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Respiratory Support

QuestionAnswer
What is ideal breathing pattern for SMI, IPPB, Aerosol therapy, ect slow, deep inspiration, inspiratory pause/hold 1-3 sec, exhalation is slow passive and relaxed, pt may relax in between maneuvers with normal tidal volume breathing
How do you position a pt for breathing techniques prone for ARDS, fowlers for CHF, lateral fowlers for the obese pt, good lung down for unilateral lung disease
Ventilatory muscle training benefits pt by increasing their muscle strength and endurance, decreaseing dyspnea, the need for medication and hospital visits
What are the indications for SMI, incentive spirometry prevention of atelectasis
How do you perform SMI hourly while the pt is awake for 10 breaths, date time and volume should be charted but not duration, increase or decrease volume goals based upon pt performance
What are the indications for IPPB prevent atelectasis, prevent or decrease pulm edema, decrease work of breathing, mechanical bronchodilation, distribute aerosols, manipulate of insp-exp pattern, improve alveolar collateral ventilation and cough mechanism
What are the contraindications of IBBP unskilled practitioners and users, massive pulm hemorrhage, untreated pneumo, dirty equipment
What are the hazards of IBBP hyperventilation, impeding venous return, gastric distention, pneumothorax, excessive oxygenation and increased air trapping in COPD pt, active tuberculosis
What is the Bird Mark 7 positive pressure, pneumoatically powered, time triggered, pt triggered, pressure cycled, assist and control modes, flow adjustable
In a Bird Mark 7 flow rate control what ratio is adjustable I/E ratio, increasing the flow will increase the E time and decreasing the flow will increase the I time
In a Bird Mark 7 air-mix off will give 100% source gas setting, flow rates are reduced because room air is not entrained, must increase flow setting when changing to 100% source gas setting
In a Bird Mark 7 air mix on will give oxygen concentration between 40-80%
In a Bird Mark 7 what happens under pressure volume is changed by adjusting the pressure limit, max pressure 60 cmH2O, leaks in the circuit will prevent normal cycling to exhalation, obstruction/coughing would prematurely end inspiration
In a Bird Mark 7 what happens under sensitivity higher the number indicates increased pt effort decreased sensitivity, lower number indicate decreased pt effort increased sensitivity
What is a Bennett AP-4 and AP-5 Ventilators positive pressure, electrically powered, compressor driven, pt cycled assist mode only, flow limited, pressure limited, appropriate for IPPB therapy in a home setting
Control changes that effect the FIO2 when the airmix is on and ventilator is powered by 100% O2, if you increase pressure then increase FIO2
Control changes that effect the FIO2 when the airmix is on and ventilator is powered by 100% O2, if you decrease flow increased inspiratory time will increase FIO2
Control changes that effect the FIO2 when the airmix is on and ventilator is powered by 100% O2, if the air mix is off then increase FIO2 to 100%
Control changes that effect the FIO2 when the airmix is on and ventilator is powered by 100% O2, the use of a nebulizer will increase the FIO2 on PR-11
Control changes that effect the FIO2 when the airmix is on and ventilator is powered by 100% O2, the use of terminal flow on PR-11 will decrease the FIO2
Control changes that effect the FIO2 when the airmix is on and ventilator is powered by 100% O2, sensitivity has no effect on the FIO2
Control changes that will change the Volume, increasing the pressure will increase the volume
Control changes that will change the Volume, decreasing the flow will increase the volume increased inspiratory time
Control changes that will change the Volume, increasing the flow will increase turbulence and decrease volume decreased inspiratory time
Control changes that will change the Volume, airmix and sensitivity have no effect on volume
Control changes that effect the I:E ratio, increased pressure or increased tidal volume will increase the inspiratory time and therfore change the I:E ratio
Control changes that effect the I:E ratio, increased flow will decrease the inspiratory time and change the I:E ratio
Changes in delivered volume with changing comliance and RAW, decrease compliance decrease volume
Changes in delivered volume with changing comliance and RAW, increase compliance increase volume
Changes in delivered volume with changing comliance and RAW, increase RAW decrease volume
Changes in delivered volume with changing comliance and RAW, decrease RAW increase volume
Changes in delivered volume with changing comliance and RAW, decrease compliance increase resistance decrease volume
Changes in delivered volume with changing comliance and RAW, increase compliance decrease resistance increase volume
Trouble shooting in pressure cycled ventilators if there is a loss of pressure leak, not enough flow
Trouble shooting in pressure cycled ventilators if there is excessive pressure obstruction, too much flow
Trouble shooting in pressure cycled ventilators if it fails to cycle into inspiration adjust sensitivity, tight seal around mouthpiece
Trouble shooting in pressure cycled ventilators if it fails to cycle off leak, mouth piece/mask seal, cuff leaking, fenestrated trach tube open, loose equipment connection
When do you use non invasive positive pressure ventilation neuromuscular disease, central/obstructive sleep apnea
What are the hazards of NPPV poorly fitting mask, irritation or ulceration from mask, leaks around mask or in tubing, gastric distention from high pressures
When is NPPV contraindicated pt with dysphagia
What is EPAP same as CPAP and can be used to improve oxygenation or prevent airway closure in obstructive sleep apnea
What is IPAP when this mode is set at a higher pressure than EPAP then positive pressure will be applied during inspiratory phase, maintain patent airway in obstructive sleep apnea
What is spontaneous/Timed (ST) allows pt to breathe at a spontaneous rate with combined timed breaths as in SIMV, IPAP phase will deliver inspiratory assist and EPAP will provide continuous positive airway pressure during exhalation
What is spontaneous/Timed (ST) controlled by selecting a respiratory rate and an inspiratory time percent
When using the timed mode of support for NPPV the pt cannot trigger additional mandatory breaths
A patient with uncomplicated obstructive sleep apnea will generally find relief with EPAP pressures of 5-10 cmH2O
Patients with neuromuscular disease will usually do well with inspiratory pressures of 10-15 cmH2O
Maximum pressure of 15-22 cmH2O may be necessary to achieve adequate alveolar gas exchange
During repiratory support oxygen must be titrated into the mask to achieve a desired FIO2
What is BIPAP bilevel positive airway pressure, non invasive ventilator
What are the two levels of CPAP in BIPAP IPAP one during inspiration, EPAP one during exhalation, IPAP (ventilation)should be greater than EPAP (oxygenation)
BIPAP ventilator breaths are flow triggered and require pt effort to be greater than 40 ml/sec to initiate inspiration
In BIPAP what I:E ratio is preferred 1:2
In BIPAP what is the maximum inspiratory pressure 22 cm H2O
During BIPAP the ventilator cannot provide adequate support for a pt with high airway resistance or low lung compliance
In BIPAP during operation the IPAP is the inspiratory pressure needed to abolish hypopnea and desaturation
In BIPAP during operation the EPAP is the expiratory pressure needed to keep the airway open
When is BIPAP contraindicated pt with dysphagia
Created by: buzzell6