2 Ventilatory Assistance

Question 1

Increased WOB leads to what

Answer 1

Increased energy use
Muscle fatigue
Resp failure

Question 2

Compliance
-definition
-4 things causing non compliance

Answer 2

Measurement of distensibility of lungs (stretchability)

noncompliance:
-ARDS
-pulmonary fibrosis
-pulmonary edema
-obesity

Question 3

Resistance
-what is happening in these ARDS patients

Answer 3

Opposition to the flow of gas
Increased resistance

Question 4

Tidal volume

Residual volume

Vital capacity

Answer 4

Tidal volume:
-volume of normal breath
-avg 500ml

Residual volume:
-amt of air left in lung after expiration
-avg 1300ml

Vital capacity:
-max amt of gas forcefully expired after max inspiration
-avg 4700ml

Question 5

PaO2 vs pulse oximeter/Sats

Answer 5

PaO2:
Partial pressure of O2 dissolved in arterial blood
-80-100

puls ox/Sats:
% of hgb saturated w/ O2

Question 6

Hypoxemia:
What numbers is low
What number is life threatening?
S/s
Tx

Answer 6

PaO2 <60 is low
PaO2 <40 life threatening

S/s (view early and late signs from other slide)

Tx (O2 supplement)

Question 7

Types of hypoxia (4)

Answer 7

Circulatory:
-inadequate perfusion (PE)

Anemia
-inadequate Hgb

Histotoxic
-cant use oxygen
(Cyanide/carbon monoxide poisoning)

Demand is greater than supply
(HF)

Question 8

Normal ABG numbers
PH
CO2
HCO3
PaO2

Answer 8

PH: 7.35-7.45
CO2: 35-45
HCO3: 22-26
PaO2: 80-100

Question 9

ABG :

Uncompensate
Partial
Compensated

Answer 9

Uncompensated:
-PH + 1 parameter is abnormal (CO2 or HCO3)

Partial:
-all 3 abnormal (PH, CO2, HCO3)

Compensated:
-pH normal
-but CO2 and HCO3 both abnormal
(one is compensating)

Question 10

Critical values:
PaO2
PaCO2
pH

Answer 10

PaO2: <60

PaCO2: >50

pH <7.25 or >7.60

Question 11

Hypoventilation vs hyperventilation affect on CO2

Answer 11

Hypo: increase CO2

Hyper: decrease CO2

Question 12

Respiratory acidosis causes (8)

Answer 12

COPD
Resp muscle weakness (guillain-barre syndrome)
Head injury
Drug overdose
PE
Pneumothorax
Pneumonia, atelectasis

Question 13

Respiratory acidosis

S/s

Answer 13

Hypoventilation
Restlessness/ confusion/lethargy/drowsiness
Decreased LOC
Sz
Coma
HA
Dysrhythmias from hyperkalemia

Question 14

Respiratory alkalosis causes

Answer 14

Hyperventilation (anxiety/fear/pain/fever)

Question 15

Respiratory alkalosis s/s

Answer 15

Lightheadedness
Lethargy/condusion
Numbness/tingling
Tachycardia
Cardiac dysrhythmias from hypokalemia

Question 16

Metabolic acidosis causes

Increased acids
Vs
loss of bicarbonate

Answer 16

Increased acids:
-renal failure
-diabetic ketoacidosis
-hypoxia =lactic acid

Loss of bicarbonate:
-diarrhea

Question 17

Metabolic acidosis s/s

Unique (3)
Generic (3)

Answer 17

Unique
Warm flushed skin
Dysrhthmias r/t hyperkalemia
Kussmaul resp: deep rapid RR
-(lungs compensating)

Generic:
HA
Confusion/ lethargy
N/V

Question 18

Metabolic alkalosis causes

Too much base
Vs
Loss of acids

Answer 18

Too much base:
-excessive use of bicarb
-excess use of antacids

Loss of acids:
-vomiting
-hypokalemia
-diuretics

Question 19

Metabolic alkalosis s/s

Unique (4)
Generic (4)

Answer 19

Unique:
-muscle twitching
-cramps
-weakness
-hypoventilation (lungs trying to compensate)

Generic:
-lethargy/dizziness
-confusion
-n/v