Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards
share
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

Mech/Vent Unit 3

SPC Mechanical Ventilation Unit 3 Exam 2

QuestionAnswer
What is the abbreviation for Acute Respiratory Failure? (ARF)
What is Acute Respiratory Failure(ARF)? Any condition in which respiratory activity is completely absent or is inadequate to maintain O2 uptake & CO2 clearance
What clinically is Acute Respiratory Failure? The inability of the patient to maintain PaO2, PaCO2, and pH at acceptable levels
What are the ranges of PaO2, PaCO2, & pH to cause concern for Acute Respiratory Failure? 1. PaO2 < normal range for age @ 21% FIO2 2. PaCO2 > 50mmHg & rising 3. pH < 7.35 & falling
(Remember The Wall) How do you fix O2? With supplemental O2 and PEEP 1. O2 is for Responsive Hypoxemia 2. PEEP is for Refractory Hypoxemia
(Remember The Wall) How do you fix CO2? Adjust Minute Ventilation(VE) i.e. Tidal Volume(VT) and Rate(f)
What is the difference between Hypoxia and Hypoxemia? Hypoxia is failed O2 to the tissues where Hypoxemia is lack of O2 in arterial blood
What are some Respiratory findings of Mild to Moderate Hypoxemia/Hypoxia? Tachypnea, Dyspnea, & Paleness
What are some Respiratory findings of Severe Hypoxemia/Hypoxia? Tachypnea, Dyspnea, Cyanosis
What are some Cardiovascular findings of Mild to Moderate Hypoxemia/Hypoxia? Tachycardia & Peripheral Vasoconstriction
What are some Cardiovascular findings of Severe Hypoxemia/Hypoxia? Trachy-Bradycardia, Arrythmias, & Hypertension to Hypotension
What are some Neurological findings of Mild to Moderate Hypoxemia/Hypoxia? Restlessness, Disorientation, Headaches, & Lethargy
What are some Neurological findings of Severe Hypoxemia/Hypoxia? Somnolence, Confusion, Blurred Vision, Impaired Judgment, Anxiety, & Coma
A patient with pH under what gets an ET tube? <7.25
What is Hypercapnia? CO2 Retention: a condition of abnormally elevated carbon dioxide (CO2) levels in the blood
What are some Respiratory findings of Severe Hypercapnia? Tachypnea to Bradypnea
What are some Cardiovascular findings of Mild to Moderate Hypercapnia? Tachycardia, Hypertension, & Vasodilation
What are some Cardiovascular findings of Severe Hypercapnia? Tachycardia, Hypertension to Hypotension
What are some Neurological findings of Mild to Moderate Hypercapnia? Headaches & Drowsiness
What are some Neurological findings of Severe Hypercapnia? Hallucinations, Hypomania, Convulsions, Coma
What are some signs of Mild to Moderate Hypercapnia? Sweating & Redness of the skin
What are some Respiratory findings of Mild to Moderate Hypercapnia? Tachypnea & Dyspnea
What are the 5 physiological objectives of Mechanical Ventilation? 1. To support or manipulate pulmonary gas exchange 2. Alveolar Ventilation - reduce PC02 3. Alveolar Oxygenation - (to maintain oxygen delivery) 4. Improve Lung volume 5. Reduce the work of breathing
What does "Improve Lung Volume" mean as an objective to mechanical ventilation? Prevent or treat atelectasis with adequate end inspiratory lung inflation (PEEP) achieve and maintain adequate FRC
What is the normal and critical range for pH in ventilation? Normal 7.35-7.45 Critical <7.25
What is the normal and critical range for PaCO2 in ventilation? Normal 35-45 Critical >55
What is the normal and critical range for VD/VT in ventilation? Normal 0.3-0.4 Critical >0.6
What is the normal and critical range for PaO2 in Oxygenation? Normal 80-100 Critical <70 (on O2)
What is the normal and critical range for P(A-a)O2 in Oxygenation? Normal 5-15 Critical >450 (on O2)
What is the normal and critical range for a/A O2 in Oxygenation? Normal 0.75 Critical <0.15
What is the normal and critical range for PaO2/FIO2 in Oxygenation? Normal 475 Critical <200
What 5 disorders of the CNS(Central Nervous System) associated with REDUCED drive to breath? 1. Depressant drugs 2. Brain or brainstem lesions (stroke, head/neck trauma, tumors, spinal cord injury) 3. Hypothyroidism (causes lethargy) 4. Sleep apnea caused by idiopathic central alveolar hypoventilation. 5. Inappropriate O2 therapy in retainer
What 3 disorders of the CNS(Central Nervous System) associated with INCREASED drive to breath? 1. Increased metabolic rate 2. Metabolic Acidosis 3. Anxiety associated with dyspnea
What 2 brain disorders can alter the respiratory pattern? 1. Cheyne Stokes 2. Biot's Respirations 3. Also tumors, stroke, and trauma from accidents can alter the pattern of respiration.
What is Cheyne Stokes? Vt gradually increase and then decreases and is then followed by a brief apneic episodes.
What is Biot's Respirations? The respiratory rate changes but tidal volumes all stay the same.
Brain disorders can also do what? So you must then do what? Can also affect the glottis response, So you must protect the airway
What 4 disorders are associated with neuromuscular function? 1. Paralytic Disorders 2. Paralytic drugs 3. Drugs affecting neuromuscular transmission 4. Impaired muscle function
What are 7 Paralytic Disorders associated with neuromuscular function? 1. Myasthenia Gravis 2. Tetanus 3. Botulism 4. Guillain-Barre' Syndrome 5. Poliomyeltits 6. Muscular Dystrophy 7. Amyotrophic Lateral Scerosis
