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Cardio 2 > Forms of Invasive Life Support > Flashcards

Forms of Invasive Life Support Flashcards

1
Q

parenchyma

A

the functional tissue of an organ as distinguished from the connective and supporting tissue.

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2
Q

pulmonary toilet

A

exercises and procedures that help to clear your airways of mucus and other secretions.

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3
Q

Indications for Mechanical Ventilation - respitory ​

A

Meetphysiologicneedsinacute respiratory failure

Indicated by failure of the respiratory system to maintain an adequate balance of pH, PaO2, and/or PaCO2

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4
Q

indications for Mechanical Ventilation - protect

A

Protect the airway and lung parenchyma (drug overdose, cerebrovascular accident, head or spinal cord injury)

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5
Q

indications for Mechanical Ventilation - upper

A

Relieve upper airway obstruction (tumor, allergic reaction, edema)

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6
Q

indications for Mechanical Ventilation - toilet

A

Improve pulmonary toilet in pt with excessive secretions or inability to successfully clear secretions by coughing

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7
Q

Patient not able to breath - b/c

A
  • Airflow obstruction
  • Noncompliant lungs/thorax
  • Respiratory muscle weakness
  • Need for positive pressure mechanical ventilatory assistance (acute respiratory failure with resulting inadequate oxygenation)
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8
Q

pt should not breath - b/c

A
  • Need to minimize oxygen consumption by decreasing work of breathing (septic shock)
  • Inability to protect the lower airway from aspiration
  • Surgical or diagnostic procedure
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9
Q

Ventilator pressure

A

Positive pressure – air pushed in to fill the lungs

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10
Q

Intubation or Airway Adjunct - ventilation

A
  • Oral pharyngeal
  • Nasal pharyngeal
  • Endotracheal
  • Tracheal
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11
Q

when is Oral Endotracheal Tube used

A

it is the last resort

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12
Q

Oral Endotracheal Tube 4 primary reasons

A
  1. Upper airway obstruction
  2. Inability to protect the lower airway from aspiration
  3. Inability to clear secretions from the lower airways
  4. Need for positive-pressure mechanical ventilatory assistance
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13
Q

Tracheostomy Tube - upper

A

Complete upper airway obstruction
(emergent)

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14
Q

Tracheostomy Tube - intubation​

A

Long term intubation

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15
Q

Tracheostomy Tube - face

A

ETT (endotracheal tube) impossible due to facial trauma

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16
Q

Tracheostomy Tube - work

A

decreased work of breathing

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17
Q

Tracheostomy Tube - weaning

A

Facilitate ventilator weaning- reduced need for sedation, improves ability to clear secretions, improved patient comfort

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18
Q

Possible Complications of Tracheostomy

A
  • Misplacement of tube
  • Primary hemorrhage
  • Pneumothorax, hemothorax * Surgical emphysema
  • Infection
  • Late hemorrhage
  • Tracheoesophageal fistula
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19
Q

Tracheostomy

A

an opening created at the front of the neck so a tube can be inserted into the windpipe (trachea) to help you breathe.

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20
Q

Speaking with a Tracheostomy

A

Passy-Muir Valve

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21
Q

Passy-Muir Valve mechnism

A
  • Opens on the inhale, closes (“seals”) on exhale
  • Air is redirected around the trach tube, up through the vocal cords, upper airway, and out the mouth
22
Q

Settings that affect oxygenation - ventilator

A
  • FiO2
  • Positive end-expiratory pressure (PEEP) (mm of H2O)
23
Q

Settings that Affect Ventilation - ventilator

A
  • Respiratory rate (breaths per
    minute
  • Tidal volume (milliliters)
  • Minute volume (mL/min)
  • Inspiratory to expiratory ratio (I:E)
24
Q

Controlled mechanical ventilation (CMV) - spontaneously breathing

A

Patient not spontaneously breathing

25
Q

Controlled mechanical ventilation (CMV) - machine control

A

Total control of ventilation à patient matches machine settings

26
Q

Controlled mechanical ventilation (CMV) pt status

A

Patients in coma, sedated, or cannot breathe on own

27
Q

Assisted Control (AC) - TV

A

Patient initiates breath and machine delivers pre-determined TV

28
Q

Assisted Control (AC) - RR

A

Pre-determined RR when breaths are not initiated

29
Q

Synchronized Intermittent Mandatory Ventilation (SIMV)- between machine breaths

A

Patient can breathe btw ventilatory breaths, which are not supported by machine

30
Q

Synchronized Intermittent Mandatory Ventilation (SIMV) - RR and TV

A

RR set, and each breath receives a TV that depends on the patient’s effort

31
Q

Pressure Support Ventilation (PSV) - applies to what kind of breaths

A

Applies only to spontaneous breathes

32
Q

Pressure Support Ventilation (PSV) - mechanism

A

Once the patient triggers the ventilator, the preset positive pressure is delivered

33
Q

Pressure Support Ventilation (PSV) - TV and RR

A

Patient controls RR and inspiratory time; TV determined by pt and machine

34
Q

Pulmonary Barotrauma

A

Complications Associated with Mechanical Ventilation

  • alveolar rupture due to the use of positive pressure
  • If too much pressure is pushed in can cause pneumothorax
35
Q

Auto PEEP

A

Complications Associated with Mechanical Ventilation

  • Incomplete expiration prior to the initiation of the next breath causes
    progressive air trapping (hyperinflation).
  • Need to ensure correct settings or could have inc CO2 retention
36
Q

Reduced cardiac output

A

Complications Associated with Mechanical Ventilation

  • Could occlude the aorta or vena cava based on patient position or
    pressures being delivered
  • Increase in mediastinal pressures could shift the heart and reduce CO
37
Q

Mechanical Ventilation Weaning

A

The process of discontinuing mechanical ventilation so that the patient can return to spontaneous breathing.

38
Q

During weaning, patient is monitored for

A
  • ABG’s (arterial blood gases)
  • Respiratory rate, depth and pattern
  • Pulse oximetry
  • HR and rhythm
  • Mental status changes
39
Q

T piece used when

A

during the process of ventilatory weaning

40
Q

T piece process

A

the pt is doing all of the work

41
Q

CPAP or BiPAP weaning

A

CPAP or BiPAP modes to provide airway support and trial weaning

42
Q

Pacemaker

A

small device that’s placed (implanted) in the chest to help control the heartbeat. - arrhythmias

43
Q

AICD

A

implantable cardioverter-defibrillator - able to perform defibrillation, and depending on the type, cardioversion and pacing of the heart.

44
Q

VAD

A

a mechanical pump used to support heart function and blood flow in people with weak or failing hearts. The device is implanted in the body and pumps blood from the heart’s lower chambers to the rest of the body.

45
Q

ECMO

A

people with life-threatening illness or injury that affects the function of their heart or lungs. ECMO keeps blood moving through the body and keeps blood gasses (oxygen and carbon dioxide) in balance.

46
Q

Intraaortic balloon pump (IABP) - femoral insert

A

cannot flex hip

47
Q

Intraaortic balloon pump (IABP)

A

Assists with circulation of blood and reduce oxygen consumption

48
Q

Hemodialysis function

A

Replaces the function of the
kidneys

49
Q

hemodynamically stable pt - is PT okay

A

yes, Must monitor vital signs

50
Q

Hemodialysis precautions

A

Avoid using the arm with arteriovenous fistula when measuring BP

Cardio 2 (12 decks)

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