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Neonatal Class > Exam III > Flashcards

Exam III Flashcards

1
Q

Neonates may be extubated from what rate?

A

10-12

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2
Q

A CO2 >55 what will PIP range would the RT need to achieve?

A

Increase the PIP to 25-30

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3
Q

What is the maximum PEEP therapy?

A

10

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4
Q

True or False: To support weaning we have to ensure that the problem has been solved

A

True

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5
Q

For ventilator weaning the FIO2 must decrease in increments of 2-5% to achieve what percent?

A

40%

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6
Q

What are the minimum acceptable ventilator settings for CPAP trials

A

PIP <25 cmH2O
RR 10-12 bpm
FIO2 .40
PEEP <5

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7
Q

CPAP NIV is typically started at an FIO2…

A

10% higher than the ventilator setting

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8
Q

How do you calculate the E-Time?

A

60/RR=TCT TI+X=TCT

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9
Q

On a pneumatic ventilator, the pressure manometer swings back towards the negative side. What must you do?

A

Increase flow

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10
Q

On a pneumatic ventilator, when evaluating what is set and the patient’s data you notice that they are hitting the pressure max (decrease in compliance). What does this mean?

A

They are in PC, if the PIP is lower than P Max they are in volume control

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11
Q

On a pneumatic ventilator, if the patient is constantly hitting the pmax what is their compliance?

A

Down

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12
Q

What is PAW affected by?

A

PEEP, PIP, I:E Ratio, Flow

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13
Q

How do you calculate MAP?

A

(PIP-PEEP)xTIxFlow
_____________________ +PEEP
60

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14
Q

What is a pao2 <50 and an FIO2 >60% an indication for?

A

PEEP therapy

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15
Q

Describe true statements involving PAW

A

-Keep PAW between 10-14
-MAP >12 may contribute to barotrauma
-It is the average pressure on the airways and lungs during a complete inspiratory and expiratory cycle
-Calculated electronically by vent
-Increasing MAP, increases oxygenation

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16
Q

True or False: Pressure limited ventilation, an increase in PEEP may include an increase in pco2

A

True

17
Q

In PC, if we increase PEEP there will be an increase of CO2 why?

A

The DP is smaller, therefore making a smaller VT and causing a rise of CO2

18
Q

What are the ETT sizes, landmarks, and laryngoscope sizes?

A

> 1000g 2.5 ETT, Miller 00
1000-2000g 3.0 ETT, Miller 0
2000-3000g 3.5 ETT Miller 0
3000-4000 3.5-4.0 Miller 1

Landmarks:
1000-7cm
2000-8cm
3000-9cm

19
Q

A patient has CDH and the physician is requesting to evaluate for a PPHN what do we do to determine this?

A

Hyperoxia/Hyperventilation Test:
-Administer 100% FIO2 and manually ventilate for 5-10 min
-If pao2 >100 then they have PPHN
-Little to no change means CDH

20
Q

Scenario: CDH patient is started on INO. What are some values you must remember for inital set up of HFOV?

A

MAP set 2-5 above conventional, Bias Flow set to 20 (10-15 for pre-term)

21
Q

If a baby on HFOV has no wiggle, what must you increase?

A

Increase the amp

22
Q

A patient on HFOV has a low CO2, what must you do?

A

Decrease the amp 3 times then increase the hertz

23
Q

Scenario- 40 week GA not vigorous (i.e. mec baby) what are the initial settings for this patient?

A

Initial Settings:
<1000g

VTE 4-6
RR 30-50
PEEP 3-5
FIO2 10% above what they were on or 1.0 unless contraindicated
TI .25-.4
PIP 18-25
PS 6-10 Per VTE
Trigger .25-.50

<1500g

VTE 5-6
RR 20-45
PEEP 5-7
FIO2 10% above what they were on or 1.0 unless contraindicated
TI .4-.5
PIP 18-25
PS 6-10 per VTE
Trigger .25-.50

24
Q

INO is not available for a MEC patient, what should you for the patient?

A

Keep the abg between ph7.45-7.50 and CO2 25-35 torr-decrease PVR drop co2 to blow it off

25
Q

Once INO has arrived for the patient, HFJV is initiated what does the HFJV hold?

A

PIP

NOTE: PEEP IS ON CONVENTIONAL VENTILATOR

26
Q

INO is not reading correctly, high calibration should read…

A

45

27
Q

What are the lung protective settings?

A

VTE 4-6
TI .4-.7
RR 40-60
PEEP 4-7
PIP 25-28

28
Q

What are the ABG value ranges?

A

<1000g
pH >7.25
paco2 45-55
pao2 55-65
HCO3 15-18

<1500g
pH >7.25
paco2 45-55
pao2 50-70
HCO3 18-20

Neonatal Class (3 decks)

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