Oxygenation (B)

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Author:
mckenzielarmstrong
ID:
258342
Filename:
Oxygenation (B)
Updated:
2014-01-25 16:43:42
Tags:
Oxygenation Basic Cardiac Monitoring
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Test 1
Description:
Oxygenation and Basic Cardiac Monitoring (B)
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  1. What does PEEP do?
    Holds alveoli open after expiration. A little left over in lungs to allow for longer gas exchange.
  2. PEEP stands for:
    Positive end expiratory pressure
  3. Normal PEEP setting:
    5cm of H2O (but can go up to 15-20cm)
  4. PSV stands for
    Pressure support volume
  5. PSV used for
    Augment pt's inspiratory pressure (effort).
  6. What we want inspiratoy pressure to be at least
    -20
  7. Ideal ispiratory pressure
    -70 to -100
  8. ABGs are checked q__ when pt first put on vent
    30 mins
  9. We can decrease __ if PEEP is added
    FiO2, bc pt ventilates better
  10. What does the same thingas PEEP, but during spontaneous breaths?
    CPAP
  11. Most common cause of high pressure alarm?
    Pt needs to be suctioned
  12. Ventilatory asynchrony is
    Pt breathing aginst the vent. Tx by changing method or sedation
  13. Most common cause of low pressure alarm?
    Pt disconnection. PEEP can pop off, or pt can extubate themself.
  14. If high pressure alarm isn't r/t increased secretions, may also be r/t
    development of tension pneumothorax. ASSESS pt.
  15. What barotrauma gets bigger w/each breath?
    Tension pneumothorax
  16. Tension pneumothorax can lead to what heart-related complication?
    Decrease cardiac output
  17. When pt on PEEP, what cardiac issues may develop?
    decreased BP r/t increase interthoracic pressure and impaired venous return.
  18. Measure __ when pt on PEEP
    MAP
  19. 3 Methods for weaning off vent
    IMV/SIMV, CPAP, T-piece
  20. How to wean when pt on IMV/SIMV:
    (1) lower resp rate, (2) lower FiO2, (3) continue.
  21. Hallmark of respiratory failure is:
    Hypoxemia
  22. Tx for V/Q mismatch
    O2 therapy, b/c not all gas exchange units are effected
  23. What is shunting?
    When blood passes thru pul circulation without participating in gas exchange
  24. Failure of utilization occurs w/___ and means
    Septic shock; o2 is delivered to cells but not extracted
  25. Pathophys of ARDS
    increased pulmonary capillary membrane permeability, destruction of elastin and collagen, and microemboli and pulmonary artery vasoconstriction. The fluid in the caps leave the caps and fill up the alveoli
  26. Define refractory hypoxemia
    As you increase FiO2, the PaO2 goes down. Hallmark of ARDS
  27. Classic symptom of ARDS
    refractory hypoxemia
  28. Classic tx for ARDS
    PEEP. PEEP holds alveoli open and pushes fluid back into circulation. They can be on higher levels of PEEP (like 10 cms). Also tx w/vasopressors to maintain MAP.
  29. ARDS timeline
    First week: injury, then pul edema, atelectasis. V/Q mismatch. Then, lungs become fibrous and decreased compliance.
  30. White out/White lung is a late manifestation of
    ARDS; early CXR look normal or have a few infiltrates
  31. If infants reach original due date and still having problems breathing they're dx w/
    BPD
  32. ARDS is
    Sudden progressive form of respiratory failure; stands for Adult Resp Distress Syndrome
  33. Dx criteria for ARDS (PaO2)/(FiO2)
    Less than 200

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