What are the 4 paralytic drugs associated with neuromuscular function? 1. Curare 2. Nerve Gas 3. Succinylcholine 4. Insecticide Poisoning
What are the 3 type of drugs affecting neuromuscular transmission? 1. Aminoglycoside Antibiotics 2. Long term Adrenocorticosteroids 3. Calcium Channel Blockers
What 5 disorders result in impaired muscle function? 1. Electrolyte Imbalance 2. Malnutrition 3. Peripheral Nerve Disorders 4. Atrophy 5. Fatigue
What are the 1st 4 disorders the result in increased W.O.B. (Work of Breathing)? 1. Pleural Occupying Lesions 2. Chest wall deformities 3. Increased airway resistance 4. Lung tissue involvement
What are the 2nd 4 disorders the result in increased W.O.B. (Work of Breathing)? 5. Pulmonary Vascular Problems 6. Increased metabolic rates with accompanying pulmonary problems 7. Postoperastive Pulmonary Complications 8. Dynamic Hyperinflation (air trapping)
What pleural occupying lesions result in increased W.O.B.? Pleural Effusions, Hemothorax, Empyema, & Pneumothorax
What chest wall deformities result in increased W.O.B.? Flail Chest, Rib Fracture, Kyphoscoliosis, & Obesity
What increase airway resistance result in increased W.O.B.? Increased Secretions, Mucosal Edema, Bronchoconstriction, Foreign Body Aspiration
What lung tissue involvement result in increased W.O.B.? Interstitial Pulmonary Fibrotic Disease, Aspirations, ARDS, & Pulmonary Edema
What pulmonary vascular problems result in increased W.O.B.? Pulmonary Thromboembolism & Pulmonary Vascular Damage
What is Normal W.O.B.? A healthy persons normal W.O.B. is approximately 1-4% of their total oxygen consumption at rest.
W.O.B. may increase to as much as what in unhealthy adults? 35-40%
What does MIP mean? Maximum Inspiratory Pressure
What does NIF mean? Negative Inspiratory Force
T/F MIP and NIF is the same thing? True
What does MEP mean? Maximum Expiratory Pressure
What does Vt mean? Tidal Volume
What does VC mean? Vital Capacity
What does PEFR mean? Peak Expiratory Flow Rate
What is a Manometer used for measuring? MIP (maximum inspiratory pressure) & MEP (maximum expiratory pressure)
What does FEV1 mean? Forced Expiratory Volume in 1 sec.
What does PEF mean? Peak Flow
Simplicity Spirometry System is used to measure what lung volumes? Vt, VC, FEV1, PEF
What are the indications of MIP (Normal & Critical) of ARF and need for mechanical ventilator support. Normal -50 to -100cmH2O Critical 0 to -20cmH2O
What are the indications of MEP (Normal & Critical) of ARF and need for mechanical ventilator support. Normal +100cmH2O Critical <+40cmH2O
What are the indications of VC (Normal & Critical) of ARF and need for mechanical ventilator support. Normal 65-75ml/kg Critical <15ml/kg
What are the indications of Vt (Normal & Critical) of ARF and need for mechanical ventilator support. Normal 5-8ml/kg Critical <5ml/kg
What are the indications of RR (Normal & Critical) of ARF and need for mechanical ventilator support. Normal 12-20bpm Critical >35bpm
What are the indications of FEV1 (Normal & Critical) of ARF and need for mechanical ventilator support. Normal 50-60ml/kg Critical <10ml/kg
What are the indications of Peak Flow (Normal & Critical) of ARF and need for mechanical ventilator support. Normal 100-850L/min or L/sec
What is the best indication of ARF or Ventilation? PaCO2
PaCO2 > 55mmHg & pH <7.35 indicates what? Acute Hypoventilation or Hypercapneic Respiratory Failure
Hypoxemia with an increased W.O.B. is an indication for what? That mechanical ventilator support is needed
How do you calculate PAO2? FIO2 x (PB-47) - PaCO2/0.8 FIO2 >60% don't use 0.8
What is PaO2? Index of O2 loading of Hb in arterialized blood
What is normal PaO2 on room air? 80-100mmHg
How can PaO2 an indication for ARF or Ventilation? PaO2 <70mmHg on 60% O2
What does P(A-a)O2 mean? Also known as A-a gradient it is the difference between the alveolar and arterial O2?
T/F P(A-a)O2 is an indicator of oxygenation? True
What is the normal and critical range of P(A-a)O2? Normal 5-15mmHg on room air Critical >450mmHg on O2
What is the normal range of A-a gradient of 21% O2 and 100% O2? 5-15mmHg at 21% 100-150mmHg at 100%
T/F A-a gradient will decrease with age? False-it will increase
T/F A-a gradient increase as the FIO2 increases? True
T/F A-a gradient indicates the amount of shunt? True
What is the Standard Criteria for Mechanical Ventilation? 1. Apnea of absence of breathing 2. ARF 3. Impending Respiratory Failure 4. Hypoxemic Respiratory Failure with an increase W.O.B. or an ineffective breathing pattern.
What are the 1st 2 goals of Mechanical Ventilation? 1. To Provide the pulmonary system with support to maintain an adequate level of alveolar ventilation 2. To reduce the W.O.B. until cause of ARF is removed
What are the 2nd 2 goals of Mechanical Ventilation? 1. To restore pH balance to the arterial and systemic areas 2. To increase O2 transfer & oxygenation to body organs & tissues
Trying to fix CO2s with O2 or PEEP and O2 with rate or VT is like what? Trying to teach a pig to sing-It wastes your time and is hard on the pig
How do you instruct a patient with a MIP/NIF and MEP maneuver? The patient is to breath in from the device (manometer) while the respiratory therapist occludes the thumb port of the t-piece connector containing 2 one-way valves
Created by: Langhout1418