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NURS 470 > Mechanical Ventilation > Flashcards

Mechanical Ventilation Flashcards

1
Q

What do crackles indicate in the lung?

A

fluid

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2
Q

What does ATRIA stand for when talking about early symptoms of hypoxia?

A

Anxiety, Tachycardia, Restlessness, Irritability, and Apprehensive

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3
Q

What are the late symptoms of hypoxia?

A

Seizures, Coma, Cyanosis, Loss of consciousness

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4
Q

How many liters of oxygen can a nasal cannula administer per minute?

A

1-6L

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5
Q

How many liters of oxygen can a high flow nasal cannula administer per minute?

A

up to 60L

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6
Q

What is a common disease process that causes crackles in the lungs?

A

pneumonia

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7
Q

What is a pulse ox best used for?

A

to follow trends

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8
Q

What is the definitive way to test pulmonary function?

A

Obtain an ABG

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9
Q

What is the pneumonic used to identify early symptoms of hypoxia?

A

ATRIA (Anxiety, Tachycardia, Restlessness, Irritability, and Apprehensive)

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10
Q

Where might cyanosis first be seen?

A

sublingually and around the mouth

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11
Q

What is the critical O2 value for ICU patients?

A

90

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12
Q

What does a simple face mask prevent?

A

CO2 rebreathing

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13
Q

What is the flow of oxygen for a simple face mask?

A

8-12L/min

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14
Q

What is the flow for a Venturi mask?

A

4-10L/min

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15
Q

What is a large benefit of utilizing a Venturi mask?

A

You can titrate the FiO2 accurately

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16
Q

How does a non rebreather mask work?

A

has one-way valves to prevent exhaled air from returning to the bag

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17
Q

When is a non rebreather mask used?

A

for rapid desaturation

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18
Q

What is the flow rate of a non rebreather mask?

A

10-15L/min

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19
Q

When can a non-rebreather mask be used?

A

During codes and if a patient rapidly goes down to less than 90% O2

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20
Q

What happens if a patient is consistently receiving FiO2 greater than 60%?

A

It will burn the epithelial cells within the lungs and damage the lungs

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21
Q

If blood pressure and oxygen begin to go down at the same time, which issue takes priority?

A

Blood pressure

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22
Q

When is Bipap normally used?

A

CHF, Neuromuscular diseases, and COPD

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23
Q

How high should you raise the bed if you are trying to ensure proper oxygenation in a patient?

A

HOB elevated to 45 degrees

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24
Q

When is a Cpap used?

