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Critical Care <3 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Risk factors for opioids

A

resp depression
hypotension
constipation
CNS depression

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2
Q

risk factors for ketamine/acetaminophen

A

increased risk for liver/kidney damage

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3
Q

What are the indications neuromuscular blockade?

A

Emergency intubation
Manage elevated ICP
improve tolerance of ventilation

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4
Q

How do we determine if neuromuscular blockade is enough?

A

Train-of-four

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5
Q

What is the care of immobile, paralyzed patient?

A

eye lubrication
DVT prophylaxis
oral care
urinary catheter
vital signs and assessments
Repositioning and ROM

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6
Q

ARF is defined as…?

A

inability of the resp system to provide oxygenation and/or remove CO2

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7
Q

Two ways ARF can be classified

A

oxygen failure resulting in hypoxemia but no rise in CO2
or
ventilation failure resulting in hypercapnia and hypoxemia

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8
Q

What is type 1 ARF?

A

oxygenation failure
PaO2 LOWER THAN 60 mm hg WITH NORMAL-DECREASED CO2

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9
Q

What is type 2 ARF?

A

ventilation failure (hypercapnic)
PaCO2 GREATER THAN 45 mm hg

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10
Q

what are the 4 mechanisms that reduce PaO2 causing oxygenation failure?

A

Hypoventilation
V/Q mismatch
intrapulmonary shunting
diffusion defects

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11
Q

What is ventilation?

A

amount of gas that enters the alveoli per minute

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12
Q

What factors can lead to hypoventilation?

A

drug overdose
neuro disorders
abd/thoracic surgery (pain)

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13
Q

what is intrapulmonary shunting?

A

blood passes thru lungs w/o picking up any oxygen

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14
Q

What can cause intrapulmonary shunting?

A

atelectasis
pneumonia
pulmonary edema

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15
Q

What is V/Q mismatch?

A

ventilation and perfusion mismatch
the rate of ventilation does not match rate of perfusion

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16
Q

What is normal ventilation?

A

4 L/min

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17
Q

What is normal perfusion?

A

5 L/min or 0.8 ratio

18
Q

What are some causes of V/Q mismatch?

A

pneumonia
PE
pulmonary edema

19
Q

What are diffusion defects?

A

oxygen has a difficult time moving across membrane

20
Q

what can cause diffusion defects?

A

fluid in alveoli
pulmonary fibrosis

21
Q

Oxygenation effects 3 things?

A

Cardiac output
hemoglobin
tissues

22
Q

what is a normal cardiac output?

A

600-1000 mL

23
Q

What 2 things cause failure of ventilation?

A

V/Q mismatch
hypoventilation

24
Q

What do you assess for ARF?

A

manifestations of hypoxia and hypercapnia
vital signs
breath sounds
neuro function

25
Q

What are EXPECTED findings for ARF?

A

dyspnea
vital sign abnormalities
cough
chest pain
alteration in cognition

26
Q

what are UNEXPECTED findings for ARF?

A

resp rate above 30
O2 sat less than 90 and doesn’t respond to oxygen therapy
signs of shock
abnormal ABGs
resp arrest

27
Q

Interventions for treating ARF

A

maintain patent airway
optimize oxygen delivery
minimize oxygen demand
treat underlying cause

28
Q

signs of respiratory muscle fatigue

A

diaphoresis
nasal flaring
tachycardia
retractions

29
Q

What is Acute Respiratory Distress Syndrome and what is the criteria?

A

severe form of ARF
1.) acute onset within 1 week
2.) bilateral pulmonary opacities not explained by other conditions
3.) altered PaO2/FiO2 ratio

30
Q

What are some common causes of ARDS?

A

sepsis
pneumonia
aspiration

31
Q

What are the risk factors for ARDS?

A

alcohol use disorder
female
older than 60

32
Q

Explain acute stage of ARDS

A

uncontrolled inflammation
damage to the alveolar epithelium, becomes more permeable and fluid leaks

33
Q

Explain proliferative phase of ARDS

A

lungs try to heal itself but causes scarring
making lungs stiffer further worsening hypoxemia

34
Q

Explain fibrotic stage of ARDS

A

lungs become stiff and fibrotic
decreased residual capacity
Rt > Lt shunting

35
Q

Expected assessment findings for ARDS

A

Agitation
restlessness
dyspnea
increased RR and WOB
increased HR decreased Cardiac output

36
Q

What tests would you look at for ARDS?

A

chest XR
pulmonary function tests
BNP and coags
ABGs

37
Q

What are unexpected findings of ARDS?

A

labs indicating organ failure
delirium
ET-tube mispositioning

38
Q

What is prone positioning?

A

placing patients on their stomach to help them breathe better

39
Q

Benefits of prone positioning

A

less lung compression
improve heart function
better drainage of secretions

40
Q

Management of ARDS

A

Low tidal volume ventilation to minimize trauma
PEEP to keep alveoli open
Prone positioning
ECMO

41
Q

VAP Bundle

A

HOB 30-35
Oral care q 2 hours
Ulcer prophylaxis
DVT prophylaxis
Spontaneous awaking trials

42
Q

CLABSI bundle

A

Hand hygiene
CHG
Barrier precautions
Catheter Care maintenance

Critical Care <3 (16 decks)

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