wk 3 respiratory ppt/1

Question 1

tidal volume Vt

Answer 1

volume of air inspired/expired with each breath

Question 2

hypercapnic RF causes include - chest wall

6

Answer 2

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

Question 3

hypoxemic RF shunt causes

Answer 3

1. anatomic shunt

2. intrapulmonary shunt

Question 4

early signs of RF

4

Answer 4

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

Question 5

what is a consequence of hypoxemia and hypoxia

Answer 5

cells shift from aerobic to anaerobic metabolism

Question 6

noninvasive PPV

2

Answer 6

BiPAP

CPAP

Question 7

how is Vt determined

Answer 7

by weight; normally 500-800 with avg 600

Question 8

to treat hypercapnic RF

1

Answer 8

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

Question 9

fraction of inspired oxygen in the air

Answer 9

FiO2

Question 10

what happens when cells shift from aerobic to anaerobic metabolism
4

Answer 10

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

Question 11

a sudden increase in ___ indicates a serious condition

Answer 11

PaCO2

Question 12

what will help with matching the v/q

3

Answer 12

ambulate
deep breaths
IS

Question 13

nursing and collaborative management

4

Answer 13

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

Question 14

hypercapnic RF causes include - CNS

3

Answer 14

1. OD
2. brainstem infarction
3. spinal cord injury

Question 15

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

Answer 15

SIMV

Question 16

two ways to treat hypoxemic RF

Answer 16

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

Question 17

COPD is what type of RF

Answer 17

hypoxemic failure - fluid in airways, not exchanging as much

Question 18

PaO2

Answer 18

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

Question 19

gradual increase means what

Answer 19

compensation occurs (COPD with URI)

Question 20

why do you try to bag controlled?

Answer 20

they can aspirate from the excess intake of air

Question 21

late sign of RF

Answer 21

cyanosis

Question 22

a sudden decrease in ___ indicates serious condition

Answer 22

PaO2

Question 23

what is something you do every time you intubate

Answer 23

x ray

Question 24

shunting happens when what

Answer 24

you don’t have a v/q match

Question 25

hypercapnic RF is am imblanace between

Answer 25

ventilatory supply and demand

Question 26

SIMV

Answer 26

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.

Question 27

PEEP

Answer 27

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

Question 28

why do you caution high levels of PEEP

Answer 28

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

Question 29

hypoxemic RF causes from ventilation perfusion include | 6

Answer 29

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

Question 30

hypercapnic RF causes include - airways and alveoli | 3

Answer 30

1. asthma 2. emphysema 3. CF

Question 31

RF specific clinical manifestations | 6

Answer 31

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

Question 32

what rate do you bag at

Answer 32

12-20 bpm

Question 33

RF dx studies | 8

Answer 33

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)

Question 34

what is PPV

Answer 34

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

Question 35

how to mobilize secretions | 5

Answer 35

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

Question 36

SaO2

Answer 36

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

Question 37

how to determine A/C

Answer 37

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

Question 38

increase v/q is caused by

Answer 38

blood issues itself as opposed to the alveoli

Question 39

oxygen therapy - delivery system should | 3

Answer 39

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

Question 40

hypoxemic respiratory failure aka

Answer 40

oxygenation failure

Question 41

once you intubate what do you do next

Answer 41

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

Question 42

hypercapnic RF causes include - neuromuscular conditions | 3

Answer 42

1. MD 2. GBS 3. MS

Question 43

hypoxemic RF diffusion limitation causes include | 6

Answer 43

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