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Semester 5 PMCP Exam 2 > Respiratory Equipment > Flashcards

Respiratory Equipment Flashcards

1
Q

wall flow meter -

A

adjusts the flow of O2

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2
Q

Nasal canula delivers between _ and _ L per minute

what % of oxygen

A

1-6L

24-44% O2

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3
Q

Normal air is what percent oxygen

A

21.4%

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4
Q

1 L is how much oxygen

A

24%

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5
Q

High flow nasal canula delivers between _ and _ L per minute

A

6-15 L

43-72%

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6
Q

What is something special about high flow nasal canula

A

Need a humidifier to keep air moist

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7
Q

Face mask delivers _ and _ liters per minute

A

5-10:

35-55%

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8
Q

Cool Aerosol mask (CAM) delivers between _ and _ liters per minut

A

10-12 liters per minute

need higher flow but can’t tolerate nasal

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9
Q

Non-rebreather - minimum flow is

A

10-15 liters per minute

60-80% O2 with no humidity

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10
Q

Non-rebreather - bag deflation

A

bag should not deflate more than 1/3 with inspiration

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11
Q

When will someone be on a non-rebreather

A

often when deciding to put them on vent or not - also when come off of vent

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12
Q

Non-rebreather - are they breathing in their own air

A

NO!

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13
Q

Misty Ox - High flow CAM - what percent O2

A

60-96%

with humidifier

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14
Q

When is misty-ox high flow CAm used

A

when come off vent and are trying to get them stronger so they dont go back on vent

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15
Q

Can you take a patient out of the room with misty-ox high flow CAM

A

NO! you can walk them in the room, but you cannot take them off of this system

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16
Q

Venturi mask flow is how many liters per minute

A

3-6 or 4-10?
24-50% O2
Precise FiO2

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17
Q

Why would you ask for a venturi mask

A

you can use it to take them around without having to drain an oxygen tank
Dont need to order - just ask RT

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18
Q

Who would you not use a venturi mask with

A

misty ox or non re-breather

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19
Q

Venturi mask - where is the air coming from

A

mixing the air from the outside with the air coming from the wall or tank

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20
Q

Trach collar - delivers how much O2

A

24-50%

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21
Q

Describe the trach collar

A

Pt has an artificial airway - you can connect this to venturi so not using oxygen tank up

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22
Q

Gas injection nebulizer (GIN)

A

Extremely high flow
100% O2
GREEN TOP

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23
Q

Ambu bag - how do you use it

A

push down halfway when they breath in and let it go when they exhale

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24
Q

Common mistake of oxygen delivery with someone who has a trach

A

applying oxygen over their mouth! NOO! Give it through the trach!

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25
Q

Should you have someone with a stuffy nose on a nasal canula

A

NO!

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26
Q

NC for mouth breather?

A

NO

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27
Q

What can lead to poor oxygen flow

A

valve turned off
tube is pinched
tank is empty

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28
Q

Patients may be cyanotic if pulse ox is lower than what

A

90%

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29
Q

Symptoms of hypoxemia

A 
Tachycardic
Dyspnea
Cyanosis
Perspiring (diaphoresis)
HA
Mental distrubance
Maybe hyperventilat
Inc RR
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30
Q

Treat hypoxemia by

A

dec work of breathing with oxygen

reduce myocardial work

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31
Q

How is oxygen found in the blood with pulse ox

A

bound to hemoglobin

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32
Q

SaO2 measures what

A

oxyhemoglobin

oxygen taken from blood draw!!! (ABGs)

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33
Q

SpO2 is measured how

A

pulse oximetry

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34
Q

Types of pulse oximetry

A

bedside or portable in hand

probe can be finger, ear, nose

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35
Q

Know what can alter pulse oximtry reading

A

polish, rapid HR, cold hand, excessive mvmnt…

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36
Q

What O2 sat is good enough for us to work with

A

90%

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37
Q

What does the textbook say is normal

A

More than 92

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38
Q

SpO2 in patients with COPD

A

want it to be 90-92 but if their norm is 88 you can work with them at 88

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39
Q

Pediatric SpO2 norm

A

65-85%

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40
Q

What is considered significant desaturation

A

3%

Rate it by how fast they return to baseline and how it impacts their performance

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41
Q

Suctioning - types

A

oropharyngeal
nasotracheal
endotracheal

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42
Q

Oropharyngeal suctioning - what is used

A

Yankauer suction tip
Only one that PT can do and pt could do it too
Getting suction from oral pharyngeal cavitiy

