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RCP 180 Unit I
Mechanical Ventilaiton
| Question | Answer |
|---|---|
| SIMV stands for? | Synchronized Intermittent Mandatory Ventilation |
| This type of mechanical ventilation allows the patient to breath spontaneously while the ventilator provides a minimum minute ventilation | SIMV |
| This mode of ventilation is used with COPD patients to normalize ABG’s mainly because it allows the patient to set their own rate and pattern | SIMV |
| This mode of ventilation is used with patients experiencing tachypnea to avoid hyperventilation and also pulmonary embolis | SIMV |
| This mode of ventilation is used for weaning patients from the ventilator | SIMV |
| This mode of ventilation is used to reduce barotrauma ((the excessive pressure in the thorax)) | SIMV |
| This mode of ventilation is used with PEEP (Positive End Expiratory Pressure) to reduce barotraumas | SIMV |
| This mode of ventilation allows patient to set the respiratory rate while the ventilator will maintain a minimum rate. Any patient initiated breathing will result in the patient receiving either the pressure or volume set by the machine. | Assist/Control Mode |
| This mode of ventilation is not good if they are hyperventilating | Assist/Control mode |
| This mode of ventilation, the machine will self-cycle at a preset rate. It does not allow patient to initiate ventilation. | Control Mode |
| With this mode of ventilation, Non-apneic and non-sedated patients will often “fight” the ventilator, requiring sedation and/or paralyzation. | Control Mode |
| This mode of ventilation is indicated for head trauma/surgery patients (for induced hypocarbia), status asthmaticus, flail chest, etc.. | Control Mode |
| With this mode of mechanical ventilation, only the patient can initiate ventilation. It is used with IPPB type treatments and is not recommended for continuous ventilation. | Assist mode |
| Name the four modes of mechanical ventilation as discussed in class> | 1) Assist Mode, 2) Control Mode, 3) Assist/Control Mode, 4) SIMV (Synchronized Intermittent Mechanical Ventilation) Mode |
| What are the 4 goals of therapy for the mechanically ventilated patient? | 1)provide pulmonary systm suppt needed to mntain adequate alveolar ventilation 2)reduce wk of breathing until the cause of resp failure is removed 3)restore normal a/b balance 2 the arterial & systemic areas 4)increase O2 xfer & O2nation 2 body organs/tis |
| What is the standard criteria for the institution of the Mechanical Ventilatory Support? | 1) Apnea or absence of breathing when reversible disease is present (absolute indication) 2) Acute Respiratory Failure 3) Impending respiratory failure 4) Severe hypoxemia attributed to increased work of breathing or an ineffective breathing pattern. |
| When Assessing Oxygenation needs, What are the Normal and Critical Value ranges for PaO2? | Normal Range: 80 – 100 mmHg Critical Value: <70 mmHg (On O2) |
| When assessing Oxygenation needs, what are the Normal and Critical Value Ranges of P(A-a)O2 (also known as the A – a gradient)? | 1) Normal Range: 2 – 30 mmHg 2) Critical Value: > 450 mmHg (on O2 Usually on 100%) (When you have an A-a gradient that high, the treatment will have to be a Positive Pressure O2 therapy, traditional O2 therapy will not help) |
| With the P(A-a)O2 or the A – a gradient, do you want the gradient to be wide or narrow? | ((want the gradient to be narrow)) ((is the O2 in the Alveolar Level reaching the Arterial Level)) |
| How do you calculate the Alveolar Equation (PAO2)? | PAO2 = (PB-47) FiO2 – PaC02 x 1.25 |
| What is the airway resistance equation? | RAW = Ppeak – Pplat/Vdot (peak Flow) measured in LPM |
| What are the normal values for airway resistance? | Normal Raw =.6 to 2.4 cmH20/L/Sec (this is normal healthy range) |
| What are the normal airway resistance values for a intubated pt? | For an intubated person = 6.0 or > as Each ET tube size decreases the RAW Increases |
| What are the normal airway resistance values for a asthma and emphysema pt? | 13.0 to 18.0 |
| What is the formula for dynamic lung compliance | CDYN = VT/PPEAK-PEEP |
| What is the formula for static lung compliance? | CSTATIC = VT/PPLAT-PEEP |
| What are the three types of Mechanical Ventilation? | 1) Negative Pressure 2) Positive Pressure 3) High Frequency |
| Attempts to mimic the actual function of the respiratory muscles to allow breathing through normal physiological mechanisms. | Negative Pressure Ventilation |
| An example of a negative pressure ventilator is? | the “iron lung” |
| True or False: In negative Pressure Ventilation, the negative pressure is generated throughout the thoracic area and is transmitted across the chest wall into the intrapleural space and finally into the intra-alveolar space | True |
| True or False: During Negative Pressure Ventilation, the intra-alveolar space becomes increasingly positive in relation to the pressure at the mouth | False: The intra-alveolar space becomes increasingly negative in relation to the pressure at the mouth ((at the mouth it is ambient)) |
| True or False: During Negative Pressure Ventilation, expiration occurs when the negative pressure around the chest wall is removed and the normal elastic recoil of the lungs allow air to flow out passively | True |
| Currently, the use of negative pressure ventilation is primarily seen and used where? | In the Home Care Setting |
| This occurs when a mechanical ventilator literally blows air into the patient’s lungs by way of an endotracheal tube or mask. | Positive Pressure Ventilation |
| During ___________ at any point during ___________ the inflation pressure at the upper airway will equal the sum of the pressures required to overcome the elastic resistance of the lung and chest wall and the resistance of the airways. | a) Positive Pressure Ventilation b) Inspiration |
| True or False: During Postive Pressure Ventilation, the pressure in the alveolus progressively builds and becomes more positive. | True |
| List the advantages of Pressure Support Ventilation | 1) Supports Spontaneous VT 2) Decreases WOB 3) Assists in Weaning 4) Helps reduce Atrophy 5) Improves PT comfort 6) Decreases need of sedation |
| List the 3 indications for Pressure Support Ventilation? | 1) Increase WOB 2) Weaning 3) Respiratory Muscle Weakness |
| What does Static Lung COmpliance MEasure? | The Compliance of the lung tissue itself |
| What does Dynamic LUng compliance measure? | Lung tissue and the thorax |
| What are static and dynamic lung compliance measure in? Or how are they measured | ml/cmH20 |
| What is the amount of time for an inspiratory pause or hold? | .5 to 1.5 seconds |
| In pressure control ventilation, is used when PIP reaches what cmH2o? | > than 50 cm/H20 |
| Pressure control ventilation is recommended for FIO2's above this number? | >60% |
| Pressure Control Ventilation is also used for PEEP at what levels of cmH20? | 15 cmH20 |
| Respiratory therapists would use SIMV vs assist/control to reduce what? | barotrauma |
| What mode can be used with most patients in most cases. | assist/control |
Created by:
jlsteely
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