Critical Care: Respiratory Flashcards
What diseases would require increased PEEP?
ARDS, COVID, Heart Failure + Pneumonia, COPD
When would the RR on a vent be changed up or down?
To blow off or retain CO2 based on ABG
What is the assist control mode of ventilation used for?
Vent does all the work [set volume of air continuously]
Used during intubation/most supportive ventilation mode
Intermittent Ventilation(SIMV)
Synch to patients breath [patient can determine volume]
Allows pt to take back over manual breathing [used to wean off ventilation]
**Close observation required
Pressure Support
Patient triggers breaths [no set RR] [last step before extubation]
What is FiO2 and the standard amount used during ventilation?
FiO2 = Fraction of inspired oxygen/ Concentration of O2 in inspired air + based on provider orders
Amount = 30-100%
**O2 above 0.60 can cause O2 toxicity
COPD outline
S/S- Chronic cough + sputum production, dyspnea, barrel chest, ALOC, headache, hypotension, respiratory acidosis causing vasodilation
Lab/Dx/Tx- Focused respiratory assessment, high fowlers, supplemental O2, ABG, possible intubation [BiPAP], Solumedrol SVN, ABX + steroids, hydration + suction
Asthma Exacerbation outline
S/S- Wheezing, decreased breath sounds, tachypnea, cough, anxiety, ALOC, trouble completing sentences
Analyze- Recent move, pollen/dust, secondhand smoke, illness, stress
Labs- Respiratory Alkalosis
Solutions- Admin O2,
Quick Relief: Albuterol/Ipratropium
Short Acting: Methylprednisolone, prednisolone, prednisone
Long acting: Budesonide/Fluticasone, Methylprednisolone, Salmeterol, Solumedrol
Actions- Raise HOB, monitor vitals
Eval Outcomes- Decreased WOB, better oxygenation, less supplemental O2, Asthma exacerbation plan, demonstrate correct use of inhaler/spacer
**Xopenex used instead of albuterol with increased HR
ARDS
Causes- Pneumonia, COVID, Trauma, Large blood transfusions, burns
S/S- Decreased urine output, increased BUN/Creatinine, Hypoxemia, ALOC, Headache, decreased BP
Tx- ABX, increased PEEP, prone positioning to help oxygenation, intubation
Nursing interventions- Oral care Q2-4 hrs, Turns Q2H, possible suctioning, PPI administration
Respiratory Insufficiency causes
Causes: Atelectasis, Trauma, Airway obstruction, Drug overdose, COPD exacerbation, Asthma Exacerbation
Respiratory Failure causes + interventions
Causes: Severe COVID, ARDS
[Inability to breathe on their own]
Intervention: Intubation & O2 (Ambu-bag) or emergency trache
S/S of respiratory failure
Headache (due to hypercapnia)
Severe Dyspnea (due to hypoxemia)
Low blood pressure (due to acidosis)
Altered LOC (due to hypercapnia)
