exam 1 Flashcards
what is the significance of the lower inflection point?
useful in determining optimal PEEP
what ventilator changes could be made to over-distention?
Increase I-time
If a patient has a PaO2 level of 62 the patient is exhibiting what level of hypoemxia?
mild
the normal range for alveolar partial pressure of oxygen (PAO2) is what?
100-673 torr
what are the indications for PEEP?
bilateral infiltrates on the CXR, recurrent atelectasis with low FRC, PaO2 <60 torr on FiO2 >0.6, refectory hypoxemia
how do you know if optimum PEEP is being used?
highest level of ESC, highest cardiac output, lowest VD/VT level
what is a contraindication for PEEP?
High ICP
what is the equation when wanting to obtain a certain PaCO2? (finding what VT would be used)
Known PaCO2 x Known VT/Desired PaCO2
what are the causes of Resp Alkalosis?
pain and anxiety, CNS disorders, Medications that stimulate ventilation, Hyperventilation
What is the equation to figure out deadspace to VT ratio?
PaCO- PeCO/PaCO
what should you monitor while suctioning the patient?
HR and Rhythm, SpO2 and color, General Appearance, RR
What is the purpose of a HiLo Evac tube?
provides continuous suction above the cuff to clear secretions
what is an indication bronchodilator therapy was effective?
there is an increase in peak expiratory flow rate, there is a reduction in PIP, auto-PEEP (if present) and transairway pressure
what statements regarding permissive hypercapnia are accurate?
pH levels are allowed to fall to 7.2-7.25, PaCO2 levels are allowed to raise to 50-100, Supplemental O2 likely to be required
what statements regarding closed suction caths are true?
they decrease the risk of hypoxemia, alveolar collapse
they decrease the risk of developing VAP
what is the purpose of flexible fiberoptic bronchoscopy?
to visualize upper and lower resp tract
what is an contraindications of prone positioning?
spinal cord injury
what is the purpose of prone positioning a patient?
increase oxygenation
if a patient has a unilateral lung disease what is the best position to place them in to optimize oxygenation?
positioning the healthy lung side down
green, foul smelling sputum is an indicative of what?
pseudomonas
your patient is putting 10 ml/hr of urine out, what type of output is this?
oliguria
VAP is associated with what?
increased length of stay, increased healthcare cost, increased mortality rates
an injury that occurs at the alveolar level in the lung when a patient is being ventilated is called?
ventilator induced lung injury
what interventions are useful in prevention of VAP?
elevate the head of the bed, proper placement if feeding tube, peptic ulcer prophylaxis, sedation vacation, deep vein thrombosis prophylaxis
which of the following actions would result in an increased mean airway pressure?
long I-time, PIP of 40, increase in VT, use of 20 of PEEP
how do you calculate the cerebral perfusion pressure?
systolic BP + (2 X Diastolic BP)/3
this answer - ICP????
what mode can prolong the weening process?
SIMV
which of the following lab results are useful in evaluation of renal function?
BUN, Serum electrolytes
what conditions increase barotrauma?
High PEEP, aspiration of gastric fluid, ALI/ARDS, high peak airway pressure, bullous lung disease
if pressure support ventilation is used to wean patient from mechanical ventilation, at what PSV level should patient be extubated?
5
what methods are used to correct PEEP?
decrease I-time
decrease RR
how is WOB evaluated?
esophageal pressure, airway pressure, flow
what are the advantages of automatic tube compensation?
support or overcome imposed WOB caused by the end tube, to improve patient-ventilator synchrony, reduce air trapping since the resistance to expiratory flow is decreased, improve patient comfort
which of the following criteria must be met prior to putting patient on spontaneous breathing trial?
a partial or complete reversal of underlying lung condition, patient is hemodynamically stable
which of the following measurements evaluates the patients ventilatory rate?
P0.01
