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Finals for spring 2017 > Finals > Flashcards

Finals Flashcards

1
Q

bicarb levels

A
  • changes slowly
  • Either excrete or retain bicarb
  • begins in 12-24 hr
  • completes change in 48-72
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2
Q

spontaneous

A

chest wall moves out, negative pressure is created, alveoli lengthen and widen, gas flows in

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3
Q

Heart rate range

A

60-100 beats

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4
Q

what does ERS stand for?

A

European Respiratory Society Task Force on standarization of Fuction testing

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5
Q

what does CMV mean?

A

Controlled mandatory ventilation

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6
Q

Goals of mechanical ventilation

A
  • improve alveolar ventilation
  1. decrease PaCO2
  2. Increase PaO2
  • improve distribution of ventilation
  • aid the failing heart
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7
Q

IC=

A

IRV + VT

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8
Q

what does CPAP mean?

A

Continuous Positive Airway Pressure

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9
Q

what is a normal frequency for the ventilator?

A

8-16 /min

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10
Q

When RV is greater than 130%

A

Air trapping

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11
Q

severe ARDS

A

<100

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12
Q

normal valves for static compliance

A

60-100 cm per cm H2O

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13
Q

PA02-PaO2

A

10-15 mmhg

values widen as FIO2 increases

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14
Q

Gas diffusion tests are reported at

A

STPD

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15
Q

V̇e=

A

Vt • f

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16
Q

Formula for dynamic compliance

A

VT/PiP-PEEP

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17
Q

formula for static compliance

A

Vt/Pplat-peep

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18
Q

%sat=

A

95-100%

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19
Q

what does RV stand for?

A

Residual volume

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20
Q

pH range

A

7.35-7.45

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21
Q

what is the purpose of pulmonary function testing?

A
  • chest wall disease
  • Neuromuscular disease
  • Disability and rehabilition
  • pre/post surgury
  • disease progression
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22
Q

indications for mechanical ventilation

A
  1. apnea
  2. acute ventilatory failure
  3. impending acute ventilatory failure
  4. pulmonary abnomalities
  5. secondary abnormalities leading to ineffective ventilation
  6. severe oxygenation deficit
  7. post operatively
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23
Q

complications of PEEP/CPAP

A
  • barotrauma
  • Pneumothorax
  • decreased venous return
  • decreased cardiac output
  • decrease PaO2
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24
Q

What happens when mechanical deadspace increases?

A
  • VA is decreased
  • CO2 is increased
  • pH is decreased
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25
Q

what is assist control for?

A
  • Providing full ventilatory support
  • Patients with stable respiratory drive can trigger mechanical breaths
  • decrease the patient’s work of breathing
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26
Q

if FEV1/FVC is less than 70% it is obstruction, If FEV1 is greater than or equal to 80%

A

Mild obstruction

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27
Q

what does MMV stand for?

A

Mandatory minute ventilation

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28
Q

Qualifications for home therapy (non-exceptions)

A
  • SaO2 less than or equal to 88%
  • PaO2 must be less than or equal to 55 mmhg on RA
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29
Q

Restrictive Lung Disease

A
  • Pulmonary Fibrosis
  • Sarcoidosis
  • Pneumoconiosis
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30
Q

Blood pressure range

A

90/60-120/80 mmhg

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31
Q

formula for total O2 contant with Hgb

A

[1.34(Hgb)(sat)]

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32
Q

Time for withhold of a Methlxanthines

A

12 Hours

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33
Q

Asthma and obesity

A

increases DLCO

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34
Q

increased PaO2

A

Decrease DLCO

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35
Q

what does ERV stand for?

A

Expiratory Reserve Volume

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36
Q

DL/VA <40%

A

severe diffusion defect

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37
Q

4th and 5th generation

A
  • Microproccessor
  • Volume and pressure control
  • Various ventilator modes
  • Pressure targeted ventilation and adaptive support ventilation
  • Closed loop
  • Waveforms
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38
Q

Respiratory rate range

A

12-20

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39
Q

Third generation ventilator

A
  • pressure control and volume control ventilation
  • Microprocessor
  • First use of APRV
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40
Q

formula for total O2 contant with amount dissolved in plasma

A

(.003 • PaO2)

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41
Q

Bicarb range

A

22-26 Meq/L

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42
Q

what is the purpose of therapeutic PEEP? and what is the classification number of therapeutic peep?

