Mechanical Ventilation & Moderate Sedation (Week 2) Flashcards
What is the goal when administering oxygen as a medication?
Mechanical Ventilation
administer the lowest possible level to achieve a satisfactoroy PaO2 or SaO2
How many liters should a nasal canula run at?
Mechanical Ventilation
1 - 6 L per minute
(28 - 44% O2)
How many liters should a high flow nasal cannula run at?
Mechanical Ventilation
up to 60 liters per minute
delivers up to 100% heated & humidified O2
positive pressure helps open alveoli for gas exchange
What is unique about a High Flow Nasal Cannula?
It has positive pressure which helps to open alveoli for gas exchange
PEEP: Positive End-Expiratory Pressure
What type of oxygen therapy is the most accurate / precise?
Mechanical Ventilation
Venturi Mask
What is unique about a Venturi Mask?
Mechanical Ventilation
Most Accurate method of O2 delivery
- used for patients with COPD
How many liters should a non-rebreather bag be set at? What is unique about a non-rebreather bag?
Mechanical Ventilation
10 - 15 liters per minute
- Delivers up to 100% O2 – highest delivery O2 using low flow O2
Nursing Management of Oxygen Therapy
Mechanical Ventilation
Ensure O2 is being administered as ordered
* confirm device is properly positioned
* Replace if it’s dislodged
* Monitor O2 saturation w/ pulse ox
* Transport patient with O2
Observe for complications of therapy
What does it mean if the bands shift to the left in terms of labs?
There is a large grouping or number of immature neutrophils (immature WBCs)
Over time these will help people fight off infections
Memory Trick to Interpret ABGs
Mechanical Ventilation
Respiratory Opposite – pH & CO2 arrows move in opposite directions
Metabolic Equal – pH & CO2 arrows move in same direction
What are the normal ranges for pH, PaCO2, HCO3?
What are the normal ranges for paO2 & O2 Sat or SaO2?
KNOW THIS!!!!!!
pH: 7.35 - 7.45
PaCO2: 35 - 45
HCO3: 22 - 26
- PaO2: 75 - 100
- SaO2: 95 - 100%
Describe the pH, PaCO2, & HCO3 in respiratory acidosis
Mechanical Ventilation
pH: low
PaCO2: HIGH
HCO3: normal
Describe the pH, PaCO2, & HCO3 in respiratory alkalosis
Mechanical Ventilation
pH: HIGH
PaCO2: low
HCO3: normal
Describe the pH, PaCO2, & HCO3 in metabolic acidosis
Mechanical Ventilation
pH: low
PaCO2: normal
HCO3: low
Describe the pH, PaCO2, & HCO3 in metabolic alkalosis
Mechanical Ventilation
pH: HIGH
PaCO2: normal
HCO3: HIGH
What happens to the pH during acidosis vs. alkalosis?
Mechanical Ventilation
acidosis = low pH
ALKALOSIS = HIGH pH
Does the PaCO2 or HCO3 change during resipratory acidosis / alkalosis?
Mechanical Ventilation
PaCO2 changes
HCO3 = normal
Does the PaCO2 or HCO3 change during metabolic acidosis / alkalosis?
Mechanical Ventilation
PaCO2 = normal
HCO3 changes
What is the purpose of mechanical ventilation & when is it indicated?
Mechanical Ventilation
Replace or assists with respirations
Indications: apnea & ineffective breathing
What is the difference in Non-Invasive & Invasive mechanical ventilation?
Mechanical Ventilation
Non-Invasive: = BiPap
* positive airway pressure
* keeps alveoli open
* patient MUST be mentally oriented
Invasine = intubation
* endotrachial tube (ETT) is inserted through nose or mouth (can be left in for several weeks)
In what circumstance would you avoid doing endotracheal intubation (invasive mechanical ventilation) If endotracheal intubation cannot be used, what should be done?
Oral Trauma
Unable to intubate orally then you should intubate nasally unless you are concerned that the patient might have facial fractures
What are patients who are nasally intubated at a higher risk for?
Sinus infection