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weaning/ext/nppv > test1-gary-spring > Flashcards

test1-gary-spring Flashcards

1
Q

What is the normal VC rate?

A

65-75 ml/kg of ibw

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2
Q

What is the critical value of VC?

A

10-15 ml/kg of IBW

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3
Q

What is a normal Vt?

A

5-8 l/kg of IBW

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4
Q

What is a critical Vt?

A

Less than 5 l

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5
Q

What is normal range for MIP?

A

-100 to -50 cmH2O

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6
Q

What is critical value for MIP?

A

-20 to 0

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7
Q

What is normal for MEP?

A

100

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8
Q

What is critical value?

A

Less than 40

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9
Q

What is normal value for FEV1?

A

50-60 ml/kg

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10
Q

What is critical value of FEV1?

A

Less than 10

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11
Q

What is normal value of PEFR?

A

350-600

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12
Q

What is critical value of PEFR?

A

75-100

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13
Q

How do you find Vt if you have min volume & Freq?

A

Vt= Min Volume/Frequency

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14
Q

What is a normal Min volume?

A

6-10 LPM

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15
Q

Predictor of success for NPPV includes a PaCO2 greater than ______ but less than _______.

A

PaCO2 > 45

PaCO2 < 92

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16
Q

Predictor of success for NPPV includes a pH less than ______ but greater than _______.

A

pH < 7.35 & > then 7.22

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17
Q

Name some other predictors of success for NPPV

A

Minimal Air Leak
Low severity of disease
Improvement in gas exchange in 30m to 2 hrs
Improved RR & HR

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18
Q

Goals of non invasive vent for acute care include?

A 
Improve gas exchange
Avoid intubation
Decrease mortality
Decrease length of time on vent
Decrease hospital stay
Decrease VAP
Relieve symptoms of resp distress & improve comfort
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19
Q

Long term goals of NPPV include?

A 
Relieve or improve symptoms
Enhance quality of life
Avoid hospitalization
Increase survival
Improve mobility
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20
Q

What limits inspiration in NPPV?

A

Pressure limited

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21
Q

What is the normal setting of humidification?

A

30 degrees heat

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22
Q

If you increase Vt it can cause increase/decrease in CO2?

A

Increase

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23
Q

How can you improve oxygenation?

A

Increase PEEP

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24
Q

What setting assists with blowing out CO2?

A

CPAP or Peep

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25
Q

What setting is useful for acute cardiogenic edema?

A

CPAP to recruit FRC so they can oxygenate

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26
Q

NPPV is reserved for patients to facilitate weaning who have _____ or _______ as in others their condition worsens.

A

COPD or CHF

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27
Q

NPPV is indicated in the chronic care of COPD when the PaCO2 is > then _____ & ____ hospital admissions.

A

55

2 hospital admissions

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28
Q

What is the first line therapy for central or obstructive sleep apnea or lung parenchymal disease during nocturnal hypoventilation?

A

CPAP, NPPV when that fails

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29
Q

What happens if you increase your peep & make no other changes to NPPV?

A

Decrease your driving pressure

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30
Q

What is the best thing to do to relieve dyspnea?

A

Provide O2

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31
Q

How do you improve oxygenation?

A

increase FIO2 or Increase Peep

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32
Q

How much time should you allow to see improvement to guage if treatment is success in NPPV?

A

1-2 hours

33
Q

How can you decrease PaCO2?

A

Increase pressure

34
Q

What type of respiratory failure should NPPV not be used for?

A

Hypoxic resp failure

35
Q

Name some reasons not to use bipap.

A

Apnea, hemodynamic instability, facial burns, uncooperative patient, facial trauma, high risk of aspiration, copious secretions, anantomic abnormality that interferes with gas delivery

36
Q

If you increase your EPAP too much what condition can occur?

A

Hypotension

37
Q

What is the name of the hole on clear plastic piece that allows for elimination of CO2 & cannot be plugged?

A

Intentional Leak Port

38
Q

What is the name of the aqua blue valve that opens when forward velocity of flow stops?

A

Anti-asphyxia valve

39
Q

Higher Vt further increases vol of _______ ______.

A

CO2 rebreathing

40
Q

As I time increases then CO2 rebreathing increases/decreases?

A

Increases

41
Q

A normal RSBI value is ?

A

Less than 60-150 breaths/min

42
Q

What is critical value on resp rate?

A

> 35

43
Q

What produces the contraction in the heart?

A

Muscle depolarization

44
Q

____ ______ results when a cell chemically changes as it does with sodium potassium pump.

A

Electrical impulse

45
Q

The ECG shows us the ______ of _______.

A

Polarity of muscles

46
Q

What do we see on the ECG?

the SA node sending the impulse or response of the signal

A

Response of the signal

47
Q

The stage where there is no electrical impulse, see positive on outside & negative on inside

A

Cell is resting or polarized

48
Q

P-wave & QRS wave show what stage?

A

Depolarization

49
Q

What is your inherent rate of SA node?

A

60-100

50
Q

What is the inherent rate of AV Node?

A

40-60

51
Q

What is the inherent rate of purkinje fibers?

A

20-40

52
Q

This makes heart beat faster & can cause any clump of cells to take over?

A

Irritability mechanism

53
Q

When dominant pacemaker fails & next one takes over & paces heart at its inherent rate

A

Escape Mechanism

54
Q

What system causes decreased irritability, decreased rate, & FOC

A

Parasympathetic system

55
Q

This system directly influences entire heart

A

Sympathetic system

56
Q

This system works only on the SA Node

A

Parasympathetic system

57
Q

How do you assess mechanical activity?

A

Pulse, BP, CO

58
Q

How do you assess electrical activity?

A

ECG

59
Q

What produces electrical current?

A

Contraction

60
Q

A wave from base to apex is called a _____.

A

Vector

61
Q

This item will record

A

Oscilloscope

62
Q

Name the 3 electrodes you minimally need?

A

Positive, Negative, & Ground

63
Q

What are the 3 basic categories of leads?

A

Limb Lead
Augmented lead
Pre-Cordial Lead

64
Q

Lead I is placed on ________ to _______.

A

Left arm to right arm

65
Q

Left arm shows a positive/negative pattern on lead I & right arm shows positive/negative pattern.

A

Rt arm is negative

Left arm is positive

66
Q

Lead II shows right arm _______ & left leg as ______.

A

Negative

Positive

67
Q

Lead III shows left arm as ________ & left leg as _______.

A

left arm negative

left leg positive

68
Q

This type of lead makes single limb positive & all other negative?

A

Augmented lead

69
Q

How many leads are used with augmented lead?

A

6

70
Q

This type of lead will improve dx accuracy & provide another 6 views?

A

Precordial

71
Q

This type of lead can show myocardial infarction

A

Precordial

72
Q

What are your normal lead colors:
Ground = ?
Negative = ?
Positive = ?

A 
Ground = green
Negative = white
Positive = red or black
73
Q

With this type of lead a weak electrical signal is amplified?

A

Augmented lead

74
Q

What is minimum number of electrodes needed?

A

3

75
Q

How long must someone spont breath during trial to pass?

A

30-120 minutes

76
Q

Name some factors that contribute to failure of extubation?

A 
Older age
Repeated or traumatic intubations
use of iv sedation
duration of mech ventilation
anemia
severity of disease
reason for intubation
duration or number of spont breathing trials
77
Q

What tests for airway patency?

A

Cuff leak test

78
Q

Complete airway obstruction is called?

A

laryngospasm

weaning/ext/nppv (1 decks)

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