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Fundamentals II > Lecture Final > Flashcards

Lecture Final Flashcards

1
Q

What are the 2 Pharyngeal Airways

A

Nasopharyngeal and Oropharyngeal

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2
Q

What’s the size ranges for nasopharyngeal airways

A

6 for adult women
7 for adult male

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3
Q

Why do we use a nasopharyngeal airway

A
  • frequent suctioning
  • facilitate ventilation
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4
Q

If the nasopharyngeal airway is too short then it cannot separate the soft palate from the posterior

A

wall of the pharynx

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5
Q

If the nasopharyngeal is to long it may enter the

A

larynx, causing laryngeal reflexes or enter the space between the epiglottis and vallecular, leading to a potential obstruction

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6
Q

How do you measure a nasopharyngeal tube?

A

earlobe to the tip of the nose

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7
Q

How do you insert a nasopharyngeal airway

A

Parallel to the nasal floor, beveled edge towards the septum w/ water soluble lube

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8
Q

What are some contraindications with nasopharyngeal airways?

A
  • nose bleed
  • infection
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9
Q

How do we keep the nasopharyngeal from sliding out

A

safety pin

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10
Q

Nasopharyngeal airways should be restricted for what type of pts?

A

semi conscious

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11
Q

Oropharyngeal airways should be restricted to what type of pts? And why?

A

unconscious, to prevent gagging and aspiration

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12
Q

2 types of oropharyngeal airway

A
  • Berman
  • Geudel
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13
Q

Geudel has a

A

single center channel

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14
Q

Berman uses a

A

2 sided channel

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15
Q

How do we insert oropharyngeal airway

A

upside down and flip it around

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16
Q

Why do we use an oropharyngeal airway?

A
  • to prevent airway obstruction
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17
Q

If Oropharyngeal airway is to small it may not

A

clear the tongue

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18
Q

If it is to large it can push the

A

epiglottis against the larynx

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19
Q

If the oral airway is protruding out of the mouth what do we do?

A

Take it out and replace it

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20
Q

Esopharyngeal- Tracheal Combitube (ETC) may be inserted into the

A

esophagus or trachea

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21
Q

Combitube is inserted

A

blindly

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22
Q

ETC is also called a

A

Double- Lumen airway

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23
Q

Endotracheal Tube is inserted in the

A

trachea

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24
Q

What are some parts of an ETT

A
  • cuff
  • pilot ballon
  • pt end
  • machine end
  • markings
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25
Q

Laryngeal Mask Airways (LMA’s) airway pressure is____ and cuff pressure is ____

A

airway= 20
cuff pressure= 60

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26
Q

How many times can a LMA be autoclaved?

A

up to 40 times

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27
Q

Does LMA prevent from aspiration?

A

No

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28
Q

Contraindications of LMAs

A
  • does not prevent from aspiration
  • should not be used on conscious pts
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29
Q

If we need a lower airway resistance (Raw) with ETT what do we need to use?

A

bigger ETT

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30
Q

What is the most common problem of why a pt may need an airway?

A

Tongue falling backwards

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31
Q

What are some Indications for airways? (4)

A
  • airway protection (risk for aspiration)
  • support of ventilation
  • suctioning (coupies amounts of secretions)
  • MV
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32
Q

What position do we put pts before intubating them?

A

Sniffers position
(flexion of cervical spine)

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33
Q

Why do use a Tracheostomy Tube for an airway?

A
  • Long-term airway
  • If nasal or oral is not available
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34
Q

When inserting a Tracheostomy for the first time what has to be in the trache? and why?

A

Obturator
To reduce trauma to mucosa

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35
Q

What do we keep at the bedside for traches?

A

Same size obturator and one size smaller

36
Q

What is considered Respiratory Failure on ABG?

A

pH: <7.30
paCo2: >50
Pao2: <60

37
Q

Why would a pt need to be on mechanical ventilation?

A
  • Apnea
  • Refractory Hypoxemia
  • Respiratory failure
  • Impending Respiratory failure
  • Increased WOB
  • Inadequate alveolar ventilation
38
Q

When the pt needs the vent to do all the work for them, what is that called? And what mode do we use for this?

A

Full vent support (CMV)

39
Q

What are some examples of partial vent support?

A
  • SIMV
  • IMV
40
Q

SIMV (2)

A
  • Pts can breathe in between mandatory breaths but won’t allow breath stacking
  • Used as a weaning mode
41
Q

With CPAP mode the pt is…..
What are we setting on CPAP mode?