A

>5 cmH2O, treat atelectasis or hypoxia. For patients with increased FIO2 demand and increasing atelectasis

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43
Q

Tlo setting of APRV

A

.5-.8 seconds

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44
Q

what affects pulse oximetry?

A
  • circulation
  • Nail polish
  • movement
  • lighting
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45
Q

causes of respiratory Alkalosis

A
  • central nervous system stimulation
  • Hypoxemia
  • Pulmonary Emboli
  • Mechanical ventilation
  • Pulmonary disorder
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46
Q

what is the concentrations in the gas diffusion test?

  • __
  • __
  • __
  • __
A
  • 21% O2
  • 0.3% CO
  • 10% helium/Methane/Neon
  • Balance N2
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47
Q

TLC=

A

IRV + VT+ERV + RV

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48
Q

in volume controlled ventilation what is constant and what will vary?

A

Volume constant- Pressure varies

Pressure limitation will cause VT not to be reached

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49
Q

second generation ventilator

A
  • first apperance of patient-triggered inspiration
  • Most monitored Vt and RR
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50
Q

PCO2 is…

A

the best indicator of alveolar ventilation

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51
Q

Peripheral chemoreceptors

A

responds to drop in PO2

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52
Q

anion Gap normal

A

8-16 mEq/L

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53
Q

normal valves for dynamic compliance

A

30-40 ml per cm H2O

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54
Q

what does PC?

A

pressure control

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55
Q

what does GINA stand for?

A

Global initiation for asthma

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56
Q

FEV1/FVC is less than 70% than

A

Obstruction

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57
Q

if FEV1/FVC is less than 70% it is obstruction, If FEV1 is 30-49% than it is

A

Severe obstruction

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58
Q

what are predictors for Lung volume and capacities?

A

Height,Gender, and Age

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59
Q

Hazards and complications of positive pressure ventilation

A
  • pulmonary effects
  • cardiac effects
  • renal effects
  • GI problems
  • neurologic effects
  • metabolic effects
  • airway complications
  • mechanical complications
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60
Q

what is the Haldane Effect?

A

Deoxygenation of the blood increases its ability to carry carbon dioxide; this property is the handane effect. Conversely oxygenated blood has a reduced capacity for carbon dioxide.

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61
Q

positive pressure breath

A

gas/volume is delivered to the patient via airway, alveoli get filled with gas, chest wall is pushed outward

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62
Q

What if TLC is less than 65-79%

A

mild restrictive

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63
Q

Helium Dilution

A
  • Closed circuit multi-breath helium dilution test
  • Normal test time less than or equal to 3 minutes
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64
Q

CVP means

A

Central venous pressure

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65
Q

DLco decreases in

A
  • Restrictive lung disease
  • Alveolitis
  • Space Occupying lesions
  • Pulmonary interstital edema
  • Lung resections
  • Radiation Therapy
  • Chemotherapy (Bleomycin)
  • Cardiac drugs (Amiodarone)
  • COPD
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66
Q

Significant bronchodilator is effective when

A

FEV1 or FVC change of greater or equal to 12% and greater than or equal to 200 ml

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67
Q

what does IRV stand for?

A

Inspiratory Reserve Volume

68
Q

Time for withhold of a SABA?

A

4 Hours

69
Q

First generation ventilator

A

only had volume-controlled ventilation

70
Q

what is the concerns when performing a PFT?

A
  • dizziness
  • fainting
  • extreme dyspnea
  • recent stroke
  • recent MI
  • Recent opthalmic
  • recent pneumothorax
71
Q

Decrease Hb Level

A

Decreases DLCO

72
Q

What does FRC stand for?

A

Functional Residual capacity

73
Q

Time for withhold of a SACA

A

4 hours

74
Q

ECG means

A

electrocardiogram

75
Q

P/F ratio normal

A

> 300

76
Q

DL/VA 60-79 %

A

mild diffusion defect

77
Q

Swan-Ganz does

A

It is done to monitor the heart’s function and blood flow

78
Q

what is the use for CMV?

