Pulmonary Management Flashcards

1
Q

Simple Mask

A

used for short-term O2 therapy
contraindicated for those w/ CO2 retention
Difficult to talk/eat w/ mask in place
Low Flow: 6-10L/min = 35-60%

Need a MINIMUM OF 5L FLOW to flush out the CO2
CAN NOT wean to lower than 5L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Partial Rebreather Mask

A

contains reservoir bag allowing pt to rebreathe some of own exhaled air mixed w/ 100% O2
Low Flow: 6-10L/min = 40-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-rebreather Mask

A

Provides highest concentration of O2 with a mask to a spontaneously breathing patient. HAS TWO ONE-WAY VALVES preventing rebreathing of exhaled air.
Low Flow: 6-15L/min = 60-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Venturi Mask

A

delivers the most precise concentrations of O2 via a large tube w/ an O2 inlet

High flow: 4-10L/min = 24-55%
Ideal for patients with mod hypercarbia, hypoxemia, COPDr’s. No need to humidify

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Air Entrainment Mask

A

high humidity mask or face tent provides excellent humidification and oxygen from 28-100%, if kept in place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Optiflow

A

Hi flow device
special N/C prongs
delivers 5-60L/min of O2 21-80% O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pharngeal Airways

A

stop tongue from obstructing upper airway

  1. oropharyngeal airway
  2. nasopharyngeal airway (nasal trumpet)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Oropharyngeal airway

A

creates an air passage way between the mouth and the posterior pharyngeal wall

useful when the tongue and/or epiglottis fall back against posterior pharynx in anesthetized or unconscious patients obstructing the flow of air

insert the oral airway upside down until the soft palate is reached. Rotate the device 180 degrees and slip it over the tongue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nasopharyngeal Airway

A

tube inserted through a nostril, across the floor of the nose and through the nasopharynx so that the tongue doesn’t block air flow in an unconscious person.
Purpose of the flared end is to prevent the device from becoming lost inside the patient’s head
Lubricate on insertion; used for suctioning; never leave in place can lead to sinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Volume controlled ventilation

A

pre-set tidal volume (approx 10ml/kg); VT is constant for every breath delivered

assist controlled (AC)
Synchronized intermittent mandatory ventilation (SIMV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pressure controlled ventilation

A

preset inspiratory and expiratory pressures
inspiratory pressures are constant for each breath

CPAP, pressure support, pressure control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

continuous mandatory ventilation

A

CMV or AC (assist control)
we set vent to deliver a preset amount of tidal volume for each breath

pre-set: FIO2/VT/RR/PEEP
patient may over breathe, but they will get the preset VT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Intermittent mandatory ventilation

A

IMV or SIMV
preset VT and RR on vent; pt may take own breaths at their own VT

PS is added to this to support the breaths the patient takes on their own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pressure Support

A

preset pressure to assist with patient’s inspiratory
- inspiratory pressure is added to spontaneous breaths to overcome the resistance of the endotracheal tube or to increase the volume of spontaneous breaths (overcomes the “dead space” of the ventilator)

Pt takes own RR/VT
typically weaning mode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

pressure controlled ventilation

A

delivers preset pressure during a preset inspiratory time at a preset respiratory rate
used in stiff noncompliant lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

High frequency oscillatory ventilation

A

does not require breaths therefore prevention “stretch injury” delivers a small volume of gas at a rapid rate

17
Q

high frequency ventilation

A

delivers small volume of gas at a rapid rate
high frequency positive pressure ventilation (HFPPV) delivers 60-100 breaths/min
high frequency jet ventilation (HFJV) delivers 100-600 cycles/min
high frequency oscillatory ventilation (HFO) delivers 900-3000 cycles/min

18
Q

volumetric diffuse respirator (VDR)

A

intrapulmonary percussive ventilation IPV with sub tidal volume deliveries

frequency of 50-900 cycles/min

19
Q

PIP-Peak Inspiratory Pressure

A

highest level of pressure applied to the lungs during inhalation

20
Q

positive end-expiratory pressure (PEEP)

A

positive pressure is applied to the airway during exhalation
3-20cm H2O (usual setting)
normally with exhalation airway pressure drops to 0, with PEEP the pressure drops to the PEEP set level

21
Q

Volume alarms

A

patient doesn’t receive preset VT

  • inadequate spontaneous VT
  • disconnection of circuit from ETT or other break in the circuit
  • leak in cuff of ETT
  • tube out of position
22
Q

Pressure Alarms

A

high pressure alarm will sound if preset pressure limit is exceeded

  • secretions and mucus plugs
  • kinks in ETT tube or tubing; pt isn’t laying on tube
  • talking
  • dysynchrony
  • barotrauma - stiff lungs
23
Q

signs of distress

A

rapid shallow breathing, use of accessory muscles, restlessness, tachycardia, PVCs, increased/decreased BP, change in LOC, decreased PO2, increased PCO2