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Topics of Respiratory Care > Test 1 Ch. 7 Intial Ventilator Settings Based on Pulmonary Disorder > Flashcards

Test 1 Ch. 7 Intial Ventilator Settings Based on Pulmonary Disorder Flashcards

1
Q

Normal lungs
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A

Mode: VC or PC-CMV
IBW: 6-8
RR: 10-15
Flow: 60
FW: Descending or constant
Ti: 1
PEEP: greater than or equal to 5
Fio2: greater than or equal to 50%

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2
Q

COPD
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A
  • Mode: VC or PCMV
  • IBW: 6-8
  • RR: 8-12
  • Flow: >60 (80-100)
  • FW: Descending or constant
  • Ti: 0.6-1.2
  • PEEP: greater than or equal to 5 or 50% of intrinsic PEEP
  • FiO2: <0.5
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3
Q

Neuromuscular disorder
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A
  • Mode: VC-CMV
  • IBW: 6- 8
  • RR: 8-12
  • Flow: greater than or equal to 60
  • FW: Descending or constant
  • Ti: 1
  • PEEP: 5
  • FiO2: 0.21
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4
Q

Asthma
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A
  • Mode: VC or PC- CMV
  • IBW: 6-8
  • RR: 10- 14
  • Flow: 60- 70
  • FW: Descending
  • Ti: less than or equal to 1
  • PEEP: Only to offset intrinsic PEEP and improve triggering
  • FiO2: greater than or equal to 0.5
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5
Q

Closed head injury
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A
  • Mode: PC or VC- CMV
  • IBW: 6- 8
  • RR: 15- 20
  • Flow: 60
  • FW: Descending or constant
  • Ti: 1
  • PEEP: 0-5 w/ caution, only in severe hypoxemia
  • Fio2: 1.0
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6
Q

ARDS
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A
  • Mode: PC or VC- CMV
  • IBW: 4-8
  • RR:12-35
  • Flow: greater than or equal to 60
  • FW: Descending or constant
  • Ti: 1
  • PEEP: 5 to >15
  • Fio2: 1.0
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7
Q

CHF
Mode
IBW
RR
Flow
Flow waveform
Ti
PEEP
Fio2

A
  • Mode: VC or PC-CMV
  • IBW: 6- 8
  • RR: greater than or equal to 10
  • Flow: greater than or equal to 60
  • FW: Descending or constant
  • Ti: 1- 1.5
  • PEEP: 5-10
  • Fio2: 1.0
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8
Q

Why would a pt with normal lungs be on Mechanical ventilation?

A
  • Drug overdose
  • Surgical pts not waking up after
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9
Q

Because COPD pts have a resistance issue, what can we do to give them more time to exhale?

A

Lower the RR to increase expiratory time

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10
Q

Why is I-time lower in COPD pt’s?

A

The less time for inspiration will give the pt more time in expiration

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11
Q

Why do we hyperventilate pt’s with closed head injuries?

A

It decreases the amount of blood flow to the brain and helps control ICP and swelling

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12
Q

Why are we cautious w/ PEEP in closed head injuries?
What should we do instead?

A

The pressure can increase ICP. If it is not necessary then we do not need it. Start w/ 100% FiO2

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13
Q

Why do we use higher PEEP in CHF?

A

To push fluid out of the alveoli. 100% FiO2 is used to help oxygenate

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14
Q

Anatomic Dead Space is calculated as

A

1mL/lbs

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15
Q

Anatomic Dead space is defined as volume lost in the pt’s

A

conducting airways where no gas exchange occurs

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16
Q

Examples of anatomic dead space

A
  • trachea
  • bronchi
17
Q

Examples of Mechanical dead space

A
  • Long ETT
  • Closed system suction
  • HME
18
Q

Minute Ventilation equation

A

VE= Vt x RR

19
Q

Alveolar minute ventilation equation

A

VA=(Vt - Vd) x RR

20
Q

I:E ratio is adjusted by 3 vent controls

A
  • Vt
  • Flow rate
  • RR
21
Q

Adjustments in flow rate alters…

A

inspiratory time (I- time)

22
Q

What are the 2 types of ventilation?

A
  • Minute ventilation (VE)
  • Alveolar ventilation (VA)
23
Q

As you change flow…

A

you change the I-time

24
Q

The higher the flow…

A

the lower the I-time
(ex: If I increase the flow rate, it lowers the I-time)

25
Q

The lower the flow…

A

the higher the I-time
(ex. If I decrease the flow rate it increases the I-time)

26
Q

How do you manipulate I:E ratio?

A
  • With Vt, Flow rate (volume control)
  • RR
  • I-times (pressure control)
27
Q

The higher the Vt…

A

The higher the I-time

28
Q

The lower the Vt…

A

the lower the I-time

29
Q

Increasing RR…

A

decreases expiratory

30
Q

Define Total cycle time (TCT)

A

the total amount of time for 1 breath; from inspiration to expiration

31
Q

Example:
Pt is on RR of 10 bpm. What is TCT?

A

6 seconds
(60/10= 6)
Whatever the RR is divide that by 60 and it will give you TCT
FYI there are 60 seconds in 1 minute

32
Q

If COPD pts RR is 8-10 bpm. What is there TCT?

A

6 to 7.5 seconds

33
Q

How can you improve oxygenation? (6)

A
  1. Increase FiO2
  2. PEEP
  3. Improving ventilation
  4. APRV or Bilevel ventilation
  5. Pressure w/ Inverse ratio
  6. Proning
34
Q

Improving ventilation is based on who’s law?

A

Dalton’s Law
(If there is less CO2 in the blood, there is more room for oxygen)

35
Q

What does APRV or Bilevel ventilation focus on?

A

Mean Airway pressure

Topics of Respiratory Care (20 decks)

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