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Problems with VentilationMedical-Surgical Nursing-7th edition

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ARDS develops from an _______ injury.
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alveolar
What are the 2 most common triggers of deaths in patients with ARDS?
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Sepsis and pneumonia
Most cases of VAP are the result of...
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aspiration of bacteria from the mouth and GI tract
For a patient with ARDS, enteral nutrition should begin within _______ of admission.
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24 hours
_______ = pulmonary edema, _______ = COPD, _______ = atelectasis or pleural effusion, _______ = pneumonia
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crackles = pulmonary edema, rhonchi = COPD, dimished/absent = atelectasis/effusion, bronchial sounds over lung periphery = pneumonia
How does milrinone lactate/ Primacor increase perfusion in ARDS patients?
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Inotrope and vasodilates pulmonary bed.
_______ is when the alveolar- capillary membrane becomes damaged and more permeable to intravascular fluid.
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ARDS
Hypoxemia and a PaO2/FIO2 ratio below _______ despite increased FIO2 by mask, NC or ET tube are hallmarks of ARDS.
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below 200 (may have a normal PaCO2 despite severe dysnpnea and hypoxemia)
What are 4 direct lung injuries that can lead to ARDS?
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Near drowning, aspiration, chemical irritation, and aspiration pneumonia.
How does prone positioning benefit a patient with ARDS?
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Improves V/Q, increases aeration by decreasing compression of the posterior areas of the left lung by the heart, clears out debris, decreases inflammation, increases O2 and perfusion.
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Which positional therapy can be used to position patients at angles up to 60 degrees?
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Kinetic (bilateral turning)
When placing someone prone, how should their arms be positioned?
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Swimmer's pose: one at side and one extended above head.
In a 24 hour period, an ARDS patient should be prone for at least _______.
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18
What are the disadvantages of prone positioning?
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Tube dislodgement, patient desaturation, skin breakdown, and facial edema.
How does mechanical ventilation positively impact the alveoli with ARDS?
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It opens them up.
A patient who is lateral or side-lying should be placed with the _______ lung down.
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good
What are the clinical signs of hypoxia?
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Changes in mental status like confusion; anxiety; dusky skin; and dysrhythmias.
What is the normal 1:E ratio?
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1:2, expiration twice as long as inspiration.
A _______ should be done if a PE is still suspected despite unclear findings from an EKG, CXR, ABGs, D-dimer and ultrasound.
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ventilation/perfusion scintigraphy, normal is 0.8:1 (*2 or more segmental perfusion defects = increased likelihood of PE)
How is a personal best determined for an asthmatic?
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Test 3 different times on 2 good days between 12-2 pm. *Check every morning and during attack against this personal best .
  
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