A
  • doing all the WOB on their own
    (we only set PEEP, Pressure support and FIO2)
42
Q

IMV

A

Pts can breathe in between mandatory breaths, however does not prevent breath stacking

43
Q

What does trigger a breath mean

A

starting a breath

44
Q

Examples of triggering

A
  • pt
  • flow
45
Q

What does cycling a breath mean?

A

ending a breath

46
Q

Examples of cycling

A
  • time
  • pressure
47
Q

What are some modes of ventilation?

A
  • SIMV
  • IMV
  • CMV
  • PSV
  • CPAP
  • VC- CMV
  • PC- CMV
48
Q

What is the equation for Ideal BodyWeight for Male and Female

A

M: 106+6(H-60)/ 2.2
F: 105+5(H-60)/ 2.2

49
Q

What are the initial vent settings

A

Vt= 6 to 8
RR= 10 to 20
Fio2 = >50
PEEP=5
Pressure Support=5

50
Q

What are the vent settings for ARDS

A

Vt= 4 to 6
RR= 15 to 25
PEEP= high
Fio2= high

51
Q

As airflow resistance increases, what happens to the pv loop?

A

the pv loop widens

52
Q

If a vent is in a volume control mode, what was set?

A

a preset volume

53
Q

If vent is in a pressure control mode, what was set?

A

preset pressure and the pt can breathe their own Vt

54
Q

What is the Peak inspiratory pressure (PAW) alarm set to

A

10 above PIP

55
Q

What is the apnea alarm set to?

A

20 seconds

56
Q

On the vent what settings can we use to fix the blood gas if a pt is in Respiratory Acidosis (High CO2)?

A

Increase RR
Increase Vt

57
Q

What settings can we use on the vent to fix the blood gas if a pt is in Respiratory Alkalosis ( Low Co2)?

A

Lower the RR
Lower the Vt

58
Q

What are the weaning parameters? (4)

A
  • RSBI: <105
  • NIF: >-20
  • VC: >15
  • P100: 0 to -2
59
Q

How do we have a pt perform a VC?

A

Blow all their air out and the next deep breath in is their VC

60
Q

How does a pt perform a NIF?

A

Deep breath in and hold it

61
Q

What is the RSBI equation

A

RR/VT

62
Q

ME should be

A

less than 10

63
Q

If a pt’s ME is greater than the normal value, what does this mean?

A

The WOB is increased. The pt is working to hard to breathe

64
Q

What is the ME equation?

A

ME= VT x F

65
Q

What is a normal ME?

A

5 to 6

66
Q

Does a pt have to meet all the weaning parameters to pass SBT?
How fast we can wean a pt depends on?

A

No;
the protocol set

67
Q

What is the dead space equation

A

paco-peco/paco

68
Q

If a pt is intubated b/c of airway protection or surgery can they be weaned quickly?

A

yes

69
Q

What pt population will take a longer time to be weaned from MV?

A
  • COPD
  • Static Asthmatic
70
Q

What is weaning success?

A

The pt successfully passed SBT and can spontaneously breathe w/o the need for reintubation

71
Q

What is weaning failure?

A

Failure of SBT or the need for reintubation

72
Q

If the loop is shifting towards a pressure access, towards increased PIP what is happening to compliance as the airway pressure gets higher? Which means?

A

decrease compliance; the lungs become less compliant

73
Q

B/c of widening of the plvloop decrease of compliance causes an

A

increased airway resistance

74
Q

As the pvloop gets smaller, compliance is

A

increased

75
Q

Increased compliance in pv loop means

A

decrease airflow resistance

76
Q

What causes airway resistance in a pt (3)

A
  • secretions
  • tube size
  • dead space
77
Q

Can higer tidal volumes cause an increase PIP?

A

yes

78
Q

What can we do if a pt has an increased PIP?

A

suction

79
Q

What can cause a high pressure alarm to go off?

A
  • Pt coughs
  • secretions
  • kinks in tube
80
Q

What can cause a low pressure alarm to go off?

A
  • Leaks in circuit tubing
  • pt disconnection
81
Q

What does proning help with?

A

oxygenation

82
Q

If the tidal volume is low on CPAP mode what can we do to increase Vt?

A

Increase pressure support

83
Q

The difference between IPAP and EPAP is

A

pressure support

84
Q

What are some NIV

A
  • CPAP
  • BiPAP
85
Q

What can decrease static compliance?

A
  • Tension pneumothorax
  • air trapping
86
Q

What can increase static compliance?

A

emphysema

Fundamentals II (13 decks)

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