Term
| What varies on a volume vent |
|
Definition
Pressure & flow/Volume is SET
(time is a cycling parameter & does not help deliver volume) |
|
|
Term
| What varies on a Pressure vent |
|
Definition
| Volume & flow/ Pressure is SET |
|
|
Term
| What is the objective of mechanical ventilation (MV) |
|
Definition
decrease work of breathing (WOB)
treat hypoxemia
fix or manipulate alveolar ventilation (VA) |
|
|
Term
| What is the difference in using a volume vent compared to a pressure support (PS) vent |
|
Definition
Volume is LONG term
Pressure Support is SHORT term |
|
|
Term
| What two laws are applied in Mechanical Ventilation |
|
Definition
|
|
Term
| In mechanical ventilation, what is the cycling parameter |
|
Definition
ends inspiration & starts expiration
(an MV can have more than one cycling parameter)
Volume,Pressure or Time can end inspiration |
|
|
Term
| What are four indications of continuous mechanical ventilation |
|
Definition
Apnea
Acute ventilatory failure
Non responsive hypoxemia
Impending respiratory failure |
|
|
Term
| Name two things that can go wrong on a ventilator |
|
Definition
Obstruction (high pressure)
Leak (low pressure) |
|
|
Term
| Why is a humidification system necessary when using a ventilator |
|
Definition
Upper airway is bypassed
need humidity to help prevent mucus plugging & arterial hypoxemia |
|
|
Term
| Can low compliance tubing be used in MV |
|
Definition
NO
High compliance only due to the pressures/volumes used |
|
|
Term
| What are the indications for intubation |
|
Definition
Patent airway
protect from aspiration
bronchial hygiene
mechanical ventilation |
|
|
Term
| The physiological effects of intubation are: |
|
Definition
Decreased dead space
May increase respiratory rate
May increase WOB |
|
|
Term
| What are some complications of intubation |
|
Definition
1.esophageal intubation
2.oral trauma
3.R or L mainstem bronchus intubation (tube going in too far)
4.aspiration during procedure
5.vocal cord damage
6.tracheal stenosis
7.tissue necrosis |
|
|
Term
| The components for an effective cough are: |
|
Definition
Adequate Tidal Volume (VT)
Abdominal contraction
Glottic closure |
|
|
Term
|
Definition
Pressure measurement in MV for volume
(the hold or pause of inspiratory after a peak) |
|
|
Term
|
Definition
Difference in pressure created by the force exerted by the blower
(ex: between the blower & balloon- the force air is blown into balloon) |
|
|
Term
|
Definition
Pressure measurement for volume in MV
(Peak is the high) |
|
|
Term
| What is a mode of ventilation |
|
Definition
ventilator breathing patterns that are allowed
(certain setting on a vent) |
|
|
Term
| What is a triggering effect |
|
Definition
| an initiation of a breath in MV |
|
|
Term
|
Definition
| a preset amount of pressure,flow,volume or time that a vent does not exceed during inspiration |
|
|
Term
|
Definition
| the changeover from inspiration to expiration |
|
|
Term
|
Definition
the best PaO2 without compromising CO,HR & BP
(CO-cardiac output,HR-heartrate,BP-blood pressure) |
|
|
Term
| when is it permissable to add deadspace |
|
Definition
Control mode only
(increased PaCO2) |
|
|
Term
| what happens to CO when weaning a patient from MV |
|
Definition
CO may decrease
if it drops too much, hypotension & cardiovascular collapse may result
(BP should be carefully monitored) |
|
|
Term
| what are some techniques used in weaning a patient from MV |
|
Definition
IMV (Intermittant Mandatory Ventilation)
CPAP (Continuous Positive Airway Pressure)
T-Piece (connected to circuit) |
|
|
Term
| what is the importance of psychologically preparing a patient for weaning |
|
Definition
prevent anxiety
give support
to explain what you are trying to do to get patient off MV |
|
|
Term
|
Definition
no gag reflex
intubation necessary to protect airway & prevent aspiration |
|
|
Term
|
Definition
Rapid Shallow Breathing Index
