Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N202 > respiratory/vent exam > Flashcards

respiratory/vent exam Flashcards

1
Q

movement of air in and out of lungs, passive exhalation, can give 21% (RA) to 100% oxygen

A

mechanical ventilation

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

what are some indications for mechanical ventilation

A

acute resp. failure, apnea, hypoxemia, hypercapneia, sepsis, severe COPD

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

negative pressure ventilation

A

Iron lung, no airway protection,

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

positive pressure ventilation modes are

A

assist control, synchronized intermittent mandatory ventilationpressure support ventilation

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

the most common, the ventilatior controls the amount of volume the patient will revieve, this option requires a rate, Vt, inspiratory time, and PEEP be set for the pt, when the pt initiates a spontaneous breath, a full volume breath is delievered, decreases the work of lungs

A

assist control

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

this mode requires that rate, Vt, inspiratory time, sensitivity, and PEEP are set, in between mandatory breaths, pts can spontaneously breathe at their own rates and Vt. the vent synchronizes the mandatory breaths with the pts own inspitations, this cannot be used on critically ill, or fatiqued

A

synchronized intermittent mandatory ventilation (SIMV)

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

what is a normal tidal volume

A

500 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is pressure support written as an order

A

PS 15/8

  • 15 is inhalation
  • 8 is exhalation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

this mode provides an augmented inspiration to a spontaneously breathing pt, no machine breaths, when the pt initiates a breath, a high flow of gas is delivered to the preselected pressure level, used to wean pts off vent, helps with inhalation, it decreases pts work of breathing, the vent addds a pressure boost to help with inspitations so it decreases work of breathing caused by endotracheal tube and vent tube

A

pressure support ventilation (PSV)

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

this vent option creates a positive pressure at the end of exhalation. it restores FRC.

A

PEEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

this vent option restores FRC, the pt recieving PSV or SIMV with PEEP, recieves this when breathing spontaneously, the pressure is continuous during spontaneous breathing,

A

CPAP

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

FRC

A

functional resistance capacity, helps to increase gas exchange in between breaths, keeps alveoli open

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

2 levels f positive pressure support provided with O2, high inspiratory and lower expiratory pressures via tight fitting mask; noninvasive, mask goes over mouth and nose, for inhalation and exhalation

A

BiPAP

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

what is the highest pressure measured in the lungs upon inspiration

A

peak airway pressure/peak inspiratory pressure

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

what do you want your peak airway pressure/peak inspiratory pressure to be?

A

less than 30 cm, normally 20 cm H2O, with a cough 55-60 cm H20
-it is set to end inspiratory phase to prevent trauma

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

plateau pressure (end inspiratory static pressure)

A

want it to be less than 30 cm H20, greater than 30 cm of H2O stretches lung and injuries tissue, in order to get this measurement you must pause vent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

FIO2

A

fraction of inspired O2, 21-100% (usually 40-60%), usually adjusted to maintain PaO2 greater 60 mmHg or SpO2 level of greater 90%

  • goal is to give the least amount of O2 possible
    (ex. 0.5 = 50%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vt

A

volume of gas delivered to pt during each vent breath, goal Ve 5-10 L, 5-8 ml/kg is normal
Ve = minute ventilation (RR x Vt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rate (respiratory rate)

A

set between 12-16/minute, 3 of breaths/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

I:E ratio

A

inspiratory to expiratory ratio, normal is 1:2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

high pressure limit

A

regulates maximal pressure the vent can generate to deliver a breath (Vt), when pressure limit is reached the vent terminates the breath, usual setting is 10-20 cm of H2O above the peak inspiratory pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what will higher levels of PEEP do to FiO2

A

decrease FiO2 bc it opens up alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PEEP

A

maintains pts airway pressure above the baseline, helps open alveoli, helps decrease risk of O2 toxicity, can have risk for pneumothorax, dont want to go above 8 cm of H2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

