Fundamentals Flashcards
When is mechanical ventilation indicated?
When all other non invasive modalities fail. (I.e. bipap, vapotherm, simple mask, nasal cannula)
Why is mechanical ventilation required?
Because the patient is unable to maintain clinically acceptable co2 levels and acid base status; indications of respiratory failure
What is the normal co2 range?
35-45
What is the respiratory center in the brain?
Medulla and Pons
Pathophysiology behind high co2 levels?
As the co2 levels increase the respiratory center is stimulated to increase the rate and depth of breathing. This increases the rate of Co2 removal and returns concentration to normal resting levels.
What is the pacemaker of breathing?
Medulla oblongata
Which part of the brain allows voluntary of altering breathing?
Cerebrum
What does the pons do in relation to breathing?
Smooths out respiratory rate and influences depth and length of the respiration.
Symptoms of highco2 levels?
Fatigue, Headache, lethargic, confusion and vasodilation causing hypotension.
Nsg interventions in relation to hypercapnia( High c02)
Suction when secretions are present, monitor 02 saturation, 0ral care, hob@45 degrees to prevent aspiration pneumonia, hyperventilation before suctioning, reposition q2h and check for tube feeds and hold when repositioning.
What do you do it a vent alarm goes off?
- Check patient
- check vent and tubing
- Call RT
- ensure Ambu bag is in the room
- bag pt it needed.
What to document in relation to ETT location?
Size of tubing French (most often a 7,7.5, or 8)and cm at the lip
What does PEEP mean?
Positive end expiratory pressure; amount of pressure used to keep alveoli inflated.
What is the normal level of PEEP?
5
Why would a pt need a higher level of PEEP?
In pts with stiffer and more damaged lungs, maybe caused by ARDS, or Covid
What is tidal volume?
The volume of air moved into and out of the lungs with normal quiet breathing.
What is the normal tidal volume in a healthy person?
500ml
What is FI02?
The requirement of oxygen given by the ventilator
What is pressure support?
Is used alone or added to SIMV, is used to provide a small amount of pressure on inspiration to help the patient draw a spontaneous breath
Why is pressure support often used?
It makes it easier for the pt to over come the endotracheal tube and is often used during weaning to ease the work of breathing
What is the max amount of time you can go in the icu without taking vitals?
One hour!
What does the monitoring screen of consist on the space lab monitor?
- HR
- Arterial blood pressure
- Central venous pressure
- Pulse oximetry
Where can art lines be placed?
- Radial-most common
- Femoral
- Pedal
- Brachial
What meds can be pushed through the ART line?
NONE!!!!! The only thing going I’m should be the 3 ml of NS from the pressure infuser bag
How does the saline pressure bag prevent occlusion or clot formation?
The pressure bag elicits 300mmHG to keep 3ml NS running through the line per hour, this prevents blood from getting out of the line and the patient bleeding out.
What is the best indication of perfusion?
MAP
Where are CVP taken?
The jugular Or subclavian
Where does the catheter sit for the CVP
Right outside the entrance of the right atrium
Normal CVP level?
0-8, the lower the number indicates the more dry the patient is (hypovolemic)
What does high CVP indicate?
Right sided heart failure, causing hypervolemia
What is CVP used to asses?
Right sided heart function and volume status ( the lower the number the less fluid volume)
What does ICP monitor?
Intracranial pressure ( the amount of CSF in the brain)
Normal ICP range?
0-15
Where is the ICP monitor placed?
In the lateral ventricles