f divided by VT (should be less than 105 for weaning) |
|
|
Term
| in MV monitoring, what is the first step in patient observation |
|
Definition
look at everything when entering the room
CHECK THE PATIENT
(ex:what is patients color/how fast is patient breathing/patterns of breathing,etc.) |
|
|
Term
| what patient is most likely to get auto PEEP |
|
Definition
COPD patients
(ex:Emphysema & Statis astimaticus)
treat with pressure vent & bronchodilators |
|
|
Term
| what happens to PaCO2 during weaning |
|
Definition
PaCO2 will often increase at first,then return to a more normal level
first 24hrs are the most significant in monitoring PaCO2 levels |
|
|
Term
| what is the second step in MV monitoring |
|
Definition
check the ventilator
(ex:circuitry,humidification,settings,alarms,etc.) |
|
|
Term
| what are the alarm parameters on an MV |
|
Definition
| 10-15 above & below set or what patients doing |
|
|
Term
| what modes can Pressure Support (PS) be used with |
|
Definition
|
|
Term
| what is the most important CPAP alarm in setting up |
|
Definition
|
|
Term
| what does CPAP do to benefit in treatment of Pulmonary Edema |
|
Definition
| moves fluid out to the sides |
|
|
Term
| when weaning off MV, what mode must patient be in |
|
Definition
CPAP
PS
SIMV
(T-piece)
Spontaneous
NOT PEEP by itself |
|
|
Term
| what are the differences between IMV & SIMV |
|
Definition
IMV-machine triggered
SIMV-patient triggered |
|
|
Term
|
Definition
| pressure in the lung during an inspiratory pause |
|
|
Term
| what is the #1 indication of PEEP |
|
Definition
| increased FRC (Functional Residual Capacity) |
|
|
Term
| what is the best way to improve VA (Alveolar Ventilation) |
|
Definition
| increase VT (Tidal Volume) |
|
|
Term
|
Definition
Intermittant Mandatory Ventilation
mode of support in which patient can take spontaneous breath inbetween MV breaths |
|
|
Term
|
Definition
Synchrnized Intermitant MV
mode of support in which assisted breaths are responsive to patient demand
synch to prevent air stacking |
|
|
Term
|
Definition
Pressure Support Ventilation
mode of support in which spontaneous breathing is augmented
patient triggered; pressure limited; flow-cycled |
|
|
Term
| can CPAP be put on a patient with acute ventilatory failure |
|
Definition
NO
only impending or spontaneous breathing patients |
|
|
Term
| what can be done to treat auto PEEP |
|
Definition
increase E time (expiratory time)
increase peak flow
decrease I time (inspiratory time) |
|
|
Term
| what do you alter to correct bad I : E ratios |
|
Definition
|
|
Term
| what is monitored in a PEEP trial |
|
Definition
1st BP (anything greater than 120/80 = hypertension)
2nd-check RR,HR & CO |
|
|
Term
| can dynamic compliance be altered |
|
Definition
Yes
ex: water in circuitry; kinking of circuitry; chest tube, etc. |
|
|
Term
| how can you decrease PaCO2 |
|
Definition
| increase VT & f; decrease VD (control mode only) |
|
|
Term
| how can you increase PaCO2 |
|
Definition
| decrease VT & f; increase VD (control mode only) |
|
|
Term
| what are some indications for MV |
|
Definition
any condition that may impair breathing
ex: Apnea;acute respiratory failure;oxygenation failure;impending respiratory failure,etc. |
|
|
Term
|
Definition
Positive End Expiratory Pressure
application of positive pressure in MV during exhalation |
|
|
Term
| what is head injury target pressure |
|
Definition
|
|
Term
|
Definition
Continuous Positive Airway Pressure
application of positive pressure during inhalation & exhalation with spontaneous breathing |
|
|
Term
| how long do you wait, after putting patient on MV, before getting an ABG (Arterial Blood Gas)sample |
|
Definition
|
|
Term
| what should a NIF be in MV parameters of weaning a patient |
|
Definition
| -20cmH2O within 20 seconds or less while using a manometer |
|
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