RET2874 Final Flashcards
Alveolar Oxygen Equation
PaO2 = (Pb - 47)FiO2 - (PaCO2 x 1.25)
Defibrillation (biphasic) initial, second, and third shock intensities
120 J, 150 J, 200 J
Indications for unsynchronized counter shock (defibrillation)
V-fib, v-tach, pulseless v-tach
Cardioversion is also known as…
Synchronized electric shock
Indications for cardioversions
V-tach, SVT, A-fib, A-flutter
Initial and subsequent voltage for cardioversions
50 J, 100 J, 200 J, 300 J, 360 J
Pressure which, if exceeded during positive pressure ventilation, can cause esophagus to open and gastric distension
20-25 cmH2O
Patients with ______________ can not tolerate BHT procedures even if a secretion clearance problem exists.
Acute exacerbations of COPD
Copious sputum production is defined as
25-30 mL/day
Supine position with the patient inclined at an angle of 45 degrees so the pelvis is higher than the head.
Trendelenberg
Trendelenberg contraindications
Gross hemoptysis, icp > 20mmHg, uncontrolled hypertension, distended abdomen, post neurosurgery, uncontrolled airway at risk for aspiration, esophageal surgery
Percussion should be performed for _______.
3-5 min
Vibration should be performed _____ percussion.
After
MI:E indications
Chronic neuromuscular patients
Involves active expiration against variable flow resistance at pressures of 10-20 cmH2O
PEP
BHT for infants
PDPV
BHT for children
Exercise, PEP, PDPV, ACB, HFO
BHT for children > 12 years
Exercise, ACB, PEP, PDPV, HFO
BHT for neuro patients
PDPV, suction, MI:E
BHT for patients with musculoskeletal weakness
PEP, MI:E
Medications for BHT
N-acetylcysteine, dornase alfa, hypertonic saline
Incentive spirometry criteria
VC > 15 ml/kg or IC > 33%; no difficulty with secretions
In IPPB the __________ and ___________ determine the tidal volume.
Set pressure, flow rate
IPPB indications
The need to improve lung expansion AND other therapies are unsuccessful, patient cannot cooperate, inability to clear secretions
Absolute contraindication for IPPB
Tension pneumothorax
Initial pressure setting for IPPB
10-20 cmH2O
Initial sensitivity setting for IPPB
1-2 cmH2O
The goal of IPPB is _____ ml/kg of IBW or at least ___ of the patient’s predicted inspiratory capacity.
10-15, 30%
Inspiration occurs at ambient pressure and expiration generates an increased pressure that gradually decreases as expiratory flow decelerates.
PEP
Inspiration occurs as ambient pressure and maintains positive pressure throughout expiration.
EPAP
Maintains positive airway pressure throughout both inspiration and expiration.
CPAP
PEP preset pressures
10-20 cmH2O
EPAP preset pressures
10-20 cmH2O
CPAP preset pressures
5-20 cmH2O
CPAP indications
Unresponsive atelectasis with hypoxemia, cardiogenic pulmonary edema
IPPB is ________ cycled.
Pressure
The sensitivity setting is __________ on a Bird IPPB.
Pressure
With IPPB, PIP should initially be set at ____________, with _____________ flow.
10-15 cmH2O, moderate
For an alert patient at high risk for atelectasis or has atelectasis and VC > 15 ml/kg or IC > 33% predicted use…
IS along with deep breathing, frequent repositioning, and early ambulation
For patients with minimal risk of post op atelectasis use…
Deep breathing exercises, frequent repositioning, and early ambulation
For patients who are high risk for post op atelectasis or has atelectasis AND secretion retention and a VC > 15 ml/kg or IC > 33% predicted use…
PEP or EPAP with bronchodilators, deep breathing exercises, frequent repositioning, early ambulation, and directed cough
High risk of post op atelectasis AND unable to use IS, PEP or EPAP with VC
IPPB