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Persing Chap 11-17 note cards
Terms in this set (109)
Turn control ventilation is most commonly used for adults with what lung condition?
What effect does decreasing CL having delivered tidal volume and Indian a receiving pressure limited ventilation?
Decrease is tidal volume
What level of pressure is 1/4 should be used for winning so that our aw is overcome while breathing is spontaneous?
5 to 10 cm H2O
How's the ostrich and status of a patient worsens while using an O2 mask, at what point should CPAP be starting?
If 50% of 60% O2 still results in hypoxemia.
How is VE calculated?
Vt X RR
How is alveolar ve calculated?
Calculate the ventilator tubing compliance when the volume is set at 200 mL in an inspiratory pressure of 50 cm of water pressure is generated
200/50= 4 mL/ cm H2O
using the tubing components in question number 7 calculate the corrected title value in the patient receiving a title on a 700ml with a peak inspiratory pressure of 20
an initial ventilator set up at what range should the ventilator rate be set?
8 to 12
How should the appropriate ventilator tidal volume be delivered?
8 to 10 milliliters per kilogram of ideal body weight
What's four hazards of peep.
Barotrauma, decreased venous return, decreased cardiac output, decreased urinary output.
Define optimal peep.
The level of peep that improves lung compliance without decreasing cardiac output
after the pep level is increased, how can it be determined that cardiac output has been adversely affected?
Decreasing PvO2 levels and a drop in blood pressure.
How may the ventilator low pressure alarm be activated?
Leaks in the circuit, patient disconnect
This way the ventilator high pressure line may be activated.
Decrease in lung compliance, Airway secretions, bronchospasm, water in the ventilator tubing, kink in the ventilator tubing, coughing
How should a high-pressure alarm be set?
5 to 10 centimeters of water pressure above average Peak inspiratory pressure.
List some factors that affect Raw.
Bronchospasm, water and the ventilator tubing, mucosal edema, secretions will increase Raw.
What is normal Petco2 ?
35 to 45 mmhg, or 4.5% to 5.5%
six conditions that result in a decreased PETCO2 reading.
Hyperventilation, apnea, total Airway obstruction, hypertension, pulmonary embolism, decreased cardiac output.
list two conditions that result in an increase PETCO2 reading.
List criteria that indicate mechanical ventilatory assistance is necessary
List the complications of mechanical ventilation
Barotrauma, pulmonary infection, atelectasis, tracheal damage, decrease venous return, decrease urinary output, lack of nutrition, Pulmonary O2 toxicity.
calculate the static CL if the title volume is 750 Peak inspiratory pressure is 46 is 8 and Plateau pressure is 28.
37.5 millimeters per centimeter of H2O
list some conditions that result in decreased CL.
Pneumonia, pulmonary edema, consolidation, atelectasis, air trapping, fully Fusion, pneumothorax, a r d s..
What is indicated if Peak inspiratory pressures are increasing with the plateau pressure is not increasing?
Raw is increasing.
List three advantages of high-frequency ventilation over conventional ventilation.
Reduce risk of barotrauma, reduce risk of cardiac side-effects, Improvement and we could mucociliary clearance.
A ventilator patient receiving an fio2 of 3 has a pao2 of 60 mmhg. To increase the pao2 to 80, what change in the fio2 must be made?
Increase fio2 to .4 80 X .3/ 60 = .4
Bentley price in the AC mode with a ventilatory rate of 8 as a paco2 of 55. To decrease the paco2 240, what change was he made the ventilatory rate?
Increase the ventilator rate to 11/ min
a 36 year-old woman is receiving mechanical ventilation in the simv mode with the following settings right of ten title volume of 650 FL 2.4 and peep 5.
Increasing the tidal volume or ventilator rate
a ventilator patient receiving NFL 2.7 + p e p of 8 as a pao2 of 147 mmhg. What Ventilator adjustment should be made to reduce the pao2?
Decrease the fio2
When the volume time waveform, if the tracing does not return to Baseline, what does this indicate?
Leaks in the tubing or around the ET tube or chest tube; air trapping.
List two lung disorders classified as COPD.
Emphysema, chronic bronchitis
What's the common findings on the chest radiograph of a patient with emphysema.
Flattened diaphragm, increase lung markings, reduce facial markings, bullae or bleb formation.
What pao2 level should be maintained for a COPD patient with chronic hypoxemia?
List the clinical signs and symptoms of cor pulmonale?
Pedal edema, distention jugular veins, enlarged liver.
How does O2 therapy help prevent or treat Cor pulmonale?
By causing pulmonary vasodilation of pulmonary vessels, thereby decreasing pulmonary hypertension.
The amount of which type of white blood cell is characteristically elevated in the sputum and blood of a patient with asthma?
What aerosolized medication is used to treat P. jiroveci pneumonia?
List four causes of cardiogenic pulmonary edema.
