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clinical III quiz

clinical III quizzing

QuestionAnswer
Indications for bipap Avoid intubation Relieve symptoms Improve gas exchange Improve QOL
Hazards of bipap Barotrauma from pressures Facial sores Decreased VR and CO Hyper/hypo ventilation.
Indications of Oxygen Therapy Documented hypoxemia Suspected hypoxemia Severe Trauma Acute MI (Keep alarm at 95%)
Hazards of Oxygen Therapy Depression of Ventilation (Pa02> 60) ROP (PaO2 > 80 mmHg) Nitrogen Washout (FiO2 > 50%) Oxygen Tozicity (FiO2 > 50%)
Indications for Pulse Oximetry Adequacy of arterial saturation Assess response to treatment
Hazards of Pulse Oximetry Pressure sores Electrical shocks
Indications for suctioning To remove secretions Ineffective cough
Hazards of suctioning hypoxemia dysrhythmia mucosal tears infection
Indications for SVN/MDI Deliver medications mobilize secretions Decrease WOB
Hazards of SVN/MDI Bronchospasm (allergic to med) Tachycardia, Infection Hyperventilation
Indications for IS Conditions predisposing to atelectasis (abd/thoracic sx, post-op) Treat atelectasis Patients w/Restrictive lung ds
Hazards of IS hypoxemia from removal of mask Hyperventilation, fatigue low risk of barotrauma
Indications for IPPB Lung Expansion (VC<10ml/kg, neuro,atelectasis) Short-term NIV Deliver meds (unable SVN)
Hazards of IPPB Barotrauma from pressures Decreased VR, CO Increased ICP
Indications of EzPap Prevent or treat atelectasis dec air trapping mobilize secretions Optimize med delivery
Hazards of EzPap Barotrauma from pressures Hemodynamic compromise Increased ICP Gastric Distention
Indications for CPT Mobilize secretions (>25 ml/day) Remove soft foreign bodies Atelectasis from mucus plugging Improve V/Q by turning
Hazards of CPT Hypoxemia Vomiting and aspiration Pain/injury to ribs hypoxemia
Indications for Mechanical Ventilation IVF (VC<10 ml/kg, MIP -20 cmH20, RSBI > 105, VT < 5ml/kg, RR>35) AVF (ph < 7.25, PaCO2 > 55) Apnea and Prophylactic (CHI, Smoke) Severe Oxygenation Issue (P/F < 200, PAaO2>350 on 100%)
Hazards of Mechanical Ventilation Decreased CO, VR Increased ICP Barotrauma Decreased splanich or gastric perfusion
Indications for ABG evaluate PaCO2 and A/B balance Assess response to tx Monitor severity of disease Severe SOB
Hazards of ABG Arteriospasm Hemorrhage Trauma Pain, infection
How do you treat Respiratory Acidosis? increase the RR, PS, VT or decrease the dead space Ex A/C, A, C
How do you treat respiratory alkalosis? decrease the RR, PS, VT or increase the dead space
VC-CMV Preset Vt, Preset Rate, Pressures Vary If patient overbreathes, they get preset Vt. Hazard is respiratory alk. Yu need to switch to SIMV if patient is overbreathing the ventilator and alk.
PC-CMV Preset Pressure, Preset Rate, VT varies Indicated when PIP >40 cm, Plat >30. If patient overbreathes they get preset pressure. If they don’t over breathe they get back up rate Ex: A/C, C, A
SIMV Preset Vt, Preset Rate, Pressures Vary If it is in between a mechanical breath, patient will get their own tidal volume. If it is time for a machine breath patient will get set Vt.
PSV Preset Pressure, Vts vary (2 pts) Set to achieve Vt 5-7 ml/kg and RR < 30 Only applied to spontaneous breaths Dec WOB, and Inc Spont Vt (3 pts)
CPAP/PEEP Preset pressures, Vt vary (2 pts) Indicated PaO2 is <60 on FiO2 >50%
PRVC Preset Vt, Preset Rate, Preset HPL Pressures vary Machine measures exhaled Vt. Will increase or decrease IP (PC) by 3 cmH20 to get desired Vt. The pressure stays < 5 HPL
Troubleshoot Vent: HP alarm HP alarm: kinked tubing, herniated cuff, bronchospasm, Pneumothorax, secretions
Troubleshoot Vent: LP alarm LP Alarm: loss sys press (gas, power), loss circuit pressure (ett cuff, loose humidifier, loose circuit), premature term (Ex PF)
Troubleshoot Vent: FiO2 alarm FiO2 alarm: inapp alarm or Fi02 setting, bad cell
Names and dosages for Albuterol (Proventil/Ventolin), 0.5% solution: 0.5 mL=2.5mg or 90 mcg/puff.
Receptor/MOA for Albuterol B1 and B2: B1 increases HR and myocardial contractility. B2 Relaxes bronchial smooth muscle, stimulates mucociliary activity
Hazards of Albuterol Palpitations, hypertension, nervousness, tremors, hypokalemia, hyperglycemia
Names/dosage of Xopenex Levalbuterol, 1.25mg, .63mg, .31mg
Receptor/MOA of Xopenex B1 and B2: B1 increases HR and myocardial contractility. B2 Relaxes bronchial smooth muscle, stimulates mucociliary activity
Hazards of Xopenex hypokalemia, tachycardia, hyperglycemia
Names/dosage of Atrovent Ipratropium Bromide, 0.02% solution = .5mg 18 mcg/puff
Receptor/MOA of Atrovent Muscarinic = blocks AcH from binding to M receptors allowing dilation of airways
Hazards of Atrovent Dry mouth, pupillary dilation,increased IOP, and HR
Names/dosage of Duo Neb Alubuterol + Atrovent 0.5 mg Atrovent, 3.0 mg Albuterol
Receptor/MOA of Duo Neb M, B1, B2: Muscarinic = blocks AcH from binding to M receptors allowing dilation of airways, B1 increases HR and myocardial contractility. B2 Relaxes bronchial smooth muscle, stimulates mucociliary activity
Hazards of Duo Neb Palpitations, hypertension, nervousness, tremors, hypokalemia, hyperglycemia hypokalemia, tachycardia, hyperglycemia Dry mouth, pupillary dilation, Increased IOP and HR
Names/Dosage of Intal Comolyn Sodium, 20 mg/ampule, 800 mcg/puff
Receptor/MOA of Intal Mast cells/inhibits degranulation of mast cells
Hazards of Intal Cough, wheezes
Names/dosage for Mucomyst N-Acetylcysteine, 10%=6ml, 20%=3ml
Receptor/MOA for Mucomyst Disulfide bonds/breaks up bond and replaces with sulfhydryl-thins secretions
Hazards for Mucomyst Bronchospasm, stomatitis, nausea, rhinorrhea
Names/Dosage for Singulair Montelukast, 4 mg, 5 mg and 10 mg tablets
Receptor/MOA for Singulair Blocks CysLT1 on leukotrienne receptor/blocks bronchoconstriction and mucous production
Hazards of Singulair headache, infection
Names/Dosage for Advair Serevent/Fluticasone, DPI=100mcg/50mcg, 250mcg/50mcg, 500mcg/50mcg
Receptor/MOA for Advair B2 and steroid receptor: B2=Relaxes bronchial smooth muscle, stimulates mucociliary activity, Glucocorticoid/steroid binds to receptor and helps regulate transcription of anti-inflammatory substances-↓ swelling
Created by: bowen.jessica1