional residual capacity (FRC)

36
Q

What will PEEP decrease?

A

venous return, thus decreasing CO

37
Q

What is Pressure Support kind of like?

A

a low-dose CPAP

38
Q

What is Pressure Support?

A

it’s a positive pressure to help with inhalation

39
Q

How does Pressure Support help with inhalation?

A

it overcomes the dead space and the work of breathing on ventilated breaths

40
Q

What is Pressure Support often used with?

A

weaning off the vent

41
Q

What does Pressure Support work on?

A

only spontaneous - patient initiated breaths

42
Q

What do you need to chart when your patient is ventilated (other than breath sounds, suctioning, and suctioning tolerance)?

A

rate
exhaled volume
peak inspiratory pressure

43
Q

When charting the rate, what do you chart?

A

ventilator rate AND patient’s respirations (to know if patient is assisting)

44
Q

What should the Exhaled Volume be?

A

within 10% of the ventilated breaths (Tidal Volume)

45
Q

If patient’s tidal volume is 500, what should the exhaled volume be?

A

between 450 and 500 - at least 90% of the T. V.

46
Q

If we get the exhaled volume within 10% of the T. V., what does this indicate?

A
  1. the cuff seal is good

2. the lungs are expanding and recoiling

47
Q

When comparing the T. V. with Exhaled Volume, should we look at the patient-initiated breaths?

A

no, because unless they are breathing in as deeply as the ventilator would have, it won’t be a correct percent

48
Q

What is the Peak Inspiratory Pressure (PIP)?

A

the peak airway pressure that it took to deliver the T. V.

49
Q

Since oxygen is delivered under pressure, what is Peak Inspiratory Pressure (PIP) looking at?

A

how much pressure it took to deliver the oxygen and tidal volume to the patient

50
Q

If there is a low PIP, what could it indicate?

A

something has disconnected so there is ecreased pressure in the hose

51
Q

What can an increased PIP indicate?

A
  1. kink in tubing
  2. mucous plug (needs suctioning)
  3. pt is coughing
  4. pneumothorax
  5. getting worse - lungs becoming more stiff
52
Q

If a ventilator alarm is going off and it is not your patient and you cannot quickly figure out what is wrong with the ventilator, what do you do?

A

bag the patient

53
Q

Should you turn off the ventilator alarm?

A

NO - it means the patient is not getting enough oxygen

54
Q

What does incoming oxygen need?

A

to be heated and humidified

55
Q

What does warm and humidified oxygen do?

A

thins secretions
maintains airway
helps prevent dryness

56
Q

What are the weaning parameters? (MOVE)

A

Mentate
Oxygenate
Ventilate
Expectorate

57
Q

What ventilator setting and ABG labs indicate that you should NOT try to wean the patient off the vent?

A
  1. FiO2 greater than 40%
  2. PEEP greater than 5
  3. PaO2 less than 60
  4. SaO2 less than 90
58
Q

What does the FiO2 and the PaO2 need to be to start weaning?

A

FiO2 less than 40% WITH a PaO2 greater than 60

59
Q

What vital signs indicated that you should NOT try to wean patient off the vent?

A
  1. Resp >30 or <6
  2. Tachycardia
  3. BP that is increased or decreased by 20%
  4. decreased saturation
  5. dysrhythmias
60
Q

What should you assess for after extubation?

A
  1. vocal cord damage
  2. hoarseness
  3. Laringeo edema

From Flashcardlet (107 decks)

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