mechanical ventilation - exam 1
questions with answers
Reasons for Mechanical Ventilation - ANSWER: ✔✔- Acute Respiratory Failure
- Ventilatory Failure - not moving adequately but perfusing
- Oxygenation Failure - moving air but perfusing inadequate
- Combined Ventilatory and Oxygenation Failure
Acute Respiratory Failure - ANSWER: ✔✔- Classified as blood gas abnormality
- PaO2 less than 60 mm Hg (however, less than 80 is hypoxemia)
- PCo2 greater than 45 mm Hg with acidosis.
- Sa02 less than 90%. (pulse oximetry)
- Can be caused by ventilatory failure, oxygenation failure or a combination of both.
- Whatever the cause, the patient is hypoxemic.
Ventilatory Failure - ANSWER: ✔✔- Can result from inadequate chest wall movement not allowing
enough air movement into and out of the lungs, which causes carbon dioxide to be retained.
- Muscle weakness that occurs with some neuromuscular diseases such as Myasthenia Gravis, ALS, brain
stem dysfunction can cause inadequate ventilation.
- Table 32-2
- Shallow resp, agonal resp, probs with brain
Oxygenation Failure - ANSWER: ✔✔- Oxygenation failure results when air moves in and out the lungs
without difficulty, but does not oxygenate the blood sufficiently.
- Poor diffusion of oxygen at the alveolar level.
- Air that is low in oxygen
- Abnormal hemoglobin that fails to bind oxygen.
- Table 32-3
,Combined Ventilatory and Oxygenation Failure - ANSWER: ✔✔- Hypoventilation and poor gas diffusion
with or without poor lung perfusion.
- Examples are ARDS and combined heart failure and lung disease.
- With ards, surfactant is washed away and pt will have slower breaths and lungs fdont' move adequately
and lungs become stiff and as alveoli are affected , we don't have good oxygenation
- ABGs - most reliable way to tell about gas echange and oxygenation
- End-Tidal Carbon Dioxide Monitoring - amount of CO2 that is exhaled (normal value is 35-45). When pt
is being intubated is the most definitive way to show proper placement without x-ray
- CXR - can visualize lungs and see if pt is properly intubated, if needed
- Measures the percentage of oxygen bound to hemoglobin (normal 97%)
- Can be used for continuous monitoring or spot check.
, - Can reduce the need for frequent sampling of arterial blood
- Can it completely replace ABGs?
When is Pulse Ox Not Accurate?? - ANSWER: ✔✔- Vasoconstriction meds - epinephrine, dopamine
- Elevated carboxyhemoglobin (smokers)
- Shock - decreased perfusion and compensatory mechanisms cause vasoconstrictions
- Severe anemia - not enough circulation hemoglobin
- Arrested - blood is shunted from periphery to heart to sustain bp
Anything causing decreased perfusion
- Thick acrylic nails
End-Tidal Carbon Dioxide - ANSWER: ✔✔- Measures the level of CO2 at the end of exhalation by
changing colors
- Measured via
--- Endotracheal tube
--- Nasal or oral airway
Nursing Diagnoses related to mechanical ventilation - ANSWER: ✔✔- Impaired Gas Exchange - look at
abgs
- Ineffective Breathing Pattern - look at resp rate (12-20 (or 28 for resp failure), depth, and effort [should
be full even and unlabored with chest movement symmetrical]
- Ineffective Airway Clearance - abnormal breath sounds (crackles, wheezing, coarse, moist non-
productive cough, et tube that keeps getting clogged with secretions)
- Impaired Spontaneous Ventilation - apnea, agonal breathing, decreased rate of 10 or 8
- For unsuccessful weaning - dysfunctional ventilatory weaning process
Goals/Objectives - ANSWER: ✔✔- ABG's return within normal value - don't say normal value say a PaO2
greater than or equal to 80, pH between 7.35 and 7.45, and PaCO2 between 35 and 45
- Resp 12-28, full, even, and unlabored
- O2 sat >/ 92% (lower may be acceptable depending on the pt and doctor's order)
Alle Vorteile der Zusammenfassungen von Stuvia auf einen Blick:
Garantiert gute Qualität durch Reviews
Stuvia Verkäufer haben mehr als 700.000 Zusammenfassungen beurteilt. Deshalb weißt du dass du das beste Dokument kaufst.
Schnell und einfach kaufen
Man bezahlt schnell und einfach mit iDeal, Kreditkarte oder Stuvia-Kredit für die Zusammenfassungen. Man braucht keine Mitgliedschaft.
Konzentration auf den Kern der Sache
Deine Mitstudenten schreiben die Zusammenfassungen. Deshalb enthalten die Zusammenfassungen immer aktuelle, zuverlässige und up-to-date Informationen. Damit kommst du schnell zum Kern der Sache.
Häufig gestellte Fragen
Was bekomme ich, wenn ich dieses Dokument kaufe?
Du erhältst eine PDF-Datei, die sofort nach dem Kauf verfügbar ist. Das gekaufte Dokument ist jederzeit, überall und unbegrenzt über dein Profil zugänglich.
Zufriedenheitsgarantie: Wie funktioniert das?
Unsere Zufriedenheitsgarantie sorgt dafür, dass du immer eine Lernunterlage findest, die zu dir passt. Du füllst ein Formular aus und unser Kundendienstteam kümmert sich um den Rest.
Wem kaufe ich diese Zusammenfassung ab?
Stuvia ist ein Marktplatz, du kaufst dieses Dokument also nicht von uns, sondern vom Verkäufer Fordenken. Stuvia erleichtert die Zahlung an den Verkäufer.
Werde ich an ein Abonnement gebunden sein?
Nein, du kaufst diese Zusammenfassung nur für 12,44 €. Du bist nach deinem Kauf an nichts gebunden.