A
  • 100% ventilation support
  • no respiratory center control
  • paralyzed and sedated
  • seizure activity that would interrupt MV
79
Q

causes of hyperventilation

A
  • Psychogenic- Anxiety
  • CNS disturbances-tumor
  • Metabolic disturbances-fever, exercise
  • Drugs
  • Pulmonary diseases- low pO2
80
Q

PCO2 levels can change rapidly

A

within minutes

varies with changes in venilation

81
Q

in pressure controlled ventilation what is constant? what will vary?

A

Pressure is constant and volume will vary

82
Q

what does ATS stand for?

A

American Thoracic Society

83
Q

Time for withhold of a cromolyn sodium

A

8-12 hours

84
Q

causes of increased CO2 production

A
  • Exercise
  • Fever
  • Stress
  • Severe burns
  • Sepsis
85
Q

V̇A=

A

VA • f

86
Q

Gas diffusion test indications

A
  • Lung transplant candidacy
  • Disability
  • Medication that may cause pulmonary toxicity (amiodarone, Bleomycin)
  • Follow course of disease (decreased DLCO is associated with lung cancer)
87
Q

VC=

A

IRV + VT + ERV

88
Q

DL/VA equal to or lesser than

A

normal diffusion

89
Q

indications of APRV

A
  • patient with refractory hypoxemia
  • when conventional ventilation is not sufficient
90
Q

Time for withhold of a Slow-release methylxanthines

A

24 Hours

91
Q

Thi setting of APRV

A

4-6 seconds

92
Q

if all values are normal and if FEF25-75 is less than 80

A

Early small airway disease

93
Q

what does VC mean?

A

Volume control

94
Q

A-Line means

A

Arterial line

95
Q

mild ARDS

A

200-300

96
Q

Goals of PEEP/CPAP

A
  • increase FRC
  • Improve stability of alveoli and small airways
  • Decrease Shunt
  • improve PaO2
97
Q

increase capillary blood volume

A

increase DLCO

98
Q

What if TLC is less than 80%

A

Restrictive lung disease

99
Q

Time for withhold of a LACA

A

24 hours

100
Q

what is physiologic peep?

A

2-5 cmH2O

101
Q

moderate ARDS

A

100-200

102
Q

PaCO2 range

A

35-45 mmhg

103
Q

what are obstructive lung diseases?

A
  • Asthma
  • Emphysema
  • Bronchitis
  • Bronchiectasis
  • Cystic Fibrosis
104
Q

if FEV1/FVC is less than 70% it is obstruction, If FEV1 is less than 30%

A

Very Severe Obstruction

105
Q

what is SIMV?

A
  • synchronized with patient’s own breathing attempts
  • Can only trigger during a trigger window
  • no breaths during trigger window= machine triggered mandatory breaths
106
Q

what does A/C mean?

A

assist control

107
Q

Negative pressure ventilation concept

A

extra-thoracic pressure applied to thorax

108
Q

what does SIMV mean?

A

Synchronized intermittent mandatory ventilation

109
Q

FRC=

A

ERV+RV

110
Q

what is Choride shift?

A

the movement of CL- into the RBC as result of HCO3 molecules moving into the plasma to create ionic balance

111
Q

Time for withhold of a inhaled steroids

A

do not stop medication

112
Q

what does VC stand for?

A

Vital capacity

113
Q

what if TLC is greater than 120%

A

Hyperinflation

114
Q

what is normal starting tidal volume for ventilator?

A

6-8 ml/kg per IBW

115
Q

Central chemoreceptor

A
  • Respiratory Centers- medulla of brain stem
  • respond to PH of CSF
116
Q

what does APRV stand for?

A

Airway pressure release ventilation

117
Q

Increase COhb level

A

Decreases DLCO

118
Q

DL/VA 40-59%

A

moderate diffusion defect

119
Q

Temperature range

A

36.1-37.2 c

120
Q

Body position

A

supine increases DLCO

121
Q

what is normal range for ICP?

A

5-15 mmhg

122
Q

what does TLC stand for?