sensitivity

A

helps sincrinize the pts intrinsic (their own) with mechanical support and helps prevent the vent from hyperventilating the pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the minute ventilation goal (Ve)
5-10 liters
26
etCO2
end tidal CO2, est amount of CO2 present at the end of each exhaled breath
27
normal etCO2
30-43 mmHg
28
what are some assessments that need to be done when you have a vent pt
breath sounds, ABGs, CXR, skin, accessory muscle use, secretions, anxiety, location of ET tube, ability to speak or whisper around tube
29
what is the approx. location of an ET tube for men and women
21 cm at the lip for women | 23 cm at the lip for men
30
lactic acid greater then 2
not good, sepsis
31
what should your suctino be no higher than
120 mmHg pressure
32
anion gap
greater 17 is acidosis | less than 10 is alkalosis
33
what complications can happen with ventilators
VAP (prevent with chlorexidine, HOB elevated) mechanical over ventilation pnumothorax, sub Q emphasyma
34
what does the pt need to show in order to start weaning from the vent
breath on their own with a Vt of 350 on pressure support, RR 12/24, oxygen at 40% or less, 20-40 of baseline for BP, 10-20 of baseline for HR, PEEP of 5 (10/5), normal pH, no cardiac issues occuring
35
how will you know that the pt is not tolerating weaning
acidodic, diaphoresis, anxiety, SpO2 less 90%, SBP less 90, SBP greater 180, RR greater then 35, accessory muscle use
36
what will a increase RR cause
increase of RR = hyperventilation = decrease of CO2 = resp. alkalosis
37
action of propofol
rapidly acting hypnotic, produces amnesia, inhibits sympathetic vasoconstricter nerve activity
38
contriindications of propofol
allergy to glycerol, soybean oil, egg products, pregnancy, or pts who are lactating
39
onset of propofol
40 seconds
40
dosage of propofol
5-50 mcg.kg.min (for no longer than 72 hours)
41
what can effect the amount of propofol that needs to be given
illicit drugs & alcohol abuse
42
what adverse effects can propofol have on pts
decrease BP/HR/CO, dysrhythmias, HA, seizures, acidosis, infection, fever, flushing, green urine
43
how often do the propofol bottles and tubing need to be changed
Q12 hours
44
ramsay sedation scale
1-5 scale, 1 is awake, anxious & agitated, restless or both 4 is asleep, brisk reponse to light tactile stimuli or loud auditory stimulus 6 is no response to anything
45
Nimbex action
non depolarizing neuromuscular blocking agent, must be given sedation and pain medications with this
46
what contraindications does Nimbex have
history of neuromuscluar disease ( have an increase of sensitivity), cant be used for rapid sequence intubation, pts with burns may show resistance
47
onset of Nimbex
intermediate (half life of 22-29 minutes)
48
dosage of Nimbex
2-6 mcg/kg/min, max dose is 10 mcg/kg/min
49
adverse effects of Nimbex
decrease BP, increase HR | cant use longer than 6 days
50
assessments that need to be done with Nimbex
TOF (train of four), recommended blockagde is 1 or 2 | 0-4, o is unresponsive to anything, 4 is less than 75% blockage
51
what is the reversal agent of nimbex
neostigmine
52
why is nimbex used
prevents t from working against vent, eliminates coughing, gagging, less O2 consumption by muscles
53
what are indications of artificial airways
prevention or relieve upper airway obstruction, decrease aspiration, facilitate secretion removal, provide closed system for positive pressure mechanical ventilation, respiratory distress
54
oral insertion of tube passed trough mouth, vocal cords, put in trachea with aid of laryngoscope or bronchoscope
ET tube
55
what are advantages of ET tube
larger diameter tube, easier to suction, can do fiberoptic bronchoscopy, reduce airway resistance & work of breathing
56
why would a nasal intubation be done
used during oral trauma
57
how long should an ET attempt be limited to
no more than 30 seconds
58
when a CXR is taken where should the tube be
tip should be 3-5 cm above carina
59
how long after placement of ET tube should ABGs be done
wait 20-30 minutes
60
what does the cuff of the ET tube need to be at
maintain 20-25 mm Hg or less | over 25 can compress capillaries which can cause cell death
61
MOV
minimal occluding volume, place stethoscope over trachea & inflate cuff to MOV by adding air until no leak at peak inspiratory pressure (end of vent inspiration) if no vent inflate until no sound after deep breath
62
MLT
minimal leak technique, similar to MOV except remove a small amount of air from cuff until a slight leak is auscultated at peak inspiration (not use on vented pts)
63
what needs to be done prior to placing an ET tube
pre oxygenate for at least 2 minutes
64
what is used to check the cuff pressure of a ET tube
manometer
65
what can be done to prevent aspiratoin with ET tube
HOB 30-45 degrees, OG tube
66
when do you suction an ET tube
on the way out, oxygenate prior to and after suctioning
67
post extubation assessment
observe for laryngospasm, stridor, diff. breathing | assess: breath sounds, neck for stridor, accessory muscle use, SpO2, LOC, RR, HR, BP
68
following extubation what complications can occur
acute laryngeal edema, hoarseness, aspiration, stenosis of trachea
69
surgical incision in trachea for breathing, sits below 2nd tracheal ring
tracheotomy
70
opening in the neck, flange, faceplate, which rests on neck between clavicles, outer and inner cannula & obturator
stoma
71
why would a pt get a trach
upper airway damage, increase comfort, suction easier, decrease work of breathing by decreasing dead space ventilation, long term vent (14 days), bypass upper airway obstruction
72
when does the complete sealing of incision of a trach happen after extubation
72 hours
73
nursing care with trachs
keep oburator at bedside, hemostat, suction equipment, mouth care,
74
what complications can happen bc of trachs
mediastinal emphysema, hemorrhage, pneumothorax, cardiac arrest, pressure sore, obstruction
75
what are indications for suctioning
visible secretions, sudden resp. distress, aspiration, increase of peak airway pressures, auscultation of adventious breath sounds, increase RR, coughing, sudden or gradual decrease in PaO2/SpO2 *suction to need not routine
76
when would you have to use a bullet?
only when have an occlusion, rarely used bc brings bacteria to airway
77
how long should you suction for
no more than 15 seconds
78
what are signs that suctioning is not being tolerated
decrease in SpO2, increase in BP, sustained cough, dysrhythmias
79
results from inadequate gas exchange, either insufficient O2 transferred to the blood (hypoxemia) or inadequate CO2 removal (hypercapnia)
acute respiratory failure * can be one or both * it is a condition not a disease
80
hypoxemic respiratory failure
PaO2 of 60 mm Hg or less | inspired O2 concentration of 60% or greater
81
hypercapnic respiratory failure
PaCO2 above normal (greater than 45 mmHg), acidemia (pH less than 7.35)
82
what are the causes of hypoxemic respiratory failure
ventilation-perfusion mismatch, shunt, diffusion limitation, alveolar hypoventilation

N202 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions