NRNP 6566 final prep 6-12
Normal pH
7.35-7.45
<7.35 Acid
>7.45 alkalosis
respiratory aklalosis
pH> 7.45, PaC02 low, HC03 low
respiratory acidosis
pH < 7.35
PaCO2 > 45
Hc03 normal 22-26
Metabolic alkalosis
pH > 7.45
HCO3 > 26
PaC02 45-35
normal oxygen levle
80-100
mild hypoxemia
60-80
moderate hypoxemia
40-60
severe hypoxemia
<40
A-a gradiatian calculation is a calculation of what?
level of hypoxia
PA02-Pa02
A-a gradiant varies with age, calculation
2.5 + 0.21 x age in years
5 causes of hypoxemia
VQ mismatch
shunt
PNA, interstitial lung dz
hypoventilation
high altitude
clinical symptoms that require intubation
neuromuscular depression or failure.
spinal cord injuries
guillain barre syndrome
trauma-spinal cord injuries, phrenic nerve injury
myasthenia gravis
shock
status asthmaticus
sustained apnea of any kind
indications for weaning from vent
, underlying process that required the vent is corrected
maintaining oxygen status
no presser support- levophed, epinephrine, etc.
Pa02 >80, FI02 of 0.5, and PEEP <8.0 cm H20
prior to seperation from the vent proceed with this ...... to determine if pt is able to
dc vent
trial of spontaneous breathing
Volume targeted assist control (AC) mode
the clinician determines tidal volume and rate/ pt can still breath over the vent. example:
pt gets RR of 12 but has an additional 2 breaths on their own, pt will still breathe 14
breaths/min. tidal volume is based on the vent.
Synchronized intermittent mandatory ventilation SIMV
clinician sets rate, and tidal volume, and peak inflation pt can also have their own
breaths. tidal volume is set based on the patient. VENT doesn't specify tidal volume.
Pressure Control
A mode of ventilation that is normally patient or time triggered, pressure targeted and
time cycled.
AC control vent settings how do you determine tidal volume?
is based on ideal body weight. careful with obese patients.
tidal volume
Amount of air that moves in and out of the lungs during a normal breath
peep
positive end expiratory pressure
Static Pressure
the pressure of air at rest, or that portion in moving air, if the air stream were to stop
Plateau pressure
Measures the compliance the entire lung
End inspiratory pause button
Peak pressure
Pressure required to get a volume of air into the lungs, fighting resistance
increase in peak pressure is a complication from which patients?
ARDS or restrictive airway patients.
high peak pressures with normal plateau pressures indicate....
resistance, such as an ET obstruction or bronchospasm
Minimal sedation
relief of anxiety, minimal affection on sensorium, anti-anixety medications
moderate sedation
-Depression of consciousness is drug induced
-Patient is able to respond to verbal commands
-Cardiac and respiratory function not usually affected
Deep sedation
client cannot be easily aroused, but can respond after repeated stimulation. respiration
may need to be supported
general anesthesia
Normal pH
7.35-7.45
<7.35 Acid
>7.45 alkalosis
respiratory aklalosis
pH> 7.45, PaC02 low, HC03 low
respiratory acidosis
pH < 7.35
PaCO2 > 45
Hc03 normal 22-26
Metabolic alkalosis
pH > 7.45
HCO3 > 26
PaC02 45-35
normal oxygen levle
80-100
mild hypoxemia
60-80
moderate hypoxemia
40-60
severe hypoxemia
<40
A-a gradiatian calculation is a calculation of what?
level of hypoxia
PA02-Pa02
A-a gradiant varies with age, calculation
2.5 + 0.21 x age in years
5 causes of hypoxemia
VQ mismatch
shunt
PNA, interstitial lung dz
hypoventilation
high altitude
clinical symptoms that require intubation
neuromuscular depression or failure.
spinal cord injuries
guillain barre syndrome
trauma-spinal cord injuries, phrenic nerve injury
myasthenia gravis
shock
status asthmaticus
sustained apnea of any kind
indications for weaning from vent
, underlying process that required the vent is corrected
maintaining oxygen status
no presser support- levophed, epinephrine, etc.
Pa02 >80, FI02 of 0.5, and PEEP <8.0 cm H20
prior to seperation from the vent proceed with this ...... to determine if pt is able to
dc vent
trial of spontaneous breathing
Volume targeted assist control (AC) mode
the clinician determines tidal volume and rate/ pt can still breath over the vent. example:
pt gets RR of 12 but has an additional 2 breaths on their own, pt will still breathe 14
breaths/min. tidal volume is based on the vent.
Synchronized intermittent mandatory ventilation SIMV
clinician sets rate, and tidal volume, and peak inflation pt can also have their own
breaths. tidal volume is set based on the patient. VENT doesn't specify tidal volume.
Pressure Control
A mode of ventilation that is normally patient or time triggered, pressure targeted and
time cycled.
AC control vent settings how do you determine tidal volume?
is based on ideal body weight. careful with obese patients.
tidal volume
Amount of air that moves in and out of the lungs during a normal breath
peep
positive end expiratory pressure
Static Pressure
the pressure of air at rest, or that portion in moving air, if the air stream were to stop
Plateau pressure
Measures the compliance the entire lung
End inspiratory pause button
Peak pressure
Pressure required to get a volume of air into the lungs, fighting resistance
increase in peak pressure is a complication from which patients?
ARDS or restrictive airway patients.
high peak pressures with normal plateau pressures indicate....
resistance, such as an ET obstruction or bronchospasm
Minimal sedation
relief of anxiety, minimal affection on sensorium, anti-anixety medications
moderate sedation
-Depression of consciousness is drug induced
-Patient is able to respond to verbal commands
-Cardiac and respiratory function not usually affected
Deep sedation
client cannot be easily aroused, but can respond after repeated stimulation. respiration
may need to be supported
general anesthesia
