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B C I T / C C P > Mechanical Vent Review > Flashcards

Mechanical Vent Review Flashcards

1
Q

What are the differences between normal and mechanical ventilation?

A

Normal: negative pressure, intrapleural, pulmonic and thoracic pressure becomes negative.

Mechanical vent: positive pressure, intrapleural remains negative but intrapulmonic becomes positive as well as intrathoracic

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2
Q

Whatare two physiological effects of mechanical ventilation?

A

1:decreased venous return due to increased intrathoracic pressure (decreased preload

2:mechanical ventilation will falsely increase cvp values.

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3
Q

Types of respiratory failure

A

Type 1: hypoxic( gas exchange)
Type 2: hypercapnia (ventilation)

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4
Q

4 physiological reasons for mechanical ventilation

A

Support alveolar ventilation,support gas exchange, increase lung volume, reduce WOB

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5
Q

Endotracheal intubation indications

A

Failure to oxygenate, ventilate, maintain/protect, clinical progression.
ET tubes are for short-med timeframe, Trach is for long term.

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6
Q

Define flow

A

Volume moving across time

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7
Q

Mechanical ventilation is made Up of 3 components, what are they?

A

Flow, volume, pressure

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8
Q

What is the relationship between volume and pressure?

A

Volume and pressure are inseparable, an increase in volume results in increased pressure

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9
Q

How does flow relate to volume and pressure?

A
  • Flow is volume moving across time, flow creates volume, and volume creates pressure.within a space.
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10
Q

What are 3 major goals of mechanical ventilation?

A

Decrease WOB, support/optimize oxygenation and ventilation, balance pH

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11
Q

What are 4 things a vent cannot do for a pt.

A

A vent cannot… Assist w/cellular gas exchange, aid transport of gases, influence cellular uptake, force pt to exhale (asthma)

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12
Q

What are the 4 modes of classic ventilation.

A

Assist /control mode, synchronized intermittent mandatory ventilation (simv), pressure control, pressure support

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13
Q

What is a controlled breath?

A

A breath that is completely controlled by the ventilator. The patient does nothing.

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14
Q

What is an assisted breath?

A

The vent senses a change inpressure or flow, this is a triggered breath. When sensed a breath is delivered.

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15
Q

When volume is a set perimeter, what will vary ?

A

Pressure will vary

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16
Q

When pressure is a set parameter, what will vary?

A

Volume will vary

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17
Q

Define assist control parameters.

A

RR + vt are set, pressure will vary, peep is an adjunct. Pt can initiate additional breaths

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18
Q

Define SIMV + parameters

A

Combination of A/C and spontaneous breathing.

The vent will delivery mandatory set breathes with set vt in coordination with the patients own breaths.

.set parameters include: RR sync with pt., tidal volume, pressure support to help pt initiated breaths.

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19
Q

Define pressure controlled ventilation + set perameters

A

The vent will deliver a set number of breaths per min until a set pressure is reached. This is a time cycled, pressure limited mode of ventilation. Volume will vary.

Set parameters include pressure control, rr, inspiratory time.

20
Q

What components make up the i:e ratio?

A

RR+ i-time

21
Q

Define pressure Support + perameters

A

Adjunct not a mode of ventilation. PSV provides an inspiratory boost to spontaneously breathing patients.

Set parameters are pressure (5-20 cmh2o)peep

22
Q

How is Vtcalculated?

A

Based on ideal body weight (6 -8ml/kg)

ARDS 4-8ml/kg

23
Q

Define peak-flow

A

The speed of gas flowing from the machine and into the lungs. Measured in litres / min. Not monitored.

24
Q

What is the preferred airway for patients requiring long term ventilatory support

A

Tracheostomy

25
Q

What is the most common airway adjunct for short to medium term ventilation ?

A

Endotracheal intubation

26
Q

The section circled on the endotracheal tube is the end that

A

Attaches to the ventilator tubing

27
Q

What is the function of the circled area on an endotracheal tube?

A

The cuff inflation port

28
Q

What should ETT cuff pressures be maintained at?

A

20-25mmHg pressure

29
Q

Nursing responsibilities during intubation include

A

Monitoring and supporting the patient and administering medications

30
Q

Medications typically given during RSI

A

Analgesic, sedative, paralyzing agent

31
Q

How long should each ETI attempt be limited to

A

30 seconds

32
Q

When viewed on CXR, how many cm above the carina should the ETT be?

A

3-4cm

33
Q

After ETI is complete and confirmed with ETCO2, what 3 tasks should be completed?

A

-cm at the teeth
-secure ETT
-Document

34
Q

What four values does the ventilator use to determine when inspiration should end?

A

-time
-flow
-pressure
-volume

35
Q

What is the variable that initiates change from exhalation to inspiration?

A

Trigger

36
Q

For a patient in volume control, which changes to the ventilator will reduce PaCO2?

A

Increase in RR or Vt

37
Q

For a patient on pressure control ventilation, which of the following changes to vent settings would reduce PaCO2

A

Increase set pressure

38
Q

Increasing PEEP on a ventilatory does what to the body?

A

Increases baseline intra thoracic pressure and decreases venous return

39
Q

How will mechanical ventilation impact the GI system?

A

-increases the risk for gastric ulceration
-increases the risk for gastric distension

40
Q

When does absorption atalectasis occur?

A

When the FiO2 is close to 1.0

41
Q

In practice, how are the adverse effects of high concentrations of oxygen minimized?.

A

The use of PEEP, using the minimal amount of fio2 possible

42
Q

How frequently should a patients readiness to be weaned be assessed?

A

Everyday

43
Q

What parameters are used for the RSBI (Rapid shallow breathing index)

A

RR/Vt

44
Q

Ability to obey commands is an essential part of the criteria indicating a patients readiness to wean

True or False

A

FASLE.

Ability to obey commands is not part of essential criteria.

45
Q

For the long term ventilated patient, weaning is complete after how many hours of spontaneous breathing.

A

24hours

46
Q

Minimizing dead space is achieved by

A

Optimizing cardiac output

47
Q

In type 1 respiratory failure. How can oxygen supply be improved?

A

-increasing driving pressure
-decreasing V/Q mismatching
-reducing system effects of hypoxia

B C I T / C C P (8 decks)

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