Chapter 10 - Vent Assistance

Question 1

Resistance

Answer 1

the opposition to the flow of gases in the airways

Question 2

Inspection

Answer 2

initial clue for potential acute and chronic respiratory problems

Question 3

Palpitation

Answer 3

Evaluates chest well excursion

Question 4

Percussion

Answer 4

Percuss chest to identify respiratory disorders such as a hemothorax

Question 5

Auscultation

Answer 5

Assess lung sounds at least every 4 hours

Question 6

Breath sounds

Answer 6

Crackles
Rhonchi
Wheezes
Pleural Friction rub
Stridor

Question 7

pH

Answer 7

7.35-7.45

Question 8

C02

Answer 8

35-45

Question 9

PaCo2

Answer 9

22-26

Question 10

End tidal carbon dioxide monitoring

Answer 10

Noninvasive measurement of alveolar CO2 at the end of exhalation. Value 2- 5 mm Hg

Question 11

Colorimetric Carbon dioxide detector

Answer 11

Used after intubation, verfies correct tube placement (trachea, not esophagus)

Question 12

Humidification

Answer 12

Recommended when oxygen is 4L/min to prevent mucous membranes from drying

Question 13

Nasal Cannula

Answer 13

Up to 6 L
O2 concentrate 24-44%

Question 14

High flow Nasal Cannula

Answer 14

15-40 L
60-90%

Question 15

Simple Face Mask

Answer 15

5 L - 12 L
30-60%

Question 16

Face Mask with Reservoirs

Answer 16

35%-60
Non rebreather 60-80%

Question 17

Venturi

Answer 17

Fixed Fio2

Question 18

Oropharyngeal airway

Answer 18

prevents the tongue from falling back and obstructing pharynx

Question 19

Oral intubation

Answer 19

A - quick, preferred method, facilitates secretion removal, less kinking
D - Discomfort, mouth care, impairs swallowing, irritation, communication barrier, bite on airway

Question 20

Nasotracheal Intubation

Answer 20

A- Comfort, Mouth care, facilitates swallowing, communication
D - More difficult to place, epistaxis, ainitus, increases breathing work

Question 21

Verification of ET tube

Answer 21

Breath sounds equal, equal chest expansion, ETCO2,

Question 22

Cuffed versus uncuffed trach

Question 23

Single versus double cannula tracheostomy

Question 24

Fenestrated tracheostomy tube

Question 25

Speaking tracheostomy tubes

Question 26

Endotracheal Suctioning

Answer 26

Need to be suctioned to ensure airway patency

Question 27

Assess breath sounds after suctioning

Question 28

Indications of mechanical ventilation

Answer 28

Acute respiratory failure, shallow breaths, abnormal patterns life saving therapy

Question 29

Positive pressure ventilation

Answer 29

Positive pressire to force air into lungs

Question 30

Vent settings

Answer 30

Mods of vent, FiO2, Volume, inspiratory pressure, RR rate, PEEP

Question 31

PEEP

Answer 31

Auto PEEP= Total PEEP - Set PEEP 5- 20 cm H20

Question 32

Modes of mechanical ventilation

Answer 32

Volume controlled, pressure vontrolled, pressire regulated, volume support, mandatory minute vent

Question 33

Noninvasive Positive Pressure Ventilation

Answer 33

Mechanical vent without ETT or tach

Question 34

Complications of mechanical vent

Answer 34

Airway problems - et out of position, unplanned extubation trach injury Pulmonary system - trauma, oxygen toxicity, infection, aspiration Cardiovascular - Hypotension, decreased cardiac output GI system - Stress ulcers PSYCHOSOCIAL

Question 35

Meds for vented patients

Answer 35

analgesics, sedatives, NM blockers

Question 36

COmmunication with vented patients

Answer 36

Individualize communication, consistant reorientation

Question 37

Nonpharmacological interventions

Answer 37

Meditation, guided imagry, relaxation, prayer, music, massage

Question 38

Wean Screen

Answer 38

Underlying Cause, Adequate Oxygenation without ..., Hemodynamic stability, adequate respiratory muscle strength, absence of factors that impair weaning

Question 39

Weaning Trial

Answer 39

ASSESS AND MONITOR THROUGHOUT WEANING PROCESS

Question 40

Weaning

Answer 40

Spontaneous breatijng for 90-120 minutes, airway clerance, assess aurway patency,

Question 41

Prior to extubation