What is changed when a pat is on PV?
Change the set pressure increased or decreased to adjust Vt
What equation is used to reduce PaCo2 on a pat vented with VC ventilation when the rate is needing to be changed due to volume being high enough?
Desired F= known F X PaCo2/desired PaCo2
What is the equation to find desired Vt in VC ventilation?
Desired Vt= known Paco2 X Known Vt/desired PaCo2
What is increased to increase Vt with a PVC time cycled ventilation?
With pressure control ventilation PCV the set pressure is generally increased to obtain the targeted Vt. PCV is Time cycled If It is short increasing it will increase volume delivery without increasing pressure.
What do you change if Vt and pressure plateu are already high to improve PaCo2?
What will need to be changed on a ventilated pat on VC and PV to decrease the PaCo2?
minute volume Ve
What are the causes of respiratory acidosis in a nonventilated patient?
chest wall abnormalities
central nervous system problems
What two values are effected if patient has respiratory acidosis and Va is not adequante on volume ventilation and pressure ventilation?
PaCo2 elevated above >45mmhg and pH decreased <7.35
What two things can be adusted when a patient is on PCV with respiratory acidosis?
Inspiratory time set pressure reaches alveolar level if this doesnt work set pressure increased to improve volume
What change in ventilation is made to ventilator to correct respiratory alkalosis or acidosis?
Vt or rate
What change is made right away when a patient is on mechanical ventilatio?
minute volume Ve
What should a therapist do if the heart rate increased during suctioning?
immediately stop suctioning and provide 100% O2
For above the cuff suctioning, what pressure is left on to continuously suction?
What is the correct size of catheter used to suction?
1/2 the size of the ET tube. equation for a size 8 ET tube 3x8=24 24/2=12Fr Size 12Fr is used
A patient with CHF has what type of secretions?
Thin white or pink frothy secreations but won't block the airway
What is the normal ratio of Vd to Vt (Vd/Vt)?
0.2 to 0.4
Where does the contraction start of the ventricle?
Starts at Q
What is pip?
Peak inspiratory pressure, this is the peak at which the flow is given at an inspiration
What is SpO2?`
Saturation of O2 on the Hb
What is an HME?
artificial nose humidity, filter,warms
What is slope (aka rise)?
Inspiratory rise time, it slows or speeds the rate at which pressure and flow exit the ventilator for a specific period of time
What is trigger?
The sensativity set too low can also cause auto peep
What is FIO2?
% of O2 to improve Oxygenation. A way to measure O2 to the tissues. Check ABG's to keep PaO2 ath 60-90mmHg below 0.4 to 0.5
What is minimal occluding volume?
volume of air measured to seal the cuff at 1 to 2%
What is minimal leak?
It allows a small amount of air to leak out of cuff
How do we check for the level of consciouness?
wake up the patient (if arousable) check for alertness, sleep, etc.
How does CPAP effect a patient on a ventilator?
It provides FiO2, inspiratory flow, peep, inflates alveoli
How is peep used to detect level of optimal peep?
static compliance, prevents atelectasis
What is plateau pressure
measures pressures needed to keep lungs extended less or equal to 35cmH2O
What wave does ventricular repolarization start?
What level is PIP set to on an alarm?
10cmH2O above and below
What is Ve set to on an alarm?
low Ve= 10% below
highVe= 10% above
What is the equation for MAP?
(PIPxIt) + (peepx Et)/total seconds
What is VC?
IRV, Vt, ERV
What is IC?
What is TLC?
IRV, Vt, ERV, RV
What is FRC?
What is predicted FVC, FEV1, FEV1% for a restrictive patient?
<80% predicted FVC, normal or <80% predicted FEV1, > or equal to predicted FEV1%
What is predicted FVC, FEV1, FEV1% for obstructive patient?
normal or <80% predicted FVC, <80% predicted FEV1, <predicted FEV1%
What is a patients trigger, target and cycle? VC
trigger=time, target=flow, cycle=volume
What is a patients trigger, target, and cycle? VA
trigger=effort, target=flow, cycle=volume
What is a patients trigger, target, and cycle? PC
trigger=time, target=ins, cycle=time
What is a patients trigger, target, and cycle? PS
trigger=effort, target=ins, cycle=flow
What is a ptients trigger, target, and cycle? spontaneous
trigger=effort, target=ins, cycle=effort
What is one cuase of increased dead space?
pulmonary embolism or low cardiac output resulting in low pulmonary perfusion
What is the ABG values with mexed acid bases?
pH increased, PaCo2 increased, PaO2 increased, HcO3 increased
What are the two sure signs of metabolic acidosis on and ABG?
pH 7.45 to 7.70 and bicarbonate 26 to 48
What are the causes of metabolic acidosis
uremic acidosis (renal failure)
What is decreased on VC when patient is breathing spontaneously?
switch ventilator to SIMV mode
could possibly sedate but a last resort if patient is anxious
On a PV what should be decreased to improve ventilation?
frequancy, and set the pressure second
To correct respiratory alkalosis in a vented patient, what should be decreased to correct ventilation on a VV vented patient?
frequancy first then Vt
What are the causes of respiratory alkalosis?
hypoxia with compensated hyperventilation
central nervous system disorders