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Module 7 > Care Of The Critically Ill Patient With Resp Dysfunctio n > Flashcards

Care Of The Critically Ill Patient With Resp Dysfunctio n Flashcards

1
Q

Tidal volume

A

Volume of air exchanged with each breath

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2
Q

FiO2

A

% of o2

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3
Q

MAP

A

Tells us how much perfusion is getting to the organs

SBP+2 (DBP/3

> 65 mmHg to perfume to organs ( we prefer 70 but 65 is the bare minimum

Around 65-100 is the sweet spot

How

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4
Q

ABGs

A

Maintain homeostasis
Resp (CO2) or metabolic HCO3

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5
Q

PaO2/FiO2 ratio

A

Determines lung injury
Normal 300-500
Acute lung injury 200-300
Significant lung injury <200
High mortality <100

We need to know this formula

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6
Q

How to figure out your map

A

SBP+2(DBP) /3

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7
Q

Normal PH

A

7.35-7.45

If less they are acidic - if over they are alklotic

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8
Q

Normal of Pao2 /FiO2 ratio

A

300-500

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9
Q

Acute lung injury of PaO2/FiO2 ratio

A

200-300

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10
Q

Significant lung injury pao2 /FiO2 ratio

A

<200

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11
Q

High mortality of pao2 /FiO2 ratio

A

<100

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12
Q

Hypoxemia

A

Ventilation and /or perfusion failure

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13
Q

Early hypoxemia

A

PaO2< 80 mmHg

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14
Q

Late hypoxemia number pao2

A

Pao2 <60 mmHg

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15
Q

Pa o2 norm

A

80-100

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16
Q

PaCo2 norm

A

35-45

If they are blowing out really fast they will be hypocapnic
If they are retaining CO then they will be hypercapnic

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17
Q

Alveolar blockage

A

Pulmonary edema
Pneumonia
ARDS
Cystic fibrosis

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18
Q

Perfusion blockage

A

PE( pulmonary embolism

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19
Q

airway obstruction

A

Asthma
COPD
Anaphylaxis
Atelectasis
Bronchospasm

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20
Q

Respiratory depression

A

Opioids overdose

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21
Q

Alveolar blockage, perfusion blockage , airway obstruction , respiratory depression all can contribute to what

A

Hypoxemia

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22
Q

Hypercapnia early

A

PaCO2 >45 mmHg

Or 50

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23
Q

Late hypercapnia

A

PaCO2 >50mmhg ( 55 0r 60 )

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24
Q

CNS conditions that cause hypercapnea

A

Spinal cord injury
Opioid OD

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25
Q

Neuromuscular conditions that cause hypercapnea

A

MS
ALS

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26
Q

Chest wall abnormalities that cause hypercapnea

A

Barrel chest
Kyphosis
Trauma - open thorax wound
( hitting the air bag on the wheel)

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27
Q

Air way or alveolar blockage that causes hypercapnea

A

COPD
Cystic fibrosis

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28
Q

What is important to keep in mind in a copd pt that has hypercapnea

A

That their PACO2 normally stays pretty high

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29
Q

S/s of resp failure early
“Must be hard reading dogs under worry”

A

Mental status changes
Breathing pattern changes ( Dyspnea , tachypnea)
HR and rhythm changes ( Tachy and hypertension)
Refusal to take oral fluids
Decrease urination (dogs under)
Wheezing or persistent coughing

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30
Q

Late signs of resp failure

A

Bradycardia , Bradypnea
Increase co2 , decrease r , decrease LOC
Lethargic , unresponsive
Cyanosis - when pao2 is 45 mmhg

31
Q

When a person who has a darker complexion we must consider a late sign of resp failure being cyanosis but what is different thing to consider?