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43
Q

Nasotracheal and Endotracheal -

A

Internal and more for those on ventilator

Suctioning out of the lungs

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44
Q

Inadequate humidification leads to

A

retention of secretions
Infection
crusting of secretions
airway obstruction

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45
Q

Intubation refers to the process of

A

placing an endotracheal tube (ETT) in a patients airway

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46
Q

Orotracheal intubation involves placing the ETT into

A

the mouth or oral cavity

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47
Q

Nasotracheal intubation involves placing the ETT into

A

the nasal cavity

48
Q

Ett is necessary for who

A

unconsious patients - to maintain an open airway and ensure ventilation

49
Q

Disadvanatges to intubation include

A

HTN, Inc HR, tracheal wall necrosis, vasovagal, fistula, inability to eat/drink/talk

50
Q

Tracheotomy is what

A

an artificial airway created surgically in the trache

51
Q

When is a tracheotomy necessary

A 
Complete upper airway obstruction
Long term intubation
Facial trauma
Sleep apnea - long term
Dec work of breathing and will remove secretions
They can eat drink and talk
52
Q

Complications of tracheotomyh

A

hemorrhage, thyroid injury, nerve injury, air leak, fistula, cardiac arrest

53
Q

What is a stoma

A

the opening in the ant neck after removing the trach

THey do not suture it shut

54
Q

Types of trach tubes - cuffed

A

has balloon at distal end to prevent air/secretions from going anywhere but the tube
cuff can be inflated or deflated

55
Q

Why would a cuffed trach tube be deflated

A

if they want to talk - the cuff needs to be deflated but you need to get them PMV

56
Q

Types of trach tube - high volume

A

low pressure requires high volume of air to inflate but will apply less pressure on the tracheal wall

57
Q

Types of trach tube - high pressure

A

low volume require a low volume of air to seal the trachea

58
Q

Can we inflate or deflate patient trach tube cuff

A

NO! talk to nursing or RT to ensure the appropriate cuff presssure first

59
Q

Types of trach tubes - cuffless

A

no cuff at distal end - sleep apnea or long term

60
Q

Type of cuffless trach tube

A

Metal (Jackson)

common for chronic trach patients

61
Q

Foam filled - type of trach tube (Binova)

A

Cuff passively inflates from atm pressure

No air is injected into the foam cuff

62
Q

What is good about the foam filled

A

it is gentle on the tracheal wall

More for a fragile trachea that is long term use

63
Q

Fenestrated - type of trach tube

A

TALKING!

window in the tube that allows air to pass from lower to upper airway for speech

64
Q

Bad thing about fenestrated trach tube

A

doesnt work well with thick secrettions so if you notice they are short of breath might be clogged

65
Q

Trach tubes are selected based on

A

individual patient needs

66
Q

Primary reason people on vents feel anxiety, fear, panic

A

inability to communicate

67
Q

How to communicate with patients who have a trach

A

nonverbal handwritting, gestures, lip reading, communication boards, augmentative communication

68
Q

Verbal methods for talking with those who have a trach

A

Passy muir valve - placed in the trach that allows air to be inhaled but then closes to allow air to exit PMV for speech

69
Q

What to be cautious of with PMV

A

cuff has to be deflated

they may be more tired when you are working with them

70
Q

Effects of trach on swallowing

A

Dec laryngeal elevation
Dec sensation
Dec subglottic pressure
Can cause aspiration (debated)

71
Q

Indications for mechanical ventialtion

A 
Resp failure
CNS dysfunction
drug overdose
Obesity
Sleep apnea
Stroke
B or SC injury
MS
Metabolic imbalance
Infection
72
Q

