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Respiratory failure - artificial airwaysMedical-Surgical Nursing-7th edition

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What are the complications of ventilating mechanically?
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Ventilator induced lung injury (VILI), DVT, decreased nutrition, and VAP.
With mechanical ventilation, the fraction of inspired oxygen (FIO2) is _______ or greater.
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21% (the same as room air) or greater
What chemical changes occur from fluid retention while on a ventilator?
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Increased Na+ and H20 retention; decreased ANP (which retains Na+); renin increases, increased angiotensin and aldosterone; increases ADH; and increases cortisol.
Type of ventilation? (+) pressure is applied only during inspiration...
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Pressure Support Ventilation (PSV)
Type of ventilation? Expands collapsed alveoli, prevents alveolar collapse, requires sedation. Used to treat ARDS.
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Pressure Controlled - Inverse Ratio Ventilator (PC - IRV)
Type of ventilation? Increases functional reserve capacity (FRC), increases aeration of patent alveoli, prevents alveolar collapse, increases O2.
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PEEP
An antibiotic must be administered within _______ of hospital admission for CAP.
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4 hours
When should a patient on NPPV be intubated?
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If the P/F ratio doesn't improve in an hour or if they deteriorate; decreased LOC; inability to clear secretions; and can't tolerate the mask.
What are signs PEEP may be set too high?
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Increased PaO2, decreased CO, increased HR, JVD.
What can cause hypoventilation on a ventilator?
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Inappropriate ventilator settings; leakage of air from the vent tubing, around the ET tube or trach cuff; lung secretions; lung observation; and low V/Q ratio.
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What is the treatment for hypoxemic respiratory failure due to a shunt?
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Mechanical ventilation and increased fraction of inspired O2 (FiO2).
What is the usual pressure range PEEP is set to in order to increase lung volume between breaths?
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3-20 cm H2O
An ET tube is usually _______ cm for women and _______ cm for men.
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21 cm for women; 23 cm for men (mark it and record it)
Once a patient is intubated, ABG's should be obtained within _______.
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25 minutes
An ET tube should be assessed every _______ for proper placement.
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2-4 hours
After intubation, the CO2 detector is not detecting CO2. Where is the tube?
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The esophagus
Type of ventilation? (+) pressure is applied during inspiration and expiration...
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Continuous Positive Airway Pressure (CPAP)
What does CURB - 65 mean in reference to community acquired pneumonia?
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Confusion, Urea over 7 or Bun over 20, Resp. rate 30 or more, Blood pressure: systolic under 90 or diatsolic under 60, and 65 years and older.
What are the 4 general indications for mechanical ventilation?
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Apnea (or upcoming known inability to breathe like sedation), acute respiratory failure, severe hypoxia, and respiratory muscle fatigue.
Type of ventilation? Patient must be able to spontaneously breath. Used for weaning. Increased pressure is supplied with each breath.
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Pressure Support Ventilation (PSV)
Type of ventilation? Pressure is applied only during expiration...
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Positive End - Expiratory Pressure (PEEP)
  
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