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NURS 460 - Adult III Exam 1 > wk 3 respiratory ppt/1 > Flashcards

wk 3 respiratory ppt/1 Flashcards

1
Q

tidal volume Vt

A

volume of air inspired/expired with each breath

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2
Q

hypercapnic RF causes include - chest wall

6

A
  1. flail chest
  2. kyphoscoliosis
  3. morbid obesity
  4. fracture
  5. mechanical restriction
  6. muscle spasm
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3
Q

hypoxemic RF shunt causes

A
  1. anatomic shunt

2. intrapulmonary shunt

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4
Q

early signs of RF

4

A
  1. tachycardia
  2. tachypnea
  3. mild HTN
  4. severe morning headache
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5
Q

what is a consequence of hypoxemia and hypoxia

A

cells shift from aerobic to anaerobic metabolism

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6
Q

noninvasive PPV

2

A

BiPAP

CPAP

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7
Q

how is Vt determined

A

by weight; normally 500-800 with avg 600

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8
Q

to treat hypercapnic RF

1

A
  1. increase minute ventilation (Ve) through increase RR or increase Vt
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9
Q

fraction of inspired oxygen in the air

A

FiO2

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10
Q

what happens when cells shift from aerobic to anaerobic metabolism
4

A
  1. lactic acid production
  2. metabolic acidosis and cell death
  3. decreased CO
  4. impaired renal function
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11
Q

a sudden increase in ___ indicates a serious condition

A

PaCO2

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12
Q

what will help with matching the v/q

3

A

ambulate
deep breaths
IS

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13
Q

nursing and collaborative management

4

A
  1. respiratory therapy
  2. mobilization of secretions
  3. positive pressure ventilation PPV
  4. noninvasive PPV
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14
Q

hypercapnic RF causes include - CNS

3

A
  1. OD
  2. brainstem infarction
  3. spinal cord injury
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15
Q

once a patient starts breathing on their own, start them on what

A

SIMV

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16
Q

two ways to treat hypoxemic RF

A
  1. increase FiO2 (oxygen getting delivered i.e. 100% = 1.0 FiO2)
  2. increase mean airway pressure
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17
Q

COPD is what type of RF

A

hypoxemic failure - fluid in airways, not exchanging as much

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18
Q

PaO2

A

partial pressure of oxygen - measurement of oxygen pressure in arterial blood; reflects how well oxygen is able to move from lungs to the blood

19
Q

gradual increase means what

A

compensation occurs (COPD with URI)

20
Q

why do you try to bag controlled?

A

they can aspirate from the excess intake of air

21
Q

late sign of RF

22
Q

a sudden decrease in ___ indicates serious condition

23
Q

what is something you do every time you intubate

24
Q

shunting happens when what

A

you don’t have a v/q match

25
Q

hypercapnic RF is am imblanace between

A

ventilatory supply and demand

26
Q

SIMV

A

Synchronized intermittent mandatory ventilation (SIMV) is a type of volume control mode of ventilation. With this mode, the ventilator will deliver a mandatory (set) number of breaths with a set volume while at the same time allowing spontaneous breaths.

27
Q

PEEP

A

positive end expiratory pressure - keeps a small amount of pressure in lungs after expiration to keep alveoli open

28
Q

why do you caution high levels of PEEP

A

can put pressure on great vessels and decrease cardiac output; normal ventilation is around +5 PEEP

29
Q

hypoxemic RF causes from ventilation perfusion include

6

A
  1. ventilation-perfusion (V/Q) mismatch
  2. COPD
  3. pneumonia
  4. asthma
  5. atelectasis
  6. pain
  7. pulmonary embolus
30
Q

hypercapnic RF causes include - airways and alveoli

3

A
  1. asthma
  2. emphysema
  3. CF
31
Q

RF specific clinical manifestations

6

A
  1. rapid, shallow breathing pattern
  2. tripod position
  3. dyspnea
  4. pursed lip breathing
  5. retractions
  6. change in I:E ratio
32
Q

what rate do you bag at

33
Q

RF dx studies

8

A
  1. H&P
  2. ABG
  3. chest x ray
  4. CBC, sputum
  5. ECG
  6. urinalysis
  7. V/Q lung scan
  8. pulmonary artery catheter (in severe cases)
34
Q

what is PPV

A

we push air into your lungs; can be invasive or noninvasive

35
Q

how to mobilize secretions

5

A
  1. hydration
  2. humidification
  3. chest PT
  4. airway suctioning
  5. effective coughing and positioning
36
Q

SaO2

A

oxygen saturation - measurement of the percentage of how much hgb is saturated with oxygen

37
Q

how to determine A/C

A

Vt (i.e 600) x RR (i.e.12) = 7.2 liters (mid volume)

38
Q

increase v/q is caused by

A

blood issues itself as opposed to the alveoli

39
Q

oxygen therapy - delivery system should

3

A
  1. be tolerated by pt
  2. maintain PaO2 at 55-60 mm Hg or more
  3. SaO2 at 90% or more at lowest O2 concentration possible
40
Q

hypoxemic respiratory failure aka

A

oxygenation failure

41
Q

once you intubate what do you do next

A

place CO2 monitor down trachea to determine if it changes colors to say it’s in the correct space, then listen to lungs and call for x ray

42
Q

hypercapnic RF causes include - neuromuscular conditions

3

43
Q

hypoxemic RF diffusion limitation causes include

6

A
  1. severe emphysema
  2. recurrent pulmonary emboli
  3. pulmonary fibrosis
  4. ARDS
  5. interstitial lung disease
  6. hypoxemia present during exercise

NURS 460 - Adult III Exam 1 (16 decks)

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