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ICU Liz > Ventilation > Flashcards

Ventilation Flashcards

1
Q

What is VT?

A

Tidal Volume - volume of gas moved in and out of the lungs in a single inspiration and expiration

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2
Q

What is RV?

A

Residual Volume - the volume of gas remaining in the lungs after maximum expiration

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3
Q

What is IRV?

A

Inspiratory Reserve Volume- the maximum volume of additional air that can be inspired after normal inspiration

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4
Q

What is ERV?

A

Expiratory Reserve Volume - The maximum amount of gas that can be forcibly exhaled after a normal expiration

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5
Q

What is FRC?

A

Functional Residual Capacity - the volume of air present in the lungs at the end of passive expiration

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6
Q

What is IC?

A

Inspiratory capacity - the total volume of gas that can be inspired after a normal exhalation

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7
Q

What is Total Lung Capacity ?

A

The maximum volume of gas contained in the lungs after maximum inspiration

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8
Q

What is VC?

A

Vital Capacity - the greatest volume of gas that can be forcibly inhaled after maximal exhalation

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9
Q

What is FiO2?

A

Fraction of Inspired Oxygen - sets the oxygen percentage and controls the mixture of gases

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10
Q

What is the Fset?

A

Relates to the number of breaths that the ventilator is set to deliver in one minute

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11
Q

What is VT?

A

The amount of gas , in millilitres that is inhaled and exhaled in each breath

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12
Q

What is MV?

A

Minute Volume - the total volume of gas delivered to the pt in one minute

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13
Q

What is PEEP?

A

Positive End Expiratory Pressure - the Positive pressure in the lungs (above atmospheric pressure) that exists at the end of expiration and prevents the closure of alveoli

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14
Q

What is P.insp?

A

Peak Inspiratory Pressure - the highest level of pressure generated in the lungs during inspiration when the pt is ventilated

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15
Q

What is P.peak?

A

Peak Airway Pressure - the highest pressure during the previous breath

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16
Q

What is ETS?

A

Expiratory Trigger Sensitivity- a setting that defines the percentage (%) of peak inspiratory flow that will cycle the ventilator into exhalation

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17
Q

What is C.stat?

A

Static Compliance- it represents pulmonary compliance during periods without gas flow, such as during an inspiratory pause.

18
Q

What is R.Insp?

A

Resistance- primarily derived from the resistance in the airways and ETT

19
Q

What is RCexp?

A

Expiratory time constant- a dynamic measurement of respiratory function in both mandatory ventilated or spontaneously breathing patients. The rate at which the lung empties

20
Q

How do you work out Tidal Volume (VT)?

A

5-8mL x pt weight

21
Q

How do you work out (FRC) Functional Residual Capacity?

A

(ERV + RV) - Expiratory reserve volume + Reserve Volume

22
Q

How do you work out Total lung capacity?

A

(IC + FRC) Inspiratory capacity + Functional Residual Capacity

23
Q

How do you work out vital capacity (VC)?

A

(IRV +VT+ERV) Inspiratory reserve volume + Tidal volume + Expiratory reserve volume

24
Q

what are the indications associated with mechanical ventilation?

A
  • airway management
  • management of respiratory distress
  • to enable sedation or paralysis
  • post op management
  • increase lung volumes and reduce WOB
  • prevention or reversal of alveolar trauma
25
Q

what are the indications for the use of PEEp?

A

used when a patient requires assistance with ventilation in order to improve the ventilation and perfusion of the lungs and increase arterial oxygen tension

26
Q

what causes high peak airway pressure and how would you troubleshoot this?

A

Ppeak is influenced by airway resistance and compliance

  • check the ventilator and settings
  • look listen and feel patient
  • check endotracheal tube
  • suction for patentcy
  • CRX for positioning
  • check for kinks or obstructions

-

27
Q

what is PS (pressure Support) and how does it work?

A

the patient has control over the respiratory frequency and the depth and length and flow of each breath.
-PS ventilation can also compensate for the increased work imposed by the resistance of the ETT and the ventilator.

28
Q

what happens to the tidal volume when pressure support is manipulated?

A

Pressure support can have an effect on the tidal volume, as it can assist with the expansion of the lungs

29
Q

what are some of the advantages Spontaneous Mode?

A
  • ensures adequate lung expansion
  • ensure adequate gas exchange
  • will support a patients spontaneous inspiratory effort (making inspiration easier)
  • pt controls inspiratory time, flow rate, frequency and expiratory time
30
Q

what is the pre-requisite for a patient receiving Spontaneous Mode?

A
  • pt RASS is -2 to 0
  • pt 8 breaths a minute or is greater than ventilators set RR
  • pt is able to initiate inspiration for every breath
31
Q

what does SIMV stand for and briefly define this mode of ventilation

A

Synchonised Intermittent Mandatory Ventilation

-ensures a set number of breaths are delivered at a set volume every minute

32
Q

what does DuoPAP mean and breifly define this mode of ventilation.

A

Duo Positive Airway Pressure
-the ventilator will deliver the number of breaths set, to the pressure set (Phigh), for the set amount of time (T-high), it will then release the breath to PEEP and offer the patient support for any breath taken in that time

33
Q

what are the signs that a patient f not tolerating the ventilator?

A
  • biting/coughing on the tube
  • swallowing
  • trying to remove the airway piece
34
Q

describe your actions if you were having problems ventilating your patient

A
  • review pt
  • check your cuff
  • check O2 + Co2 + RR
  • check for kinks
  • check equipment
  • listen to chest
35
Q

what is the function of the cuff on an ETT or Tracheostomy tube?

A

Provide a seal between the ETT and the tracheal wall to enable accurate delivery of tidal volumes during mechanical ventilation

36
Q

what is a normal cuff pressure and how often should it be checked?

A
  • cuff pressure should be maintained between 20-30cm H2O (as per the green section on the cuff manometer)
  • it should be checked at the commencement of each shift or when cuff leak is suspected
37
Q

Name a possible complication if the cuff pressure is too high

A

Too high- tissue ischemia, ulceration and necrosis of the tracheal wall

38
Q

Name a possible complication if the cuff pressure is too low

A

Too low- leak of air, oropharygeal secretions around the ETT cuff, predisposing the pt to inadequate ventilation, de-recruitment, aspirational pneumonia and ETT migration

39
Q

You are caring for a pt with an ETT. While performing a face shave, you accidentally sever the pilot line. What are your nursing actions?

A
  • inform Drs immediately
  • assist pt breathing
  • get intubation trolley
40
Q

your intubated patient suddenly starts making gurgling noises and their minute volume has decreased from 7L/min to 2L/min. What would you suspect has happened?

A

-pt may have built up secretions and require suctioning.

41
Q

your agitated pt has self extubated, what are your immediate nursing actions?

A
  • CODE BLUE
  • place either a NRM or commence on manual rebreather bag with O2 runninig
  • monitor airway and breathing
  • sedation?

ICU Liz (16 decks)

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