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Procedures II Midter

ATI

QuestionAnswer
Signs of acute respiratory failure (6) Dyspnea, Cyanosis, Skin, HR, RR, BP
Define Acute respiratory failure (ARF) Absent of insufficient respiratory activity resulting in inadequate oxygen uptake and CO2 clearance
ARF clinically observed as: PaO2 below the predicted normal range; PaCO2 greater than 50 and rising; pH falling below 7.25
Types of ARF (2) Lung Failure and Ventilatory pump failure
What is lung failure vent/perf mismatch, diffusion defects, R-L shunting, alveolar hypoventilation, inadequate FIO2
What is Ventilatory pump failure Inability of the body to maintain a normal PaCO2.
Ventilaroty pump failure causes CNS disorders, neuromuscular disorders, disorders that increase WOB
Early signs of Hypoxia or Hypercapnia Tachycardia, Dyspnea, Tachypnea, Hypertension
Later signs of Hypoxia or Hypercapnia PaO2< normal range, PaCO2 > 50, pH < 7.25, Confusion, Lethargy, Convulsions, Hallucinations, Coma
Indications of ARF & need for MV (ventilation) pH <7.25; PaCO2 55 and rising; Deadspace to VT ratio > 0.6
Indications of ARF & need for MV (Oxygenation) PaO2 <70 on FIO2 >.60; P(A-a)O2 >450 on O2; Pa02/PAO2 <0.15; PaO2/FIO2 <200
Standard criteria for instituting MV Apnea or absence of breathing, ARF, Impending RF, Refractory Hypoxemia
What % of patients do not require slow weaning? 80%
What is weaning gradual reduction of ventilatory support from a patient who is clinically improving
What are weaning protocols A set plan of action to enable the clinician to wean the patient according to established criteria resulting in extubation
Modes of weaning from MV CPAP; SIMV; T-piece trials; PSV; Closed Loop Modes; MMV; ASV; Bi Level
Weaning and extubating parameters VC >10; Ve <15; VT >4-6; F <30; MIP -20 or less; WOB <0.8; Dynamic CL >25; VD/VT <0.6
What is the most frequently used study and very reliable predictor of successful extubation Rapid Shallow Breathing Indes (RSBI)=f/Vt; Normal range 60-105
Post extubation complications Horseness, sore throat, cough, subglottic edema, increased WOB, Airway obstruction, Laryngospasm, Risk of aspiration
what are scalers Graphs measured over time
What are the 3 main types Flow VS. Time; Volume VS. Time; Pressure VS Time
How many views for Flow VS Time 5: Rectangular, Sinusoidal, Ascending, Descending, Exponential
How many views for Volume VS time 2: Ascending Ramp or sinusoidal
How many views for Pressure VS time 2: Rectangular or Exponential
What is auto PEEP or intrinsic PEEP When patient does not fully exhale inspired volume
Actions to eliminate auto PEEP Suction, bronchodilator, increase expiration time, increase PEEP
What does pressure volume loop show? Compliance of the lung, looks like a football, the narrower, the more compliant
Created by: celina1382