Lab 2 Exam Flashcards
What are 2 factors that help RRT pick the correct vent settings?
- IBW
- Disease process (diagnosis)
What some things that cause tachycardia in ventilated pts?
- Pain
- Anxiety
- Bronchospasm
- Secretions
- A-synchronized w/ the vent
What is weaning success ?
Pt being able to tolerate spontaneous breathing for 48 hrs following extubation w/o the need for reintubation
What is weaning failure?
Failure of SBT or the need for reintubation
What are sources of VAP?
- Hand hygiene
- Not changing filters
What are ways to prevent VAP?
- Wash hands
- Oral care
- HOB 30 degrees
- Closed in line suctioning
- changing filters
What mode is CMV?
Continuous Mandatory Ventilation
1. All breaths are mandatory
2. Volume-targeted or pressure targeted
3. Time-triggered
What mode is VC- CMV
Volume-Controlled Continuous Mandatory Volume
1. Volume targeted
What mode is PC-CMV
Pressure-Controlled Continuous Mandatory Ventilation
1. Pressure targeted
2. Time-triggered or pt triggered
3. Time cycled
RRT sets:
- length of inspiration
- pressure level
- backup rate of ventilation
What mode is IMV?
Intermitted Mandatory Ventilation
1. Periodic volume targeted or pressure targeted
2. Time triggered
3. Pt can breathe spontaneously between mandatory breaths w/o receiving a mandatory breath
SBT=
Spontaneous Breathing Trial
What mode is CPAP
Continuous Positive Airway Pressure
1. Weaning mode
2. 1 continuous level of positive pressure
3. Pt must be spontaneously breathing
**RRT sets:*
- Pressure support= 5
- PEEP= 5
- Fio2= >50%
What mode is PSV?
Pressure Support Ventilation
1. Constant pressure during inspiration once it sense
RRT sets:
- Inspiratory pressure
- PEEP
- Flow cycle criteria
- Sensitivity level
2. Used for weaning
The difference between IPAP and EPAP is
Pressure Support
What mode is BiPAP
Bilevel Positive Airway Pressure
1. RRT sets
- 2 pressure levels (inspiratory and expiratory positive airway pressure
What mode is PRVC
Pressure-regulated Volume Controlled
1. Volume targeted
2. Pressure controlled
3. Pt triggered
4. Time cycle
What mode is VSV
Volume Support Ventilation
1. Pressure support w/ volume targeted
2. Pt- triggered
3. Volume targeted
4. Flow cycled
What mode is MMV
Mandatory Minute Ventilation
1. Weaning mode
2. RRT sets
- minimum minute ventilation (dependent on pt’s current ME)
- High rate and low Vt alarms
What mode is SIMV?
Synchronized Intermittent Mandatory Ventilation
1. Used for weaning
2. Post-surgical pts
3. Prevents breath stacking
PEEP=
Positive End-Expiratory Pressure
What is Dynamic Compliance equation
Exhaled Vt/ (PIP- Pplat)
What is Static Compliance equation
Vt/ Pplat- PEEP)
What is the difference between CPAP and BiPAP?
- CPAP= 1 continuous level of positive pressure
- BiPAP= 2 set levels of positive pressure
VE=
Minute Ventilation
F=
RR
Vt=
Tidal volume
PIP=
Peak Inspiratory Pressure
Pplat=
Plateau Pressure
Cs=
Static Compliance
Raw=
Airway resistance
FIO2=
Fractional inspirited oxygen
I/E ratio =
Inspiratory to Expiratory ratio
VC=
Vital capacity
MIP=
Maximal Inspiratory Pressure
NIF=
Negative Inspiratory Force
What supplies are needed for Intubation
- Laryngoscope
- Blade (Mac or Miller)
- ET tube
- 10 mL syringe
- Stylet
- ET tube securing device
- Water- soluble lubricant
- Carbon dioxide detector
- Manual resuscitator
- Yankauer
How do you manipulate the vent when a pt is in Respiratory Acidosis
- Higher RR
- Higher VT
How do you manipulate the vent when a pt is in Respiratory Alkalosis
- lower RR
- lower VT
Range for RSBI (f/vt) for weaning
<60-105
Normal value for RR for weaning
<35 breaths
What type of weaning parameters are used
- NIF >-20
- RSBI <105
- Vital Capacity >15
High pressure alarms can be activated when
- Pt coughs
- Secretions
- Kinks in tube
Low pressure alarms cn be activated when
- Leaks circuit tubbing
- Pt disconnection
What is ARDS protocol
- Vt= 4 to 6
- RR= 15-25
- PEEP= high
- FIO2= high
Minute ventilation equation
ME= Vt x F
RSBI=
Rapid Shallow Breathing Index
RSBI equation
RR/ VT
ATC=
Automatic Tube Compensation
What is the definition for weaning?
The graduation reduction of ventilatory support from a pt whose condition is improving
TCT=
Total Cycle Time
TCT equation
TCT= Ti+Te
Alarms are designed to
alert clinicians of potential dangers related to the pt ventilator
A sigh is a
deep breath that is part of the normal breathing pattern
ME is defined as
the movement of air in and out of the lungs
2 weaning parameters of neuromuscular disorders
- NIF
- Vital capacity
NPPV=
Noninvasive Positive Pressure Ventilation
NIV=
Noninvasive Ventilation
What is static compliance in: Men, Women, Children and Neonates?
- Men= 40 to 50
- Women= 35 to 45
- Children 40 to 50
- Neonates= 10 to 20
If Vt is low on CPAP what can we do to increase it
Pressure support
1 thing that increases static compliance
emphysema
PTV=
What are the modes of ptv
-Pressure-Targeted Ventilation;
- CPAP
- Pressure Support
- Spontaneous/ Time
ABG for respiratory failure (vent failure)
pH= <7.30
Paco2= >50
What are some indications (goals) for Mechanical Ventilation
- Ventilation status
- Oxygenation
- WOB
- Proactiveness
What are the different levels to alarms
- Blue= FYI
- Yellow= A little urgent, take a look
- Red=Urgent! Emergency
What are the goals for adjusting PSV
- To help increase Vt (4 to 8mL)
- To decrease RR (<30 breaths/min)
- To decrease the WOB associated w/ breathing thru an artificial airway
3 thing I may see if a pt is passing their SBT
- NIF= >-20
- RSBI= <105
- ME= 5 to 6 (<10)
Things I may see if a pt is failing their SBT
- BP drops
- RR increases (30-35)
- HrR increases
- Vt decreases below 250 to 350
