Term
| What is the sudden death of an infant less than a year of afe that remains unexplained after a complete postmortem autopsy |
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Definition
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Term
| What four things could attribute to SIDS? |
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Definition
Brainstem abnormalities
Smoking environment
Co-sleeping
Unsafe sleeping practices |
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Term
| what are more things that could attribute to SIDS? |
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Definition
Sleeping prone
lack of prenatal care
maternal age of 20
Substance use
low birth weight
Smoke
low socioeconomic status |
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Term
| What position should a baby be placed to sleep? |
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Definition
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Term
| What type of sleeping environment should a baby have? |
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Definition
| firm mattress, not on sofa, free of fluff basically |
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Term
| What happens on to a baby with SIDS in the ER |
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Definition
No attempt to resuscitate
factual ? asked
antopsy
let parents say goodbye |
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Term
| How should the nurse teach the parents of child who died of SIDS? |
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Definition
Refer to support groups
Give printed materials
Respect mourning |
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Term
| What is characterized by recurring episodes of increased airway obstruction and reduction in ventilation? |
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Definition
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Term
| What is the cycle of OSA? |
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Definition
Muscles relax
throat is blocked/air
O2 levels decrease
Alarm in brain arouses person
Neck regains tone/breath again |
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Term
| What kind of clients are at risk for OSA? |
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Definition
| Obesity, over 65, large neck, males, HTN, African Amer, Large tongue, Spinal/b. stem injury, Small jaw, brain tumor, opiod use, overbite |
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Term
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Definition
Abnorm. breathing pattern
Abrupt awakenings w/ SOB
insomnia
Morning headaches
diff concentrating
Hypersomnia
Irritability
dry mouth
sore throat
snoring
pm sweats
impotence
systemic HTN
enuresis |
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Term
| With children with OSA, what occurance indicates it? |
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Definition
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Term
| How would a client with OSA be assessed? |
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Definition
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Term
| What tx could be effective for OSA? |
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Definition
loose weight
avoid alcohol
sleeping positions
CPAP
Mouth piece
smoking cessation
Meds |
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Term
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Definition
| Uvulopalatopharyngoplasty |
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Term
| What is the most effective tx for OSA? |
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Definition
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Term
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Definition
| create + pressure and splints to keep the airway open during sleep, breathing independently |
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Term
| What two meds are used in OSA? |
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Definition
Provigil: daytime sleepiness
Triptil: increase in resp drive and upper airway muscles tone. |
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Term
| What is classified as a condition but not a disease? |
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Definition
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Term
| What is the sudden life-threatening deterioration of gas exhange function of the lungs and indicates failure of the lungs to provide adequate oxygenation or ventilation for the blood? |
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Definition
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Term
| What lab indicates Hypoxemia |
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Definition
| PaO2< or equal to 60 mmHg or 60% O2 |
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Term
| what is the condition in which one has failure to get O2 in the body and failure to get CO2 out? |
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Definition
| ARF (Acute Respiratory failure) |
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Term
| When does hypercapnia occur? |
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Definition
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Term
| What is a slow detieroation of gas exch. function of the lungs or a continuing decreased function after a period of acute R. failure? |
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Definition
| CRF (Chronic Respiratory failure) |
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Term
| What are some s/s of CRF? |
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Definition
| restlessness, dyspnea, increase B/P, headache, cyanosis, diaphoresis, confusion, tachycardia, fatigue, air hunger, lethargy, tachypnea, r. arrest |
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Term
| What are the goals of CRF? |
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Definition
Correst underllying cause
intubation
Optimally restore gas exchange |
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Term
| A Pulmonary Embolism starts with a _______ and originates in the _____ _____ of the legs. Usually travels throught the ___ ___ and to ____ _____ |
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Definition
Clot/Thrombus
Deep veins
Pelvic veins
right atrium |
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Term
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Definition
Prolonged immobile
varicose veins
sit/travel
spinal injury
post op state
pregnancy
Oral BC
increase platelet count
foreign body (IV)
diabetes
increased age
obesity
constrictive clothing |
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Term
| What DX test are used for PE? |
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Definition
CXR
EKG
Peripheral vascual studies
VQ scan
Spiral CT
Pulm. Angio gram
D-Dimer (blood test for clots) |
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Term
| What could we do for prevention of PE? |
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Definition
Early ambulation
Leg exercises
anti-embolism stockings
SCDS |
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Term
| What type of meds are given for PE? |
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Definition
Anticoagulants (warfarin, heparin, lovenox)
Thrombolytic agents (urokinase, streptokinase, altplase) |
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Term
| With the meds for PE, what should be done to the pt? |
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Definition
Bed rest
VS Q 2hr
no invasive procedure
PTT/INR
Essential arterial/venipunctures
Manual pressure for 30 min to any puncture |
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Term
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Definition
Surgical embolectomy
Inferior vena cava filter |
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Term
| What should you avoid in pt on coumadin? |
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Definition
| Vit K.- green leafy veggies |
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Term
| What are some nurse managements for people with PE? |
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Definition
Don't cross legs
no dangling
don't position feet in dependent position (rest on chair/floor) |
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Term
| What is defined as +/- pressure breathing device that can maintain ventilation and o2 delivery for a prolonged period of time? |
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Definition
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Term
| When would Mechanical ventilation be used? |
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Definition
R. Failure/Distress
Impaired gas exchange/increase work of breathing
Hypercapnia/Hypoxemia |
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Term
Exerts negative pressure on external chest
Decreases the intrathoracic pressure during inspriation allows air to the lungs
Spontaneous breaths
Simple/homecare
Chronic R. failure |
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Definition
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Term
Pushes air in the lungs while expiration is passive.
