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Nurse 1 > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

What patient groups is NIV not indicated for?

A

Asthma
Type 1 resp failure
Pulmonary oedema
Metabolic acidosis
Multi-organ failure

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2
Q

What are the absolute contraindications for NIV?

A

Severe facial deformity
Facial burns/trauma
Fixed upper airway obstruction
Facial or upper airway surgery/trauma
Undrained acute pneumothorax

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3
Q

What are the relative contraindications for NIV?

A

pH < 7.15
Haemodynamic instability
GCS < 8
Cognitive impairment
Vomiting
Small bowel obstruction or marked abdominal distension

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4
Q

What must be done before starting a patient on NIV?

A

A chest X-ray

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5
Q

How can you help a patient to better tolerate NIV?

A

Appropriate sized mask
Ensure all masks have an exhalation port and anti-asphyxiation valve
Use patients dentures
Hold mask in front of face first
Regular breaks

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6
Q

What should you routinely assess for a patient on NIV?

A

Vital signs with continuous pulse oximetry
Chest wall movement
Accessory muscle activity
Patient comfort

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7
Q

What are the red flags and signs of deterioration for a patient on NIV?

A

Worsening or static ABGs despite NIV
Persistent RR > 30/min
New onset confusion, agitation or restlessness
Drop in GCS
Increased respiratory effort
Worsening tachycardia
Hypotension
Exhaustion
Increased oxygen requirement

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8
Q

What is CPAP?

A

Continuous positive airway pressure
Uses one setting to keep the airway open

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9
Q

What is BiPAP?

A

Bilevel positive airway pressure - delivery of O2 positive pressure
Uses 2 settings - one for inhalation and one for exhalation

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10
Q

What is the technique used for assisted ventilation?

A

BVM - 2 person technique

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11
Q

What is the benefit for BVM - 2 person technique?

A

It ensured a seal is applied properly

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12
Q

How do you do a BVM - 2 person technique?

A

Person 1 - holds mask to seal properly
Person 2 - delivers breath

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13
Q

What are the important things to remember when using a ventilator?

A

Ensure it is charged at all times
ICU dr or ODP will set it up

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14
Q

What nursing care is required for a ventilated patient?

A

1:1 care - ICU Dr present
Ensure correct placement - confirmed by auscultation, CO2 reading, CXR
Assess teeth level of tube placement
Mouthcare
Turning and positioning
NG tube
Catheter
Admission under ACCU

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15
Q

What does the IPAP on BiPAP do?

A

Provides ventilation
Higher than EPAP

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16
Q

What does EPAP on BiPAP do?

A

Allows removal of exhaled gas
Recruits under ventilated or collapsed lung for gas exchange

17
Q

What patient groups use CPAP?

A

T1RF
Pulmonary oedema

18
Q

What type of patients use NIV?

A

T2RF (low O2, high CO2)

Nurse 1 (24 decks)

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