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Cardiopulm JD > CPPT In ICU > Flashcards

CPPT In ICU Flashcards

1
Q

Green (ECG) normal values

A

60-90 bpm

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2
Q

Red: BP and (MAP- mean arterial pressure) normal values

A

120/80 mmHg and MAP is between 60-110, normal is 92

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3
Q

CVP (Central venous pressure) normal values

A

2-8 cmH2O or 2-6 mmHg

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4
Q

Blue- Intracranial pressure normal values

A

0-15 mmHg, can treat up to 20 mmHg, if 19, talk to nurse

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5
Q

Purple- SpO2- normal values

A

97-98

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6
Q

Endotracheal tube can be inserted by what two ways?

A

Oral and nasal

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7
Q

3 classifications of tracheostomy tubes

A

Cuffed and cuffless
Fenestrated and nonfenestrated
Metal and plastic

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8
Q

ET-T is used for short or long term management?

A

Short

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9
Q

Where are trachs inserted?

A

Below vocal cords

Btw third and fourth tracheal rings at sternal notch

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10
Q

What should the cuff pressure on the trach be?

A

Below 25 cmH2O

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11
Q

Trach patients should have what kind of motion done?

A

C/S ROM and prone positioning

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12
Q

Where are chest tubes inserted for fluid?

A

Btw fourth and fifth intercostal space at the midaxillary line for fluid (low)

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13
Q

Where are the chest tubes inserted for a pneumothorax?

A

IN the second intercostal space at the midclavicular line (high)

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14
Q

Where should the drainage container be placed for patients with a chest tube?

A

Upright and below the level of the chest connecting the tubes to an under water seal drainage system and applying suction

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15
Q

3 compartments of drainage containers

A

Under water seal drainage
A collection chamber for air or fluid
A suction chamber

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16
Q

In the 3 compartments of the drainage containers, where is it okay to see bubbles?

A

The suction chamber

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17
Q

True or false: patients connected to an under water seal drainage can be mobilized and ambulated?

A

True

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18
Q

Can percussion and vibration be performed with chest tubes?

A

Yes

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19
Q

ROM of what body part is necessary with breathing exercises for people with chest tubes?

A

Shoulder ROM

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20
Q

Orange hair syndrome

A

Patient need 2-4x amount of normal pain meds to feel relief

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21
Q

An spO2 of 90% corresponds to a PaO2 of ….

A

60 mmHg

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22
Q

Below 90% of SpO2 is a problem, and this can occur…

A

Dysrhythmias

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23
Q

At what SpO2 and PaO2 do most dysrhythmias occur?

A

SpO2- 85% and PaO2 of 50 mmHg

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24
Q

HDM-A Line: Peripheral Arterial Catheters: What artery is this usually put into?