Intubation/trach is necessary
Widely used in hospital and a lot in home
Volumed cycled vent/pressure cycled vent. |
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Definition
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Term
| What is the goal of mechanical vent? |
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Definition
Ensure pt has a patent airway
(obstruction= decreased O2)
(no vent+no O2= brain damage) |
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Term
| What is the nurses role with mechanical ventilation? |
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Definition
Monitor R status
Keep eye on equip/respond to alarms
Notify respiratory if there is a prob
Document freq. R assessment |
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Term
| What should be made sure is completed with a Mechanical ventilator? |
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Definition
Manual Ressucitation @ bedside
Self-test (working properly)
Changed q 24h
Bacteria filters checked for occlusions/tears/H2O traps |
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Term
| What should the FIO2 be upon admin and after? |
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Definition
| 100% upon initiation, 21%-100% |
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Term
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Definition
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Term
| what type of Ventilation if the pt is dependent and unable to initiate breath? |
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Definition
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Term
| What Ventilation responds to pt own inspiration breath but will do so if they don't (pt. sedated-hyperventilation and weakened muscles) |
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Definition
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Term
| What ventilation allows pt to breathe spontaneously in between ventilator breaths. |
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Definition
| Synchronous Intermittent Mandatory Ventilation |
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Term
| What ventilation is a + pressure @ end of expiration and is used adjucnted to cv, a/c, sim to increase O2 by opening collapsed alveoli? |
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Definition
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Term
| If a ventilator alarm goes off, what should the nurse do? |
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Definition
-Respond immediately
-Assess client 1st
-take off vent, and use bag until MD arrives |
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Term
| With increased secretions, kinked tubing, biting ETT, and water in tubes, what kind of alarm will the nurse expect to hear? |
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Definition
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Term
| WIth cuff leaks, d/c tubing, holes in ETT, or leaks in the humidifier, what alarm sounds will the nurse expect to hear? |
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Definition
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Term
| Delivers a present volume or pressure regardless of patient's own inspiratory efforts. Used for pts who are apneic |
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Definition
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Term
| Delivers breath in response to pt effort and if pt fails to do so within preset amt of time. Used for spontaneous breathing patients c weakened resp. muscles |
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Definition
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Term
| Ventilator breaths are synchronized with patient's respiratory effort. Used to wean pts from mechanical vents. |
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Definition
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Term
| Preset pressure that augments the pt inspiratory effort and decreases breathing work. used WITH SiMV during weaning |
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Definition
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Term
| Positive pressure applied at the end of expiration. Used with CV, A/C and SIMV to improve oxygenation by opening collapsed alveoli |
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Definition
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Term
| Similar to PEEP but used only with spontaneously breathing patients. Constant pressure is airways so resistance is decreased. |
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Definition
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Term
| Number of breaths delivered by the ventilator per min? How many? |
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Definition
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Term
| Volume of gas delivered during each vent breath? How many? |
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Definition
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Term
| Amount of o2 delivered by vetn to patient, and how is it set? |
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Definition
| max amt of pressure vent can use for a breath: set at 21%-100% to keep paco2 >60 and sao2 >90 |
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Term
| Length of inspiration compared to length of expiration: what's the ratio? |
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Definition
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Term
| Max amt of pressure the vent can use to deliver breath, how much? |
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Definition
| Pressure limit, 10-20 cm H20 above peak, MAX is 35 cm H20 |
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Term
| A high pressure alarm will sound if what happens? |
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Definition
Secretions in ett/airway/condensation in tubing
Kink in vent
Biting on ETT
Cough/gag/talking
Bronchospasm |
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Term
| With low pressure alarms, what is happening? |
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Definition
Vent tube not connected
Displaced ETT or trach tube |
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Term
| Why would a pt have a high respiratory rate? |
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Definition
Anxiety/pain
Secretions in airway
Hypoxia
Hypercabnia |
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Term
| Why would there be a low exhaled volume by the pt on a vent? |
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Definition
Vent tube not connected
Leak in cuff/cuff seal
Occurence of another alarm preventing full delivery of breath |
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