Left ventricular failure, mitral valve stenosis, aortic stenosis, systemic hypertension.
What's the signs and symptoms of pulmonary edema.
Dyspnea, frothy secretions, crackle, tachypnea, cyanosis, diaphoresis, distended neck veins, arrhythmias.
List of treatment modalities for pulmonary edema.
Supplemental O2, cardiac medications, voluntary support, Airway maintenance, morphine, diuretics.
List the various causes of ARDS.
sepsis, aspiration, near drowning, O2 toxicity, shock, thoracic trauma, extensive Burns, toxic gas inhalation, fluid overload, fat embolism, narcotic overdose.
What's the signs and symptoms of ARDS.
Hypoxemia, cyanosis, severe dyspnea, decreased lung compliance, larger a-a gradient, tachypnea
List treatment modalities for ARDS.
Mechanical ventilation with peep, diuretics, Airway maintenance, monitoring of cardiac pressures.
Air in the pleural space.
What is the Immediate treatment for a tension pneumothorax?
needle aspiration in the second or third intercostal space.
what is the most effective method for treating obstructive sleep apnea?
CPAP or BiPAP
What's 6 Parables that are measured during a sleep study.
eye movement, EEG, ECG, apnea, Chester abdominal movement, spo2.
what type of conditions are assessing the apgar score?
Heart rate, respiratory effort, color, reflex irritability, muscle tone.
Describe the appropriate intervention for the following apgar scores 0 to 3, 4 to 6, and 7 to 10.
Apgar score 0 to 3: immediate resuscitation with ventilatory assistance. 4-6: stimulation and O2 Administration. 7 to 10: routine observation, suction upper Airway with bulb syringe, dry infant, and place under warmer.
what is often the first sign of respiratory distress in an infant?
What's the Normal ABG levels for an infant.
Ph= 7.35 to 7.45; PaCO2, 35 to 45 mmhg; PaO2, 50 to70 mmhg; bicarb, 20-26, BE, -5 +5
List six indications for nasal CPAP.
Improve oxygenation to increase static lung compliance, to increase FRC, to decrease the work of breathing, to decrease intrapulmonary shunting, and to decrease PVR.
Was 5 complications of CPAP.
barotrauma, decrease venous return, air traffic, pressure necrosis, loss of CPAP from crying or displacement.
List two hazards of OT therapy in the neonate.
Turn the passing of prematurity, BPD.
Describe where the temp of the UAC should rest when properly position.
in the descending aorta at x-ray level: t6 to t2:L10 or L3-L4
List four advantages of UAC.
Usually obtained ABG levels, avoidance of frequent arterial punctures, continuous monitoring of blood pressure, infusion of drugs and fluids.
List for complications of UAC.
Infection, thromboembolism, air embolism, hemorrhage.
List 6 Pinnacle manifestations of i r d s.
Nasal flaring, grunting, retractions, tacopina, cyanosis, mixed respiratory and metabolic acidosis with hypoxemia.
List the causes of BPD.
High O2 concentrations, High ventilatory pressures
What's a clinical manifestations of BPD.
Increase Airway resistance, no more increase static lung compliance, VQ mismatch, hypoxemia while breathing room air, tachypeana, Belle Chasse, retractions, hypercapnia.
Describe the chest x-ray findings and infants with BPD.
Ground glass appearance, opacification, atelectasis, hyperlucency, bullae.
What's the treatment modalities for BPD.
O2 therapy, positive pressure ventilation, Attica even if acacian of inspired gases, CPT, adequate nutrition, maintenance of fluid balance, bronchodilator therapy, Airway suctioning.
Where's the causes of meconium aspiration.
Treasure hypoxia in utero of postmature infants leads to expulsion of meconium in the amniotic fluid, where it may be asked for you with the infant's breath.
Alyssa clinical manifestations of meconium aspiration.
Long fingernails, peeling skin, hypoxemia, I Park Avenue, tacopina, retractions, nasal flaring, grunting, barrel chest, cyanosis, crackles and rhonchi on auscultation.
Listen conditions that accompany pphn.
Perinatal asphyxia, meconium aspiration, pneumonia, sepsis, congenital heart defects, drive from attic hernia, hypoplastic lungs, hypoglycemia.
What are the manifestations of pphn.
tachypnea, hypoxemia, cyanosis, more than a 15 mmhg difference in production and post office to a pao2 on 100% O2, increase in pao2 / 100 mmhg when paco2 is maintained between 20 and 25 mmhg
What's the treatment modalities for pphn.
Mechanical hyperventilation, pao2 of more than 100 mmhg, tolazoline, nitroprusside sodium, nahco3, dopamine.
What's the cause of epiglottitis.
Les Schwab clinical manifestations of epiglottitis.
high fever, drooling, sore throat, to spend yay, tachycardia, inspiratory stridor, retractions, accessory muscle use, hoarseness, swollen epiglottis, hypoxemia, respiratory alkalosis followed by respiratory acidosis if not reversed.
