Mechanical Ventilation Flashcards
What is the FIO2
Fraction of inspired oxygen (concentration of O2 the pt is to receive)
Tidal volume
Amount of air the ventilator has been set to deliver to the pt with each ventilator breath
Respiratory rate
Number of positive pressure breaths the ventilator delivers per minute
Continuous mechanical ventilation (CMV)
Standard mode of mechanical ventilation
Ventilator delivers preset tidal volume and RR.
No allowance for spontaneous breaths.
Ventilator not responsive to client (can lead to agitation and asynchrony)
Assist/control ventilation (A/C)
Standard mode of mechanical ventilation
Spontaneous inspiratory effort of client triggers ventilator to deliver preset today volume.
If client does not trigger an assisted breath, ventilator delivers breaths at preset RR.
Intermittent mandatory ventilation (IMV)
Standard mode of mechanical ventilation
Ventilator delivers preset tidal volume and RR
Client can take unassisted spontaneous breaths between preset breaths.
“Stacking” can occur when voluntary and preset breaths occur simultaneously
Synchronized intermittent mandatory ventilation (IMV)
Standard mode of mechanical ventilation
Similar to IMV except preset ventilator breaths are synchronized with client’s spontaneous breaths to avoid “stacking”.
Can develop “stacking” of breaths and asynchrony
PEEP
Positive end-expiratory pressure
Preset amount of pressure stays in lungs at *end of exhalation, keeping alveoli open.
Used in conjunction with a standard mode of ventilation
Continuous positive airway pressure (CPAP)
Similar to PEEP but for clients who breathe entirely on own
*Keeps airway open all the time
Pressure support ventilation (PSV)
Client breathes spontaneously, but ventilator provides a preset level of pressure assistance with each spontaneous breath on *inspiration only
NI for increased secretions in airways or mucous plug
Suction as needed
NI for client coughing, gagging, or biting oral ET tube
Insert oral airway to prevent biting on the ET tube
NI for anxious client who is fighting the ventilator
Provide emotional support to decrease anxiety
Increase flow rate
Explain all procedures
Provide sedation or paralyzing agent as ordered
NI for airway size decreases related to wheezing or bronchospasm
Auscultate breath sounds
Consult with physician for management of bronchospasm
NI for pneumothorax
Auscultate breath sounds
Consult with physician about a new onset of decreased breath sounds or unequal chest excursion, which may be due to pneumothorax
NI for artificial airway is displaced (ET tube may have slipped into right mainstream bronchus)
Assess chest for unequal breath sounds and chest excursion
Obtain chest X-ray film as ordered to evaluate position of ET tube
After proper position if verified, tape the tube securely in place
NI for obstruction in tubing because client is lying on tubing or there is water or a kink in tubing
Assess the system, moving from the artificial airway toward the ventilator
Empty water from the ventilator tubing and remove any kinks
NI for increased PIP associated with deliverance of a sigh
Consult with respiratory therapist or physical to adjust the pressure alarm
NI for decreased compliance of the lung is noted or a trend of gradually increasing PIP noted over several hours or a day
Evaluate the reasons for the decreased compliance of the lungs
(Increase in PIP occurs in ARDS, pneumonia, or any worsening of pulmonary disease)
NI for a leak in ventilator circuit which prevents breath from being delivered
Assess all connections and all ventilator tubings for disconnection
NI for client stops spontaneous breathing in the SIMV or CPAP mode or on pressure support ventilation
Evaluate the client’s tolerance of the mode
NI for a cuff leak occurs in th ET or tracheostomy tube
Evaluate the client for a cuff leak (suspected when the client is able to talk b/c air escapes from mouth or when the pilot balloon on the artificial airway is flat)