A

Total lung capacity

123
Q

Base Excess=

A

-2/+2 Meq/L

124
Q

less than a 80% on FVC will qualify as a

A

Restrictive Pattern (unless obstruction is present)

125
Q

What is IC stand for?

A

Inspiratory Capacity

126
Q

increase in temperature

A

decrease in pH

increase in PCO2

Increase in PO2

127
Q

Capacity Gas diffusion

A

A-C Membrane

128
Q

Ventilation

A

Movement of air in & out of the lungs

129
Q

indications for PEEP/ CPAP

A
  • low PaO2 with high FIO2
  • Treat atelectasis and ARDS
130
Q

in mmv what is patient going to get?

A

guarantees that the patient always recieve set minute ventilation

131
Q

causes of metabolic alkalosis

A

loss of H+

  • vomiting, NG tube
  • diuretics
  • steroids

Exogenous

  • administration of bicarb

Electrolyte imbalance

  • potassium depletion
  • chloride depletion
132
Q

PA02 formula

A

[(760-47) • FIO2] - (1.25 • PaCO2)

133
Q

what percentage of patients use medium masks?

A

85%

134
Q

increasing pressure on a bird mark 7

A

increases tidal volume and increases inspiratory time

135
Q

what does PEEP mean?

A

Positive End Expiratory Pressure

136
Q

Keypoints about PSV

A
  • The higher the set pressure support= the more support the patient is receiving
  • The lower the set pressure support= more effort required from the patient
  • Back up ventilation must be set appropriately
  • F, VT, Ti, Te, and Inspiratory flow is choosen by the patient
137
Q

increasing flow rate will cause

A

tidal volume to decrease and inspiratory time to decrease

138
Q

in RBC (90%)

A

HCO3 (64%)

139
Q

how to mmhg into kPa?

A

divide by 7.5

140
Q

Normal range for a/A

A

.75-1

141
Q

what if the TLC is 50-64%

A

moderate restriction

142
Q

V̇D=

A

VD • f

143
Q

DLCO (adjusted) <80%

A

reduced diffusion

144
Q

causes of metaboloc acidosis

A

increased formation of acids

  • diabetic ketoacidosis
  • Lactic Acidosis
  • Renal failure

Loss of HCO3

  • diarrhea
  • renal tubelar acidosis

Exogenous

  • aspirin, alcohol ingestion
  • hyper-alimentation
  • diamox
  • ammonium chloride; ethylene glycol ingestion
145
Q

Altitude

A

Increases DLCO

146
Q

Time for withhold of a LABA?

A

12 hours

147
Q

if FEV1/FVC is less than 70% it is obstruction, If FEV1 is 50%-79% than it is

A

Moderate obstruction

148
Q

decrease in temperature

A
  • increase in pH
  • decrease in PCO2
  • decrease in PO2
149
Q

Nitrogen washout is

A

open circuit multi-breath nitrogen washout

150
Q

Time for withhold of a leukotriene modifier

A

24 hours

151
Q
A
152
Q

normal range for CCP?

A

70-80 mmhg

153
Q

increase PaCO2

A

Increases DLCO

154
Q

causes of hypoventilation

A
  • lung diseases- COPD
  • CNS trauma
  • Muscle paralysis
  • Obesity
  • Drug Induced
155
Q

How to turn Kpa into mmhg?

A

multiple by 7.5

156
Q

TLC is less than 50%

A

Severe Restriction

157
Q

normal range for combined O2 content

A

16-23 ml O2/dL blood

158
Q

PaO2=

A

80-100 mmhg

159
Q

what does Vt stand for?

A

Tidal Volume

160
Q

what does TEE stand for?

A

trans-esophageal echocardiography

161
Q

Respiration

A

Exchange of gases (O2 & CO2) at A-C membrane and tissue level

162
Q

MAP formula is

A

SBP+2(DBP)/3

163
Q

what if FRC is greater than 120%

A

Air trapping

164
Q

Mechanical ventilation definition

A

The act of breathing partially or totally for a patient by an automatic device connected to the patient’s airway

165
Q

normal value of Raw

A

0.6-2.4 cmH2O

Finals for spring 2017 (2 decks)

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