Respiration stuff Midterm exam

Question 1

Ventilator settings- tidal volume- formula for finding TV, peep

Answer 1

Tidal volume: Volume of gas delivered to pt during each ventilator breath
Recommended: 6-10mL/kg

Positive end-expiratory pressure (PEEP): positive pressure applied at the end of expiration (exhalation) of ventilator breaths
Usual settings 5cm H20

Question 2

How to avoid barotrauma with the use of peep

Answer 2

Barotrauma: Air can escape into pleural space from alveoli and accumulate and become trapped (pneumothorax)
-At risk ptS: COPD, ARDS
TX: Lower tidal volume (6ml/kg) to allow permissive hypercapnia

Question 3

MODS- definition of, treatment

Answer 3

Multiple organ dysfunction syndrome
Tx: Treat underlying cause
-Promote adequate organ perfusion
-Provide nutritional support/communications

Question 4

ARDS- treatment

Answer 4

Treatment:
-Prones position: considered for pts w/ refractory hypoxemia who do not respond to other strategies to increase PaO2
-Ventilation: PEEP and/or low tidal volume
-ECMO: allows lungs to heal

Question 5

ARDS- Injury/exudative phase

Answer 5

1-7 days after initial injury
-Neutrophils adhere to pulmonary circulation damaging endothelium,
-alveoli fill with fluid
-Alveolar cells are damaged resulting in surfactant dysfunction (atelectasis)
S/S: increased work of breathing & respirations
-Decreased Tidal volume resulting in resp. alkalosis

Question 6

ARDS- Reparative/proliferative stage