test1-gary-spring Flashcards
1
Q
What is the normal VC rate?
A
65-75 ml/kg of ibw
2
Q
What is the critical value of VC?
A
10-15 ml/kg of IBW
3
Q
What is a normal Vt?
A
5-8 l/kg of IBW
4
Q
What is a critical Vt?
A
Less than 5 l
5
Q
What is normal range for MIP?
A
-100 to -50 cmH2O
6
Q
What is critical value for MIP?
A
-20 to 0
7
Q
What is normal for MEP?
A
100
8
Q
What is critical value?
A
Less than 40
9
Q
What is normal value for FEV1?
A
50-60 ml/kg
10
Q
What is critical value of FEV1?
A
Less than 10
11
Q
What is normal value of PEFR?
A
350-600
12
Q
What is critical value of PEFR?
A
75-100
13
Q
How do you find Vt if you have min volume & Freq?
A
Vt= Min Volume/Frequency
14
Q
What is a normal Min volume?
A
6-10 LPM
15
Q
Predictor of success for NPPV includes a PaCO2 greater than ______ but less than _______.
A
PaCO2 > 45
PaCO2 < 92
16
Q
Predictor of success for NPPV includes a pH less than ______ but greater than _______.
A
pH < 7.35 & > then 7.22
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
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
19
Q
Long term goals of NPPV include?
A
Relieve or improve symptoms Enhance quality of life Avoid hospitalization Increase survival Improve mobility
20
Q
What limits inspiration in NPPV?
A
Pressure limited
21
Q
What is the normal setting of humidification?
A
30 degrees heat
22
Q
If you increase Vt it can cause increase/decrease in CO2?
A
Increase
23
Q
How can you improve oxygenation?
A
Increase PEEP
24
Q
What setting assists with blowing out CO2?
A
CPAP or Peep
25
What setting is useful for acute cardiogenic edema?
CPAP to recruit FRC so they can oxygenate
26
NPPV is reserved for patients to facilitate weaning who have _____ or _______ as in others their condition worsens.
COPD or CHF
27
NPPV is indicated in the chronic care of COPD when the PaCO2 is > then _____ & ____ hospital admissions.
55
| 2 hospital admissions
28
What is the first line therapy for central or obstructive sleep apnea or lung parenchymal disease during nocturnal hypoventilation?
CPAP, NPPV when that fails
29
What happens if you increase your peep & make no other changes to NPPV?
Decrease your driving pressure
30
What is the best thing to do to relieve dyspnea?
Provide O2
31
How do you improve oxygenation?
increase FIO2 or Increase Peep
32
How much time should you allow to see improvement to guage if treatment is success in NPPV?
1-2 hours
33
How can you decrease PaCO2?
Increase pressure
34
What type of respiratory failure should NPPV not be used for?
Hypoxic resp failure
35
Name some reasons not to use bipap.
Apnea, hemodynamic instability, facial burns, uncooperative patient, facial trauma, high risk of aspiration, copious secretions, anantomic abnormality that interferes with gas delivery
36
If you increase your EPAP too much what condition can occur?
Hypotension
37
What is the name of the hole on clear plastic piece that allows for elimination of CO2 & cannot be plugged?
Intentional Leak Port
38
What is the name of the aqua blue valve that opens when forward velocity of flow stops?
Anti-asphyxia valve
39
Higher Vt further increases vol of _______ ______.
CO2 rebreathing
40
As I time increases then CO2 rebreathing increases/decreases?
Increases
41
A normal RSBI value is ?
Less than 60-150 breaths/min
42
What is critical value on resp rate?
> 35
43
What produces the contraction in the heart?
Muscle depolarization
44
____ ______ results when a cell chemically changes as it does with sodium potassium pump.
Electrical impulse
45
The ECG shows us the ______ of _______.
Polarity of muscles
46
What do we see on the ECG?
| the SA node sending the impulse or response of the signal
Response of the signal
47
The stage where there is no electrical impulse, see positive on outside & negative on inside
Cell is resting or polarized
48
P-wave & QRS wave show what stage?
Depolarization
49
What is your inherent rate of SA node?
60-100
50
What is the inherent rate of AV Node?
40-60
51
What is the inherent rate of purkinje fibers?
20-40
52
This makes heart beat faster & can cause any clump of cells to take over?
Irritability mechanism
53
When dominant pacemaker fails & next one takes over & paces heart at its inherent rate
Escape Mechanism
54
What system causes decreased irritability, decreased rate, & FOC
Parasympathetic system
55
This system directly influences entire heart
Sympathetic system
56
This system works only on the SA Node
Parasympathetic system
57
How do you assess mechanical activity?
Pulse, BP, CO
58
How do you assess electrical activity?
ECG
59
What produces electrical current?
Contraction
60
A wave from base to apex is called a _____.
Vector
61
This item will record
Oscilloscope
62
Name the 3 electrodes you minimally need?
Positive, Negative, & Ground
63
What are the 3 basic categories of leads?
Limb Lead
Augmented lead
Pre-Cordial Lead
64
Lead I is placed on ________ to _______.
Left arm to right arm
65
Left arm shows a positive/negative pattern on lead I & right arm shows positive/negative pattern.
Rt arm is negative
| Left arm is positive
66
Lead II shows right arm _______ & left leg as ______.
Negative
| Positive
67
Lead III shows left arm as ________ & left leg as _______.
left arm negative
| left leg positive
68
This type of lead makes single limb positive & all other negative?
Augmented lead
69
How many leads are used with augmented lead?
6
70
This type of lead will improve dx accuracy & provide another 6 views?
Precordial
71
This type of lead can show myocardial infarction
Precordial
72
What are your normal lead colors:
Ground = ?
Negative = ?
Positive = ?
```
Ground = green
Negative = white
Positive = red or black
```
73
With this type of lead a weak electrical signal is amplified?
Augmented lead
74
What is minimum number of electrodes needed?
3
75
How long must someone spont breath during trial to pass?
30-120 minutes
76
Name some factors that contribute to failure of extubation?
```
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
What tests for airway patency?
Cuff leak test
78
Complete airway obstruction is called?
laryngospasm
