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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
Q

Where are the most alveoli located in the lungs?

A

in the bases

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26
Q

How does a Bipap machine work?

A

provides different levels of pressure during inhalation and exhalation

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27
Q

How does a Cpap work?

A

Provides continuous air pressure at a medically suggested level to treat various types of respiratory diseases

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28
Q

What pressure is the physiological normal for the lungs?

A

5cm H2O

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29
Q

How can a nurse reduce oropharyngeal bacteria and help prevent pulmonary infections?

A

provide suction toothbrushing Q12H, oral swabbing Q2H, and oropharyngeal sub-glottal suctioning Q6H

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30
Q

If the marked insertion point on an ET tube changes, what does this mean?

A

The ET tube has placement has changed

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31
Q

Why is it important to inspect positioning and stabilization of an ET Tube?

A

A change of position can obstruct airway or cause erosion and necrosis of tissue

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32
Q

Why is it important to anchor a client’s head while turning?

A

it will prevent the tube from becoming dislodged or the airway from becoming obstructed

33
Q

How often should an oral ETT be repositioned?

A

daily

34
Q

What should be documented when an ET Tube is placed?

A

size of ETT, position of ETT in relation to gum/lips, and position of ETT in relation to which side of the mouth

35
Q

What is the purposes of the ETT cuff?

A

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
Q

Are neonatal tubes cuffed or uncuffed?

A

uncuffed

37
Q

Why is it important to always suction when inspecting and cleaning the mouth of a patient that has an ET Tube?

A

it can cause ventilator associated pneumonia

38
Q

How often should patients be suctioned when they have an ET tube?

A

When you hear fluid in the lungs or you can see secretions

39
Q

Why is it important to not suction the ET tube too frequently?

A

you can damage the trachea and cause an excess buildup of mucous

40
Q

What are the two types of suctioning that can be done if the patient is on a ventilator?

A

closed suction system and open suction system

41
Q

What is one of the leading causes of death in the ICU setting?

A

Ventilator Associated Pneumonia

42
Q

What is included in the VAP bundle?

A

subglottic suctioning, oral care, ET tube rotation, GI prophylaxis, and nursing documentation

43
Q

What does the FiO2 need to be at for extubation?

A

around 30 so that other means of oxygenation can be used

44
Q

What are two main things that a patient needs to be able to do to protect their airway?

A

cough and gag

45
Q

What are 6 things to do to ensure oxygen delivery safety?

A

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
Q

What are the three modes of ventilation?

A

assist volume control, synchronous intermittent mandatory ventilation, and continuous positive airway pressure with pressure support

47
Q

What are the 5 most common ventilator settings?

A

RR, TV, FiO2, PS (pressure support), PEEP (Positive End-expiratory pressure)

48
Q

What is a normal TV?

A

approx. 5-8mL/kg

49
Q

What should FiO2 be maintained at?

A

below 50% to avoid oxygen toxicity

50
Q

What is the normal respiratory rate?

A

1 breath every 5 seconds (12 per minute)

51
Q

What is the normal PEEP range?

A

4-10cm H2O, occasionally 15-20

52
Q

What is a normal pressure support level?

A

between 5 (minimal support) and 30 (total support)

53
Q

What is a normal expiratory tidal volume?

A

ranges from 100-600mL depending on size and weight of the patient

54
Q

What is a normal peek inspired pressure?

A

25-30 cm H2O

55
Q

What are the 3 types of volume ventilation?

A

assist volume control, synchronous intermittent mandatory ventilation, and continuous positive airway pressure with pressure support

56
Q

What is the downside of increasing PEEP?

A

increase of thoracic pressure

57
Q

What is Peak Inspired Pressure?

A

How much pressure it takes to push one breath of air into the lungs

58
Q

If a patient has non compliant lungs, is the PIP higher or lower?

A

higher

59
Q

What happens with assist volume control?

A

delivers a preset RR and preset TV and each additional breath will be delivered a preset TV

60
Q

When is assist volume control used?

A

in patients with full ventilatory support

61
Q

Because there is no spontaneous breathing in assist volume control, there is also no ______ _______?

A

pressure support

62
Q

Does assist volume control allow for spontaneous breathing?

A

no

63
Q

What happens with synchronous intermittent mandatory ventilation?

A

has a preset RR and preset TV

64
Q

Ventilator breaths are _____ with pt’s respiratory effort?

A

synchronized

65
Q

When is synchronous intermittent mandatory ventilation utilized?

A

in patients that have some ability to breathe spontaneously but are not able to maintain an adequate minute ventilation

66
Q

Which mode is the most compatible mode for volume ventilation?

A

synchronous intermittent mandatory ventilation

67
Q

What does a continuous positive airway pressure with pressure support control?

A

The pressure of the breath, but the RR and TV are function of patient effort

68
Q

Why would CPAP with pressure support be used?

A

for patients that are breathing spontaneously and need to improve oxygenation

69
Q

What happens if the high pressure alarm sounds and the pressure cannot be controlled?

A

A hole can be blown in the lungs

70
Q

What can cause a high pressure alarm to sound?

A

mucous in the tube, pt biting on the ET tube, laying on the ET tube, etc.

71
Q

Why might a low pressure alarm sound?

A

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
Q

Why might a high RR alarm sound?

A

head trauma, neurogenic trauma, atelectasis

73
Q

Why might a low exhaled volume alarm sound?

A

leak from a chest tube or leak around ET tube (balloon cuff leak)

74
Q

How does pressure support help wean a patient?

A

decrease work of breathing and boost the inhalation

75
Q

How is minute volume calculated?

A

all volumes inspired in one minute

76
Q

Why is it important to deliver humidified oxygen to a patient after intubation?

A

reduces risk of stridor

77
Q

The low pressure alarm on you pts ventilator is triggered. You cannot find a disconnection in the system. Your next action is to:

A

Manually bag the patient until the cause is determined.

78
Q

Which clinical situation requires mechanical ventilation?

A

A patient in respiratory arrest.
Patients who have both respiratory and cardiac failure
Patients with brain injuries

79
Q

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?

A

false

NURS 470 (33 decks)

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