Describe the classic x-ray findings for diagnosis of epiglottitis.
what's the treatment modalities for epiglottitis.
intubation, if possible triggers Stone me if intubation is not possible O2 therapy antibiotics mechanical ventilation if necessary.
List of clinical manifestations of cystic fibrosis.
tachycardia productive cough with thick secretions increase dymphna, digital clubbing coromandel and late stages, decrease result on Flow studies and increase FRC on pulmonary function test.
List the treatment modalities for Cystic Fibrosis.
Aerosolized, CPT, O2 therapy, expectorants, Aerosolized antibiotics, continuous aerosol therapy, dornase Alfa.
What is the primary indication for acetylcysteine?
What is racemic epinephrine most commonly used for?
Upper Airway edema.
List four examples of sympathomimetic bronchodilators.
Epinephrine, racemic epinephrine, metaproterenol, albuterol, levalbuterol, salmeterol, formoterol, arformoterol.
List examples of parasympatholytic bronchodilators.
Atropine, ipratropium, tiotropium bromide.
which neuromuscular blocking agent is used primarily for short term paralysis during a difficult intubation?
how does cromolyn sodium help in the treatment of asthma?
prevents attacks by stabilizing mast cells
List five antibiotics that are Aerosolized and the conditions for which they are indicated.
gentamicin, cystic fibrosis; amoxicillin, bronchiectasis; amphotericin B, fungal infections, pentamidine, RSV.
list three corticosteroids that are commonly aerosolized.
dexamethasone, Beclomethasone, flunisolide.
What's the side effects of corticosteroid therapy.
Edema, moon face, adrenal suppression, or candidiasis.
List three leukotrienes modifiers.
Zafirlukast, montelukast, zileuton.
leukotrienes modifiers are administered for what purpose?
To prevent asthma attacks.
List four goals of Rehabilitation.
To help become more independent, cope with the disease process, understand their limitations, set goals, improve walking distance and tolerated daily activities
list 6 periodic evaluations of the home care patient that should be conducted in The Physician Office or outpatient setting.
Pulmonary function test, sputum collection analysis, ABG collection and Analysis, exercise tolerance testing, chest radiographs, CO monitoring and smokers.
How does pursed lip breathing benefit patients with emphysema?
creates a subtle back pressure into the large Airways keeping them open longer and reducing the volume of air trapped, thereby reducing the feeling of dyspnea.
List 2 types of o2 concentrators in the O2 percentage of people with each breath.
membrane concentrator, 40%; molecular sieve concentrator, 90 to 95%
What type of evaluation should be made by the RT regarding the O2 concentrators during routine visits?
Fio2 analysis, alarm checks, flow measurement, filter and Battery checks.
Calculate how long 3 lb of liquid oxygen running through a 2L nasal cannula will last.
3X 860/2.5= 2580/2.5 = 1-32 L
1032L/2=516 min or 8.6 hours
List conditions that may require home apnea monitoring.
Infants of siblings who had SIDS, BPD, neuromuscular disease, and tracheostomies; in those receiving mechanical ventilation.
Name a condition that results in an increase RV.
What type of lung condition may result in a decreased I see?
restrictive lung conditions
What device may be used at the patient's bedside to measure VC?
What pulmonary function test is the best indicator for distinguishing an obstructive lung disorder from a restrictive one?
list three tests that determine the severity of obstructive airway disease.
FEV1, FEF 25-75, FEF 200-1200
An FEV1/FVC of less than 70% indicates which type of lung disease?
What five values may be measured on a flow volume Loop?
PIF, PEF, FVC, FEV1, FEF25-75
Wells Fargo conditions in which DL is decreased.
O2 toxicity, emphysema, pulmonary edema, and asbestos, sarcoidosis, pulmonary fibrosis.
What does a before-and-after bronchodilator test determine?
The response to the Broncho dilating agent.
What does MIP, also referred to as NIF, represent?
the max amount of negative pressure the patient can generate during inspiration. determines the level as a respiratory muscle strength.
List for disease that is spread by Airborne pathogens.
Tuberculosis, histoplasmosis, Legionellosis, measles.
What device should be used in the ventilation system through which air is charged for the room of a patient with a disease caused by an Airborne pathogen to ensure safety?
List three methods that may be used to sterilize grocery therapy equipment.
autoclave, ethylene oxide gas, glutaraldehyde solution
List three diseases transmitted by spread of droplets.
Streptococcal pneumonia, epiglottitis, adenovirus, meningitis, pertussis, h influenzae
What is a nosocomial infection?
List for gram-negative organisms that may result in necrotizing pneumonia.
pseudomonas, klebsiella, serratia, and Legionella species
What methods are used to determine the effectiveness of a decontamination process?
chemical and biologic indicators, culture and swab sampling.
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