Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
375 Exam 1
Obstructive Sleep Apnea, NPPV
| Term | Definition |
|---|---|
| obstructive sleep apnea | episodes of partial or complete upper airway obstruction during sleep |
| apnea | cessation of respiratory airflow; 90% or greater decrease in airflow lasts longer than 10 seconds, may experience hypoxia |
| hypopnea | caused by shallow respirations, decrease in airflow limitation 30 - 90% can last 10 - 90 seconds |
| airflow obstruction in OSA can occur due to | narrowing of air passages with relaxation of muscle tone during sleep, the tongue and soft palate falling backward and partially or completely obstructing the pharynx |
| 3 major signs of OSA | sleepiness, excessive daytime sleepiness, sleep apnea, snoring |
| OSA signs | insomnia, dry mouth, fatigue and nocturia, attention deficit, morning headache from buildup of CO2 |
| OSA complications | over activation of the SNS, increased vascular resistance and reduced oxygenation of the heart muscle; hypertension, diabetes, coronary disease, heart failure, depression |
| diagnosis OSA | sleep and medical history; berlin questionnaire (snoring, severity, history of hypertension, obesity), STOP BANG (eight yes/no items) |
| sleep study | polysomnography, monitors sleep cycles and stages, patterns, chest and abdominal movement, oral and nasal airflow, oxygen and ocular movement |
| apnea hypopnea index | apnea + hypopnea/ hour of sleep |
| noninvasie positive pressure ventilation (CPAP/ BiPAP) | prevent airway collapse with air pressure |
| continuous positive airway pressure (CPAP) | air pressure (5 - 15) during inspiration and expiration can be delivered via nasal or facial mask; highly effective if 4 hours a night |
| bilevel positive airway pressure (BiPAP) | set to deliver a set amount of pressure during the inspiratory phase of each breath (IPAP) and then maintains a low positive pressure at the end of the expiratory phase (PEEP) |
| IPAP | 5 - 10 cm H2O, higher pressure, enhances oxygenation and ventilation |
| EPAP | 3 - 5 cm H2O, lower pressure |
| UPPP | removes obstructing tissue from tonsillar pillars, uvula and posterior soft palate |
| GAHM | places the pharyngeal muscles and base of tongue of tension |
| major concerns post op | airway and breathing, monitor for swelling, decreased oxygen levels, agitation (hypoxemia), respiratory distress, stridor (airway closing) |
| noninvasive positive pressure ventilation | ventilatory support without an invasive artificial airway, uses a mask; reduce intubation rates and ICU admissions |
| NPPV use | reduce respiratory rate, reduce CO2 levels, increase oxygen levels, correct pH, increase volume of each breath |
| NPPV indications | acute respiratory failure, heart failure, COPD exacerbation, OSA, acidosis or hypercapnia |
| CPAP | used for clients with obstructive sleep apnea, delivers continuous positive airway pressure above atmospheric pressure keeping the airway patent |
| nasal mask advantages | best suited for cooperative clients, causes less claustrophobia, allows for speaking, drinking, coughing, decreased aspiration risk |
| nasal mask disadvantages | increased risk of air leaks from the mouth, limited effectiveness in clients with nasal deformities |
| orofacial mask advantages | less cooperative clients, better for clients with mouth breathing or pursed lip breathing, more effective ventilation |
| complications for invasive ventilation | skin irritation, mouth dryness, sinus pain, barotrauma, gastric distention |
| indication for mechanical ventilation | failure to generate spontaneous ventilations, hypoxia or hypercarbia |
| goal of mechanical ventilation | maintain alveolar ventilation appropriate for client's metabolic needs, correct hypoxemia and maximize oxygen transport, rest respiratory muscle |
| volume ventilation | predetermined tidal volume is delivered with each inspiration |
| pressure ventilation | tidal volume varies based on several factors; pressure, compliance and resistance |
| PEEP | positive end expiratory pressure; exerts pressure to oppose passive emptying of the lung and keep airway pressure above atmospheric pressure; limits risk of O2 toxicity |
| alarm fatigue | sensory overload from excessive alarming, can cause delayed response or dismissal of the alarm |
| high pressure limit | secretions and coughing, excess water in tubing, tubing kinked, decreased compliance, client or ventilator asynchrony |
| low pressure limit | disconnect, loose secretions, self extubation, trach cuff leak |
| ventilator mode | way the ventilator delivers effective ventilation; setting determines on ABG, weight, LOC, respiratory muscle strength |
| assist control | every breath is supported by the ventilator, delivers a preset tidal volume with a preset rate (6 - 8); indicated for critically ill with no or weak spontaneous drive to breath, max amount of support |
| advantage assist control | guaranteed respiratory rate, guaranteed minute volume, better for CO2 removal |
| disadvantages assist control | less comfortable, may lead to deconditioning |
| pressure support | no set tidal volume or RR, set pressure level, PEEP and sensitivity, patient must be able to initiate spontaneous breaths and control overall rate and volume of each breath; used for weaning from mechanical ventilation, increased client comfort |
| synchronized intermittent mandatory ventilation (SIMV) | set tidal volume, set RR; allows spontaneous breaths, improved synchrony with the ventilator, prevents muscle atrophy |
| disadvantages of SIMV | need to have respiratory drive, can cause increase work of breathing |
| barotrauma | increase airway pressure distends the lungs and ruptures over distended alveoli |
| pneumothorax | complication of mechanical ventilation; air in the pleural space becomes trapped and increases pleural pressure that collapses the lung |
| pneumomediastinum | rupture of alveoli into the lung interstitium |
| alveolar hypoventilation | caused by inappropriate ventilator settings, leakage of air or obstruction; caused by a low tidal volume or respiratory rate, can lead to atelectasis, hypoventilation and respiratory acidosis |
| alveolar hyperventilation | overventilation; respiratory rate or tidal volume is too high, leads to respiratory alkalosis; caused by fear pain or anxiety |
| sodium and water imbalance | fluid retention can occur 48 - 72 hours after starting mechanical ventilation, lead to decrease urine output and increased sodium retention |
| ventilator associated pneumonia | contaminated respiratory equipment, inadequate hand hygiene, client's inability to cough or clear secretions |
| weaning on mechanical ventilation | reducing ventilator support, respiratory therapy will complete a spontaneous breathing trial, assess client's tolerance |
Created by:
ahommel
Popular Nursing sets