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61 Cards in this Set

  • Front
  • Back
what is an early indicator of resp depression
end tidal Co2
how much c02 they are blowing off
end tidal c02
delivers up to 5 liters of 02
filterline sampling
what should be done if a message comes up with occlusion or blockage for C02 fliterline
replace
where is sample collected in the fliterline
resevoir
reasons for uses of ETC02
sleep apnea
PCA pumps
procedural sedation
what does A-B baseline show
end of inspiration, beginning or end of expiration
rapid rise in C02, mixing of dead space and alveolar gas
B-C waveform
Alveolar plateau: alveolar gas exchange
C-D waveform
D waveform
End of exhalation
Inspiration, rapid decrease in C02
D-E waveform
causes abnormal waveforms
hypoventilation
increased C02 with decreased RR
Part airway obstruc.
loss of alveolar platueau
partial airway obstruction
causes of PAO
relaxation of upper airway
head position
intervention for PAO
head tilt
chin lift
suction/clear airway
pt take deep breaths
helps reduce gastric inflation
cricoid pressure
bag mask characteristics
RA or 100% 02
used orally or to trach/ET
ventilate to chest rise
oral airway rules
put in upside down then turn 180 degrees to lock into place
purpose of oral airways
keeps tongue from dropping back and occluding
steps for BMV technique
two ppl
E-C technique to create seal
chest rise
cricoid pressure
listen for air movement
protects against regurg of gastric contents
cricoid pressure
used to decompress stomach if too much air
OG
constant flow of 02--no valve
non-rebreathing pressure relieving bag
tells how much pressure is delivered with NRPRB
manometer
needs 02 to infalte
NRPRbag
placement of tube into mouth
ET tube
positioning of ET tube
past the larynx and sits in trachea
reason why ET is used
higher % 02
bypass obstruction
protect from aspiration
pulmonary toilet
maintain patent airway
indicated when head and neck manipulation is risky
nasal ET
surgical procedure performed when need for an artificial airway is expected to be long term
tracheotomy
decannulating
trach taken out and let close on its own
ET procedure steps
BVM attached to 100% 02
sterile suctioning equip
IV access
EKG mtr
premedicate
should be done before preoxygenating for ET
pre oxygenate
given for Rapid sequence intubation
paralytic
sedative
used to check degree of paralysis
train of four and need 1-2 out of 4
more common paralytic agents
vecuronium
rocuronium
ET tube preoxgenation technique
3-5 minutes 100% 02
intubation attempts
<30 sec
confirms placement of ET tube
inflating cuff
End tidal C02 (6 breaths and measure)
auscultate
chest xray (gold standard)
colorimetric exhaled C02 detector
colors
purple= problem
yellow= yes
where should ET tube be placed
3-5 cm above carina to prevent occlusion
measure at lip for ET shows what
how far down tube is
nsg management of ET tube placement
mtr tube 2-4 hrs
confirm mark at lips
retape when slipping
restraints
cuff pressure of ET
20-25
normal arterial tracheal perfusion
30 mm/hg
small amt of air is removed from cuff until a slight leak is auscultated at peak inflation
minimal leak technique
should be measure after intubation and on a rt basis
cuff pressure
when should suctioning be done
according to S&S
decreases r/f VAP
oral care q 2 hrs and prn
dvt prophylaxis
stress ulcer prophylaxis
gut feedings
HOB 30 degrees
handwashing
decreases pooling of secretions
elevate HOB 30 degrees
bypasses upper airway for long term
trach
needed with a trach
moisture
must be stat removed after insertion
obturator
when is trach first changed
no sooner than 7 days after insertion by physician
when are tapes for trach changed
at 24 hrs
what can excessive cuff pressure do
compress tach capillaries
limit blood flow
predispose to tracheal necrosis
how often should trach tube be replaced
monthly
should be done prior to capping
deflate cuff
splinting of stoma should be done when
coughing
swallowing
speaking
how soon does tissue form after removal of trach
24-48 hrs
two inflatable balloon cuffs
combitude