A

Radial artery

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25
HDM-A Line: Peripheral Arterial Catheters: What two things are the catheter connected to?
A flush device and transducer
26
HDM-A Line: Peripheral Arterial Catheters: Where should the transducer be placed?
At the level of the right atrium
27
HDM-A Line: Peripheral Arterial Catheters: What will the pressure readings be if the transducer is below the right atrium?
Falsely high
28
HDM-A Line: Peripheral Arterial Catheters: What will the pressure readings be if the transducer is above the right atrium?
Falsely low
29
HDM-A Line: Peripheral Arterial Catheters: What is one thing you should not change without notifying the nurse?
The height of the bed
30
This kind of line has a loop along thumb and the wrist is bandaged
A line
31
Central Venous Pressure (CVP) catheters: are placed where?
Directly into the heart (right atrium)
32
Central Venous Pressure (CVP) catheters: This is an important tool to assess...
Right atrial pressure Right ventricular function Systemic fluid status
33
Central Venous Pressure (CVP) catheters: Directly reflects ______ Indirectly reflects _______
Directly: right atrial pressure Indirectly: right ventricular end diastolic pressure
34
Central Venous Pressure (CVP) catheters: If the right ventricle is failing, what will rise?
CVP
35
Central Venous Pressure (CVP) catheters: The waveform fluctuates with inspiration _______ with spontaneous inspiration _______ with positive pressure respiration
Decreases | Increases
36
Swan Ganz: How is it inserted
Through the right atrium, right ventricle, and then passed into the pulmonary artery
37
Swan Ganz: What three things can be calculated?
Preload Contractile state Afterload
38
Pulmonary Artery Catheters: During balloon inflation, the pulmonary artery wedge pressure is calculated and the wave is _____
Dampened
39
Pulmonary Artery Catheters: Pulmonary artery wedge pressure is indicative of...
Left atrial and left ventricular end diastolic pressures
40
Pulmonary Artery Catheters: The balloon should NOT be inflated for more than ___ seconds
15
41
What side of the brain are ICP devices placed on?
Injured side of the brain
42
Two different types of neurological monitoring devices:
EVD (external ventricular drain) and Bolt
43
What two things does the (external ventricular drain) drain?
Spinal fluid and CSF
44
For someone on Bolt or EVD, how should the bed be set up?
Head of bed MUST be elevated
45
What kind of wave demonstrates sudden increases in ICP with peaks of 50-100 mmHg
Alpha wave
46
What kind of wave is a saw tooth pattern, correlates with respiratory changes and occurs decreasing brain compliance
Beta wave
47
Cerebral perfusion pressure is the drive pressure of....
Blood to the brain
48
How can CPP be calculated?
MAP-ICP=CPP
49
What value do we want CPP to be?
>60 mmHg
50
Can put a patient in trendelenberg if ICP is _____ and CPP is ____
<25 mmHg | >50 mmHg
51
MAP= formula
((2 x DBP) + SBP) / 3
52
CVP mean number is...
0-8 mmHg
53
Pulmonary artery values: Systolic: End diastolic: Mean
15-32 mmHg 4-13 mmHg 9-19 mmHg
54
Normal mean range for pulmonary artery wedge pressure is...
4-12 mmHg
55
Peripherally Inserted Central Catheter (PICC Line): Infusion of what?
Meds, nutrition, fluids, or blood products
56
Peripherally Inserted Central Catheter (PICC Line): What is the placement?
Under fluoroscopic guidance, catheter is inserted percutaneously into a vein in antecubital fossa. The tip of the Cather is moved into the superior vena cava and right atrium and goes right into the heart
57
Peripherally Inserted Central Catheter (PICC Line): What is important about blood pressure?
Cannot take blood pressure in extremity with PICC line
58
Peripherally Inserted Central Catheter (PICC Line): Can you ambulate with patient?
Yes
59
TLC (Tri Lumen Catheter): Infusion of...
Meds, nutrition and blood products | Allows blood withdrawal
60
TLC (Tri Lumen Catheter): Placement?
Inserted percutaneously into the superior vena cava through the subclavian, external jugular, or internal jugular vein or into the femoral vein of the LE
61
TLC (Tri Lumen Catheter): What needs to be ruled out before giving therapy?
A pneumothorax
62
TLC (Tri Lumen Catheter): When do you need to calcify orders for transfer training OOB with MD?
When they have a femoral catheter placement
63
Implantable Port: Infusion of... | What population usually gets these?
Drugs, TPN, blood products and other fluids; typically in patients with cancer
64
Implantable port: placement?
Percutaneous placement into super vena cava or right atrium via subclavian or internal jug vein Portal place over 3rd and 4th ribs
65
Temp pacemaker: Placement
Pacing wire is inserted transvenously through subclavian or IJ vein into right atrium, right ventricle or both
66
Temp pacemaker: Wire is ____ and device is ____
Internal | External
67
Temp pacemaker: What is a contraindication for people with a temp pacemaker?
Shoulder flexion/abduction ROM- typically for 1 month min
68
Hemo Catheter: Permits access for _____
Urgent dialysis/acute renal failure
69
Hemo Catheter: If you are on a hemo catheter, you are usually on this kind of machine as well
Dialysis
70
Hemo Catheter: Placement
Catheter is inserted percutaneously into subclavian, IJ, or femoral vein; sutured into place
71
Mechanical ventilation: If you RR is this value, you may be intubated
RR >30
72
Mechanical ventilation: May be intubated if PaCO2 >50 mmHg with pH<7.25
True
73
What is the 50/50 rule?
MV is indicated if a patient's PaO2 falls below 50 mmHg and the PaCO2 rises above 50 mmHg
74
Mechanical ventilation: Most commonly used modes of MV are...
Assist-control | Continuous mandatory ventilation
75
CMV (continuous mandatory ventilation) means that the vent is doing ______ of the work
100%
76
SIMV: means that the patient is doing _____ of the work
Less than 100%
77
PEER (positive end expiratory pressure) means that...
The patient is breathing on their own | The higher the PEEP, the more support pt needs (want PEEP to come down)
78
When the breath is patient triggered, it is referred to...
IMV
79
When the breath is delivered by the vent, it is termed
SIMV
80
Do you do PT if a patient is on a vent and is beating weaned on SBT?
NOOOOOO
81
High pressure alarm is probably because...
A/W is blocked, sputum, coughing (needs to be suctioned)
82
Low pressure alarm means:
Disconnected from vent, likely pt pops off vent
83
4 indications of CPPT in the ICU
Retained secretions Acute atelectasis or infiltrate Decrease in PaO2 or SpO2 as a result of secretion retention Prophylactic use
84
4 things that the efficacy of CPPT is determined by:
Decrease in pulmonary infection incidence Improvement in the PFT Decrease duration of mechanical ventilation Prevention of tracheostomies
85
Activities in the ICU including CPPT can increase metabolic rate by ____%
35%
86
What FEV1% is needed for patient to have an effective cough?
60%
87
Do manual techniques increase the ICP?
No, it is not a contraindication
88
It appears that the increase in VO2 and VCO2 that occurs with manual techniques returns to baseline in how many minutes?
15 minutes
89
When doing manual techniques, out of these measures what increases and what decreases? HR, BP, RR, O2
HR, BP, and RR increase O2 decrease All return to baseline in 15 min or better after PT

Cardiopulm JD (12 decks)

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