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26 Cards in this Set
- Front
- Back
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the amount of air required to seal an ET tube cuff is reflected by the cuff pressure, which is usually maintained at less than
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20 mm Hg
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Cuffs are inflated with a volume of air that is
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high enough to seal the trachea while exerting the lowest possible pressure on the tracheal wall. Therefore cuff pressures greater than 18 to 20 mm Hg impair circulation to the tracheal mucosa and necrosis may develop.
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time cycled vent
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terminates when a preset inspiratory time has elapsed
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flow-cycled vent
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triggered to stop when a preset flow rate has been achieved
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volume-cycled vent
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delivers a preset tidal volume of inspired gas
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pressure-cycled vent
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delivers a volume of gas to the airway using positive pressure during inspiration
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volume-triggered inhalation
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occurs when the ventilator completes the breath to maximize inhaled gas
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flow-triggered inhalation
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occurs when the client can initiate a breath
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negative pressure inhalation
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triggered by the initial negative pressure that begins inspiration
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time-triggered inhalation
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used to manage clients who cannot breathe on their own
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CPAP
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applied w/spontaneous respirations to keep aveoli open
positive pressure applied during spontaneous breaths |
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PEEP
positive end expiratory pressure |
used during mechanical ventilation to keep aveoli open
(pressure) positive pressure applied at the end of expiration of vent breaths |
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SIMV
synchronous intermittent mandatory ventilation |
delivers gas at preset tidal volume or pressure allowing pt to breathe spontaneously; vent breaths are synchronized to pt's resp effort
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PSV
pressure support ventilation |
used to augment pt's inspiratory efforts; pt controls rate, inspiratory flow, and tidal volume
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VAPSV
volume assured pressure support ventilation |
tidal volume is set to ensure pt receives minimum tidal volume w/each pressure support breath
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CMV
continuous mandatory ventilation |
will initiate breath if pt fails to do so within preset time
hyperventilation can occur |
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simv
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rn sets rate (say 10 resps)
the pt will at least get 10 respirations. they can overbreathe that amount which promotes respiratory muscle fatigue |
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psv
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used w/simv to support spontaneous breaths and used in weaning
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airway pressure too high alarm
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kinked or block tubing; mucus or secretion plug in et tube or airways; client coughing or fighting the vent; inspiratory flow rate too high
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manifestations of oxygen toxicity
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fatigue, lethargy, weakness, restlessness, n/v
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PPV positive pressure ventilation may lead to?
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stretch injury in the alveoli an the release of inflammatory mediators. To minimize stretch injury, the lowest possible tidal volume and PEEP should be used
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RNDx: impaired oral mucous MB
note: oral MBs can be restored to pink & moist w/in 24 hrs but oral care is an ongoing need |
provide oral care q 2 hrs
no etoh or lemon lubricate lips brush, not swab client's teeth x2 daily suction oral secretions from mouth assess for pressure areas at the corner of the mouth from et tube |
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hallmark of ARDS
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massive inflammatory response by the lungs that increases permeability of the aveolar mb, with resultant fluid movement into the interstitial & aveolar spaces
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anatomy of a code: what you need to reach for first is:
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bag-valve-mask device w/100% O2
cardiac board or head board suction setup intubation equipment iv line primed w/.9% NaCl or LR |
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r/t Breathing in a code:
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position the pt supine, open his airway, initiate breathing, observe universal precautions
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r/t Circulation in a code:
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if the pt is pulseless, initiate chest compressions
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