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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
Neuromuscular conditions that cause hypercapnea
MS ALS
26
Chest wall abnormalities that cause hypercapnea
Barrel chest Kyphosis Trauma - open thorax wound ( hitting the air bag on the wheel)
27
Air way or alveolar blockage that causes hypercapnea
COPD Cystic fibrosis
28
What is important to keep in mind in a copd pt that has hypercapnea
That their PACO2 normally stays pretty high
29
S/s of resp failure early “Must be hard reading dogs under worry”
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
30
Late signs of resp failure
Bradycardia , Bradypnea Increase co2 , decrease r , decrease LOC Lethargic , unresponsive Cyanosis - when pao2 is 45 mmhg
31
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?
The person may not be blue but will be purple ish
32
What is used to open up the lungs in ARDS
Glucocorticoid steroids and administer diuretics
33
When we give an ARDS pt feurosimide what do we assess
Potassium levels ( to see if its working or not) Check for dysrhythmias , muscle weakness
34
If given IV steroids to an ARDS pt what is important to note
Blood sugar may rise
35
What do we give before sterioids for breathing treatments to open up the lungs
Albuterol
36
What is important to teach pt to prevent ARDS
Wear a mask if spray painting inside
37
SAo2 what is it reading—- ask shallas or someone
Something is attached to hemoglobin
38
Why is it important to lay an ARDS pt on their good side
To move secretions
39
If the drainage chamber starts bubbling what does this indicate?
Alerts us for an air leak by bubbling
40
How to refill wet sunction
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
What is important to assess when having a pt with pneumothorax with a chest tube
Assesss site for drainage , and palpate the skin it may have crepetis and will indicate air is going in sub q tissue
42
On water seal you’ll see the ball going up and down what is it called?
Tidaling
43
Diagnostic labs for pulmonary embolism
D diner lab Ct scan
44
D dimer
Elevated levels from proteins that break down blood clots
45
Warfarin/Coumadin
Limit green leafy veggies , fall precautions Teach s/s of gi bleeds
46
How long does warfarin take to start in body
4-5 days so they need to start it 4-5 days before sent home
47
Heparin/warfarin diet
Don’t eat a lot of vit k ( or in moderacy)
48
What is used to see chest tube placement
Chest xray
49
When should you start trickle feeding for NG tube after crisis
Immediately
50
Bronchodilator’s BAM
Beta2agonist Anticholinergics Methylxanthines
51
Anti inflammatory agents “SLM”
Steroids Leukotriene inhibitor Mast cell stabilizer
52
Bet2agonist
Albuterol 1st in line to open up lungs
53
Anticholinergics
Ipratropium Dries up the pt Bronchodilators
54
Methylxanthines
Theophylline Long term control of asthma
55
2nd in line for asthma attack
Ipatropium
56
Inhaled steroid
Beclomethasone flutracasone Anti inflammatory
57
Leukotriene inhibitor
Anti inflammatory
58
When a pt takes a steroid what do they need to do Beclomethasone Fluticasone
Rinse their mouth..swish and spit
59
Order of resp drugs
Albuterol Ipratropium Beclomethasone or fluticasone Swish and spit
60
Do inhaled steroids effect bp
negative ghost rider
61
Diuretics
Furosemide Hydrochlorothiazide Bumetanide Spironolactone
62
Potassium sparing diuretic
Spironolactone
63
Anti coag meds
Inj heparin , ENOXAPARIN Oral - warfarin , apixaban , rivaroxaban
64
Anti inflammatory
Corticosteroids or glucocorticoids Oral - prednisone Oral or inj methyprednisolone dexamethasone , betamethasone Inhaled - Beclomethasone , fluticasone
65
What do you see with hyperkalemia on heart monitor
frequent PVCs Flat t waves, prolong qt
66
Teaching for collapse lungs
TCDB Insentive spirometer
67
Hi
68
Why do we have hypotension in lung collapse
Anything that collapses lung decreases pressure
69
“SLM” Anti-inflammatory
Steroids Leukotriene inhibitor Mast cell stabilizers
70
Steriod In slm
Beclomethasone
71
Leukotriene inhibitor slm
Montelukast
72
Mast cell stabilizers
Chromolyn
73
Heparin’s enemy
Protominesulfate
74
Warfarins enemy
Vit k

Module 7 (24 decks)

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