A

moderate to severe sleep apnea

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25
Where are the most alveoli located in the lungs?
in the bases
26
How does a Bipap machine work?
provides different levels of pressure during inhalation and exhalation
27
How does a Cpap work?
Provides continuous air pressure at a medically suggested level to treat various types of respiratory diseases
28
What pressure is the physiological normal for the lungs?
5cm H2O
29
How can a nurse reduce oropharyngeal bacteria and help prevent pulmonary infections?
provide suction toothbrushing Q12H, oral swabbing Q2H, and oropharyngeal sub-glottal suctioning Q6H
30
If the marked insertion point on an ET tube changes, what does this mean?
The ET tube has placement has changed
31
Why is it important to inspect positioning and stabilization of an ET Tube?
A change of position can obstruct airway or cause erosion and necrosis of tissue
32
Why is it important to anchor a client's head while turning?
it will prevent the tube from becoming dislodged or the airway from becoming obstructed
33
How often should an oral ETT be repositioned?
daily
34
What should be documented when an ET Tube is placed?
size of ETT, position of ETT in relation to gum/lips, and position of ETT in relation to which side of the mouth
35
What is the purposes of the ETT cuff?
Occlude the trachea from the atmosphere, so that the only gas exchange that is getting into the lungs is the air that is being administered
36
Are neonatal tubes cuffed or uncuffed?
uncuffed
37
Why is it important to always suction when inspecting and cleaning the mouth of a patient that has an ET Tube?
it can cause ventilator associated pneumonia
38
How often should patients be suctioned when they have an ET tube?
When you hear fluid in the lungs or you can see secretions
39
Why is it important to not suction the ET tube too frequently?
you can damage the trachea and cause an excess buildup of mucous
40
What are the two types of suctioning that can be done if the patient is on a ventilator?
closed suction system and open suction system
41
What is one of the leading causes of death in the ICU setting?
Ventilator Associated Pneumonia
42
What is included in the VAP bundle?
subglottic suctioning, oral care, ET tube rotation, GI prophylaxis, and nursing documentation
43
What does the FiO2 need to be at for extubation?
around 30 so that other means of oxygenation can be used
44
What are two main things that a patient needs to be able to do to protect their airway?
cough and gag
45
What are 6 things to do to ensure oxygen delivery safety?
no smoking, fire retardant gown, remove any devices which may start a flame, remove friction-type or battery-operated equipment, properly ground all electrical equipment, remove volatile and flammable materials
46
What are the three modes of ventilation?
assist volume control, synchronous intermittent mandatory ventilation, and continuous positive airway pressure with pressure support
47
What are the 5 most common ventilator settings?
RR, TV, FiO2, PS (pressure support), PEEP (Positive End-expiratory pressure)
48
What is a normal TV?
approx. 5-8mL/kg
49
What should FiO2 be maintained at?
below 50% to avoid oxygen toxicity
50
What is the normal respiratory rate?
1 breath every 5 seconds (12 per minute)
51
What is the normal PEEP range?
4-10cm H2O, occasionally 15-20
52
What is a normal pressure support level?
between 5 (minimal support) and 30 (total support)
53
What is a normal expiratory tidal volume?
ranges from 100-600mL depending on size and weight of the patient
54
What is a normal peek inspired pressure?
25-30 cm H2O
55
What are the 3 types of volume ventilation?
assist volume control, synchronous intermittent mandatory ventilation, and continuous positive airway pressure with pressure support
56
What is the downside of increasing PEEP?
increase of thoracic pressure
57
What is Peak Inspired Pressure?
How much pressure it takes to push one breath of air into the lungs
58
If a patient has non compliant lungs, is the PIP higher or lower?
higher
59
What happens with assist volume control?
delivers a preset RR and preset TV and each additional breath will be delivered a preset TV
60
When is assist volume control used?
in patients with full ventilatory support
61
Because there is no spontaneous breathing in assist volume control, there is also no ______ _______?
pressure support
62
Does assist volume control allow for spontaneous breathing?
no
63
What happens with synchronous intermittent mandatory ventilation?
has a preset RR and preset TV
64
Ventilator breaths are _____ with pt's respiratory effort?
synchronized
65
When is synchronous intermittent mandatory ventilation utilized?
in patients that have some ability to breathe spontaneously but are not able to maintain an adequate minute ventilation
66
Which mode is the most compatible mode for volume ventilation?
synchronous intermittent mandatory ventilation
67
What does a continuous positive airway pressure with pressure support control?
The pressure of the breath, but the RR and TV are function of patient effort
68
Why would CPAP with pressure support be used?
for patients that are breathing spontaneously and need to improve oxygenation
69
What happens if the high pressure alarm sounds and the pressure cannot be controlled?
A hole can be blown in the lungs
70
What can cause a high pressure alarm to sound?
mucous in the tube, pt biting on the ET tube, laying on the ET tube, etc.
71
Why might a low pressure alarm sound?
usually due to a disconnect or tubing has come apart, or there is a massive air leak (i.e. air leaking from chest tube)
72
Why might a high RR alarm sound?
head trauma, neurogenic trauma, atelectasis
73
Why might a low exhaled volume alarm sound?
leak from a chest tube or leak around ET tube (balloon cuff leak)
74
How does pressure support help wean a patient?
decrease work of breathing and boost the inhalation
75
How is minute volume calculated?
all volumes inspired in one minute
76
Why is it important to deliver humidified oxygen to a patient after intubation?
reduces risk of stridor
77
The low pressure alarm on you pts ventilator is triggered. You cannot find a disconnection in the system. Your next action is to:
Manually bag the patient until the cause is determined.
78
Which clinical situation requires mechanical ventilation?
A patient in respiratory arrest. Patients who have both respiratory and cardiac failure Patients with brain injuries
79
A patient is on CPAP, 40% FIO2, Peep of 10 and pressure support of 15 has a respiratory rate of 40, and is diaphoretic. This patient is a perfect candidate for extubation? True or False?
false

NURS 470 (33 decks)

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