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70 Cards in this Set
- Front
- Back
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What keeps the 2 pleura together and allows the lung to expand and contract. Any disruption can cause lung collapse
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negative pressure
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The I:E ratio is reversed. Considered to be a 'high' setting
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inverse ratio ventilation
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In this condition required a chest tube. THe chest wall is intact
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closed pneumothorax
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Inc secretions in vent pt may trigger
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high pressure alarm
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This occurs when there is an accumulation of transudate or exudate in the pleural space.
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Pleural Effusion
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Which pleural effusion is infectious?
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Exudate
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Which pleural effusion is just fluid?
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Transudate : CHF, fluid overload
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This life threatening event requiring chest drainage decreases cardiac output & quickly leads to cardiovascular collapse
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Tension pneumothorax leading to mediastinal shift
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This vent mod delivers pressure cycled breathing. The tidal volume varies with changes in mechanical properties of the lungs.
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Pressure controlled ventilation
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This vent setting provides pressure augmented breathing during spontaneous inspiratory breathing
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Pressure Support Ventilation
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In this mode, the vent provides no guaranteed volume or rate, but does measure spontaneous volume and rate
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Spontaneous Breathing mode
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This condition is also referred to sucking chest wound
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open pneumothorax
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On the ventilator this setting will help prevent actelectasis
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PEEP
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This one way valve can monitor air leaks and changes in intrathoracic pressure
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water seal chamber
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Type of ventilator mode that gives a guaranteed tidal volume and rate
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Assist control
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Oxygen and CO2 are exchanged between
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alveoli and pulmonary capillaries
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Which parameter primarily reflects alveolar ventilation
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PaCO2
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This constitutes a need for reintubation
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inspiratory stridor
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What intervention for patient with respiratory acidosis
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increase ventilation rate
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All of the following would be consistent with a diagnosis of ARDS except
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low PaCO2
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Each time the ventilator gives the patient a breath a gurgling sound is heard
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leaking of air around the cuff of the ET tube
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What are the 6 steps for analyzing ABG's
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1. pH - low, high or normal?
2. CO2 - low high or normal? 3. HCO3- low, high or normal? 4. Match the CO2 or HCO3 with the pH. 5. Does the CO2 or HCO3 go in the opposite direction of the pH? 6. Are the PO2 and the O2 saturation normal? |
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What does ROME stand for?
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Respiratory Opposite Metabolic Equal
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Your patients ABG results are pH 7.32, PaCO2 32, HCO3 18, Is he in respiratory or metabolic acidosis?
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Metabolic Acidosis
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Pulse oximetry
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Indirectly measures pO2. Can be affected by perfusion, cardiac output and adminstration of blood products. can be inaccurate. may need to verify with ABG's.
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Licoc monitor
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measures brain oxygen partial pressure in interstitial space.
1. Normal values > 30 mm Hg 2. Ischemia occurs < 15mmHg 3. Cell Death occurs < 15mmHg 4. Look for BtO2>25mmHG |
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End tidal CO2
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indirectly monitors PaCO2
1. it shows trends fiCO2 increases or decreases 2. Does NOT reflect the absolute value 3. Must get ABG's to correlate PaCO2 and end tidal CO2 |
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Albuterol
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bronchodilator: prevent and treat wheezing for asthma & COPD
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Ipratropium bromide
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anticholinergic: blocks the muscarinic actlycholine receptors in the smooth muscles of lungs, opening bronchi
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Flovent
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corticosteroids: Helps with asthma decreasing swelling and irritation in the airways to allow for easier breathing
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Salmeterol
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Bronchodilator - asthma & COPD
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Tobramycin and collistin
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antibiotic
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pentamadine
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antibiotic
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D-Nase
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enzyme helps CF patients
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Bronchodilators
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albuterol & sameterol
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Anticholinergics
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ipratropium Bromide
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What do anticholinergics do?
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Block the muscarnic acetylcholine receptors in the smooth muscles of the lungs and open bronchi
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Corticosteroids
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flovent
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3 types of nebulizers
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1. Breath-actuated nebulizers
2. Standard nebulizer 3. Filter nebulizer |
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What are the levels of Peak flow
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green= good, yellow=caution, call DR. red= go to ER
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O2 delivery with Nasal cannula
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1-6 LPM
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O2 delivery with venti masks
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3-15 LPM
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O2 delivery with non rebreather
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8-12 LPM
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O2 delivery with face mask aerosol
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8-50 LPM
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O2 delivery with oxymizer
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6-10 LPM
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O2 delivery with high flow nasal cannula
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8-15 LPM
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4 complications from oxygen therapy
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1. Oxygen induced hypoventilation
2. Absorption atelectasis 3. Oxygen toxicity 4. ocular damage |
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5 types of Bronchial Hygiene
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1. Percussion/postural drainage
2. Mechanical percussor 3. Vest therapy 4. IPV therapy 5. Inexsufflator |
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2 types of Volume Expansion Therapy
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1. Incentive Spirometry
2. Ez-PAP volume expansion |
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4 goals of ET intubation
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1. Pulmonary Toilet
2. Positive pressure ventilation 3. patency of upper airway 4. Protects airway from gastric contents |
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5 patient criteria for intubation
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1. obtunded mental state
2. Respiratory Fatigue 3. difficulty swallowing 4. COPD 5. Acute Lung Disease (ARDS) |
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Preselected rate and tidal volume delivery
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Assist Control Ventilation
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Delivers volume cycled breaths at a preselected rate to supplement spontaneous breathing
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Synchronous Intermittent Mandatory Ventilation (SIMV)
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Reduced airway pressure and improves gas exchange
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Pressure Controlled Ventilation
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Pressure augmented to allow patient to determine the inflation volume and respiratory cycle duration
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CPAP/Pressure Support
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All modes of ventilation performed without intubation
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Non Invasive Ventilation
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8 criteria for extubation
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1. Normal blood gases
2. NIF (negative inspiratory force) > 20 cm H20 3. TV 5mL/kg 4. RR <30 bpm 5. PIP <30 cm h20 6. Lifts head > 6sec 7. Mental status ok 8. cough present |
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Normal V (ventilation) is
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4 L of air per minute
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Normal Q (perfusion) is
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5 L of blood per minute
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Normal V/Q ratio is
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4/5 or 0.8
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When the V/Q is higher than 0.8
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ventilation exceeds perfusion
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When the V/Q is < 0.8
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there is a V/Q mismatch caused by poor ventilation
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Shift to the Left of Oxy-hemoglobin dissociation curve
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Hemoglobin has a greataffinity to hold on to oxygen
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Shift to the Right of Oxy-hemoglobin dissociation curve
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hemoglobin has a lesser affinity to hold on to oxygen
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4 conditions that can cause a difficult airway
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1. Obesity
2. Pregnancy 3. Obstructive sleep apnea 4. C-Spine immobility |
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CPAP Is similar to PEEP except
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it works only for patients who are breathing spontaneously. It is comparable to inflating a balloon and not letting it completely deflate before inflating it again.
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Control Ventilation
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Delivers preset volume or pressure regardless of patient's own inspiratory efforts. Usually used for patients who are APNEIC
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Assist-Control Ventilation (A/C)
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Allows patient to initiate a breath & delivers full TV, delivers breath if patient fails to initiate in present amount of time
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Synchronous Intermittent Mandatory Ventilation (SIMV)
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Ventilator breaths are synchronized with patient's respiratory effort. Usually used to wean patients from mechanical ventilation
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Pressure support ventilation
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Preset pressure that augments the patients inspiratory effort and decreases the work of breathing. Often used with SIMV during weaning
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