Modes of Ventilation Flashcards
(50 cards)
What is endotracheal intubation used for?-5
- maintain an airway
- remove secretions
- prevent aspiration
- provide mechanical ventilation
- bypasses the patient’s normal protective airway mechanisms
What is the endotracheal tube cuff used for?
- prevents air leaks around the tube
- prevents aspiration
- ensures ventilator is 100% responsible for patient ventilation
What needs to happen to the balloon before extubating
deflate the balloon!!
How to Verify placement of ETT tube (5) and what to do after it is verified (2)
- ETCO2 detector (checks CO2 levels, makes sure the tube is in the trachea and not the esophagus)
- auscultate chest and epigastric area
- confirm bilateral breath sounds
- obtain an order for CXR for placement verification and documentation
- CXR –> shows it is 3-4 cm above carina
- secure tube when placement is verified
- record cm at lip line for reference
ETT nursing care: airway patency -4
- suction as needed- max pressure 120 mmHg (air way patency is priority)
- maintain and secure tubing with holder
- monitor and chart cm at the lip line
- monitor CXR for correct placement
Indications for tracheostomy-5
- long-term mechanical ventilation
- frequent suctioning
- protecting the airway
- bypass an airway obstruction
- reduce WOB
Indications for ventilation- 3
- hypoxemia (PaO2 < 60mmHg on FiO2 > 0.5)
- hypercapnia (PCO2 > 50mmHg with pH < 7.25)
- progressive deterioration (increased RR, decrease VT, increase WOB)
What needs to be in the patients room at all times?
manual resuscitation bag (ambu bag)
What is PEEP?
pressure applied by the vent at the end of each breath allowing alveoli to remain open
PEEP –> What does it do? pressure ranges
- recruits open alveoli in sick lung and improves oxygenation and max gas exchange can happen
- 5-20cm H2O
complication of PEEP
-may increase intracardiac pressure (decrease venous return and CO) MONITOR FOR DECREASED CO
What does PIP do?
maximum pressure is applied to lungs during inhalation
V-AC (volume) –> who triggers support
patient triggered support –> pt initiated breaths
What does V-AC do?
delivers specific volume, but back up respiratory rate
What is CMV?
continuous mandatory ventilation –> ventilator provides 100% respiratory effort and quality
What is P-A/C?
pressure control or assist ventilation
What happens in P-A/C?
patient triggered support –> delivers specific pressure with a backup respiratory rate
in P-A/C, what does volume get based on?
lung compliance –> decreased compliance leads to decreased volume in the lungs
What is the alarm set for in P-A/C?
volume
What is the alarm set for in VAC?
increased pressure
What disease process if P-A/C typically used for?
ARDS
Why isn’t volume control used in ARDS?
volume control may increase inflammation
ventilator settings for ARDS
- pressure control ventilation
- PEEP for alveoli recruitment (12-14)
- lower tidal volume
- monitor hemodynamics/CO
- alarm set for volume
What is pressure support?
aid for mechanical ventilation –> keeps the entire lung open, not just alveoli