Resp failure

A

lack of adequate gas exchange within the lungs

73
Q

Endotracheal tube

A

used initially

securred to mouth with tape

74
Q

optimal position for endotracheal tube

A

1-2 cm above carina

75
Q

Nasoendotracheal tube used when

A

if endotracheal causes more damage

76
Q

Tracheostomy tube

A

surgically inserted around 2nd or 3rd tracheal ring

77
Q

Two types of ventilators

A

Neg pressure

Pos pressure

78
Q

Problems with neg pressure ventilators

A

not easy access to patient

79
Q

Neg pressure ventilator - how it works

A

pull the air out and cause someone to breath

but messes with their CO

80
Q

Pos pressure ventilator

A

pushing air into their lungs and then they exhale

81
Q

Classification of ventilators

A

pressure ventilators

Volume ventilators

82
Q

Tidal volume - norm

A

5-10 ml/kg of body weight

83
Q

Tidal volume is what

A

volume of air in a normal breath

84
Q

what is the tidal volume for ventilator dependent patients

A

10-15 ml/kg

85
Q

Ventilator - rate

A

number of ventilatory breaths delivered per minute

86
Q

Norm - rate

A

10-12 breaths per minute but will vary with idal volume

87
Q

FiO2 what does it stand for

A

fraction of inspired air

88
Q

FiO2 is what

A

Oxygen concentration of the gas delivered by the ventilator
Has a humidifier on it
Usually 30-100%

89
Q

FiO2 that we wont work with

A

80-100%

90
Q

Peak inspiratory pressure is what

A

pressure exerted on the lung when the required volume is delivered

91
Q

Peak inspiratory pressure alarm goes off when

A

pressure limit is reached before the preset volume is delivered
or if something is obstructing it

92
Q

PEEP stand for what

A

positive end expiratory presure

93
Q

PEEP is what

A

an expiratory maneuver in which the airway and intrathoracic pressure are not allowed to return to atmospheric

94
Q

What is PEEP used in conjunction with

A

positive pressure ventilation

95
Q

Classic criterion for using PEEP

A

inability to maintain PaO2 above 60mmHg with and inspired O2 conc of 50% or higher

96
Q

What is normal PEEP

A

5

97
Q

Ventilator can give what PEEP

A

0-15

98
Q

What PEEP do you consider as precaution for whether to work with them or not

A

10-15 range

99
Q

Inspiratory Hold

A

Maneuver that either presets the pressure or a predetermined volume is reached and held for a period of time before the exhalation is initiated
This is a setting on the vent - trying to mimic normal breathing

100
Q

Expiratory retard

A

resistance applied to exhalation whereby the circuit pressure is permitted to drop slowly to atm.
Also hleps mimin normal breathing

101
Q

Modes of ventilator - Control mode is also called

A

Constant minute ventilation

Controlled mandatory ventilation

102
Q

Modes of ventilator - control mode does what

A 
# of breaths you have is preset 
typically after surgical procedures
Vent is doing pretty much everything for them - usually used when undergoind a durgical procedure and they are sedated
103
Q

Modes of ventilator - assist control

A

set minimum # of breaths and tidal volume

Can be pressure or volume controlled

104
Q

Modes of ventilator - assist control - sensitivity is set so that if patient does breath above the preset number of breaths what happens

A

the ventilator will adjust
They can be breathing on their own and if they dont reach set volume or pressure then the machine will supplement what is needed to match the specific setting

105
Q

SIMV stands for

A

synchronized intermittent mandatory ventilation

106
Q

SIMV does what

A

sets the min number of assisted breaths and tidal volume

107
Q

SIMV - pt might breath on their own with this but what is differenct with this and assist control

A

this one they can take a breath on their own but if they do not reach the set setting it wont help them get to it… but it does have a min number of assisted breaths

108
Q

MMV stands for

A

Mandatory minute ventilation

109
Q

MMV does what

A

gives mandatory breaths when needed

Consered with rate

110
Q

PSV/CPAP stands for

A

Continuous positive airway pressure

111
Q

PSV/CPAP does what

A

technique to apply PEEP to a spontaneously breathing pt
Maintains pos pressure through resp cycle
used to wean off ventilator

112
Q

what is CPAP with smartcare

A

ventilator makes changes on its own depending on pt needs

113
Q

Caution with CPAP and smartcare

A

turn it off when working with pt

it will reset them and then the settings might be too high when you are done working with them

114
Q

NIPPV stands for

A

non invasive pos pressure vent

115
Q

NIPPV does what

A

connected to vent via tight mask

for those that dont want to be intubated but need to be ventilated

116
Q

Vent alarms

A 
1 high pressure from anything clogging it 
2 low pressure if something disconnected
3 Low PEEP/CPAP - break in line
4 low exhaled volume - something leaking
5 apnea alarm - pt not taking breath
6 inc volumes - shallow breathing
7 inc frequency - pt breathing faster
117
Q

What to do first for someone on vent

A

talk with nursing and check medical record

Semester 5 PMCP Exam 2 (6 decks)

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