A

The person may not be blue but will be purple ish

32
Q

What is used to open up the lungs in ARDS

A

Glucocorticoid steroids and administer diuretics

33
Q

When we give an ARDS pt feurosimide what do we assess

A

Potassium levels ( to see if its working or not)
Check for dysrhythmias , muscle weakness

34
Q

If given IV steroids to an ARDS pt what is important to note

A

Blood sugar may rise

35
Q

What do we give before sterioids for breathing treatments to open up the lungs

36
Q

What is important to teach pt to prevent ARDS

A

Wear a mask if spray painting inside

37
Q

SAo2 what is it reading—- ask shallas or someone

A

Something is attached to hemoglobin

38
Q

Why is it important to lay an ARDS pt on their good side

A

To move secretions

39
Q

If the drainage chamber starts bubbling what does this indicate?

A

Alerts us for an air leak by bubbling

40
Q

How to refill wet sunction

A

When it evaporates and can be refillable just turn off sunction when filling and turn back on when done ( only one who has continuous bubbling

41
Q

What is important to assess when having a pt with pneumothorax with a chest tube

A

Assesss site for drainage , and palpate the skin it may have crepetis and will indicate air is going in sub q tissue

42
Q

On water seal you’ll see the ball going up and down what is it called?

43
Q

Diagnostic labs for pulmonary embolism

A

D diner lab
Ct scan

44
Q

D dimer

A

Elevated levels from proteins that break down blood clots

45
Q

Warfarin/Coumadin

A

Limit green leafy veggies , fall precautions
Teach s/s of gi bleeds

46
Q

How long does warfarin take to start in body

A

4-5 days so they need to start it 4-5 days before sent home

47
Q

Heparin/warfarin diet

A

Don’t eat a lot of vit k ( or in moderacy)

48
Q

What is used to see chest tube placement

A

Chest xray

49
Q

When should you start trickle feeding for NG tube after crisis

A

Immediately

50
Q

Bronchodilator’s
BAM

A

Beta2agonist
Anticholinergics
Methylxanthines

51
Q

Anti inflammatory agents
“SLM”

A

Steroids
Leukotriene inhibitor
Mast cell stabilizer

52
Q

Bet2agonist

A

Albuterol

1st in line to open up lungs

53
Q

Anticholinergics

A

Ipratropium
Dries up the pt
Bronchodilators

54
Q

Methylxanthines

A

Theophylline
Long term control of asthma

55
Q

2nd in line for asthma attack

A

Ipatropium

56
Q

Inhaled steroid

A

Beclomethasone flutracasone
Anti inflammatory

57
Q

Leukotriene inhibitor

A

Anti inflammatory

58
Q

When a pt takes a steroid what do they need to do
Beclomethasone
Fluticasone

A

Rinse their mouth..swish and spit

59
Q

Order of resp drugs

A

Albuterol
Ipratropium
Beclomethasone or fluticasone
Swish and spit

60
Q

Do inhaled steroids effect bp

A

negative ghost rider

61
Q

Diuretics

A

Furosemide
Hydrochlorothiazide
Bumetanide
Spironolactone

62
Q

Potassium sparing diuretic

A

Spironolactone

63
Q

Anti coag meds

A

Inj heparin , ENOXAPARIN
Oral - warfarin , apixaban , rivaroxaban

64
Q

Anti inflammatory

A

Corticosteroids or glucocorticoids
Oral - prednisone
Oral or inj methyprednisolone dexamethasone , betamethasone
Inhaled - Beclomethasone , fluticasone

65
Q

What do you see with hyperkalemia on heart monitor

A

frequent PVCs
Flat t waves, prolong qt

66
Q

Teaching for collapse lungs

A

TCDB
Insentive spirometer

68
Q

Why do we have hypotension in lung collapse

A

Anything that collapses lung decreases pressure

69
Q

“SLM”
Anti-inflammatory

A

Steroids
Leukotriene inhibitor
Mast cell stabilizers

70
Q

Steriod

In slm

A

Beclomethasone

71
Q

Leukotriene inhibitor slm

A

Montelukast

72
Q

Mast cell stabilizers

73
Q

Heparin’s enemy

A

Protominesulfate

74
Q

Warfarins enemy

Module 7 (24 decks)

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