FCCN Level 2 Exam- 192 Q’s and
A’s
PaO2 - -partial pressure of oxygen in arterial blood, obtained using an ABG
80-100mmHG
PaO2 60=SpO2 90%
-SpO2 - -saturation of peripheral oxygen, obtained using pulse ox
90-100%
SpO2 90%=PaO2 60
-PaCO2 - -35-45
-respiratory acidosis - -low pH, high CO2
causes: CNS depression from drugs such as sedation, injury, or disease
breathe too slow, retaining CO2
-respiratory alkalosis - -high pH, low CO2
causes: pain, fever, sepsis
breathe too fast, not retaining enough CO2
-HCO3 - -22-26
-metabolic acidosis - -low pH, low HCO3
causes: diarrhea, DKA, hyperkalemia
-metabolic alkalosis - -high pH, high HCO3
causes: vomiting, suctioning, hypokalemia
-pH - -7.35-7.45
-reading ABGs - -1. evaluate pH to identify acidosis or alkalosis
2. match CO2 or HCO3 with pH state using ROME to determine respiratory or
metabolic
,3. assess whether CO2 or HCO3 state is opposite of pH to determine if it is
uncompensated, partially compensated, fully compensated, or corrected
-non-invasive ventilation - -CPAP/BiPAP
-CPAP - -continuous positive airway pressure; provides inspiratory pressure
-BiPAP - -bilevel positive airway pressure; provides inspiratory and
expiratory pressure
-intubation - -insertion of ETT into trachea
-RSI - -administration of induction agent and neuromuscular blockade agent
simultaneously
-intubation kit medications - -premeds - versed and fentanyl
sedatives - propofol, etomidate, ketamine
paralytics - succinylcholine, rocuronium
pressor - phenylephrine
-intubation preparation - --notify RT and pharmacist
-discuss need for intubation and obtain consent, ensure pt does not have DNI
order.
-evaluate whether pt has difficult airway
-verify equipment and PPE
-assure functioning IV access
-position pt
-ensure verbalization of procedural pause
-preoxygenate
-RN role during intubation - -monitor pt vital signs especially O2 sats,
administer medications, monitor time of intubation attempts, suctioning as
needed
-intubation process - --following sedation, bag mask ventilate the pt
-physician visualize ETT passing through cords
-anesthesia backup will be notified after 10 minutes or 2 attempts to secure
the airway
-post intubation care - --portable chest x-ray, ABGs
-obtain sedation and analgesia orders
-hourly RASS observation
-monitor for hemodynamic changes
, -ventilator settings - -FiO2
Tidal Volume
Respiratory Rate
PEEP
Mode
-FiO2 - -fraction of inspired oxygen; the concentration of oxygen in the air
we breathe
RA is 21%, maximum is 100%
lung protection FiO2 goal: maintain SpO2 target with FiO2 <60%
-PEEP - -positive end-expiratory pressure, provides positive pressure to
airways during expiration and helps keep alveoli open
common mechanical ventilator setting in which airway pressure is
maintained above atmospheric pressure
disadvantages: increased thoracic pressure decreases venous return to the
heart. high levels can cause barotrauma, tension pneumo
-respiratory rate - -minimum number of breaths per minute the vent will
ensure your pt takes
increase the rate to blow off CO2, decrease rate to retain
-tidal volume - -amount of air that moves in and out of the lungs during a
breath. calculated based on predicted body weight (height and gender)
6mL/kg is ideal
-minute ventilation - -tidal volume x respiratory rate
volume inspired during 1 minute
normal is 5-8L/min
-pressure support - --eases the work of breathing, helps to overcome airway
resistance of breathing through artificial airway
-cannot be used with AC or CMV
-CAN be used with SIMV
-Patient can take breaths between mandatory breaths
-used to wean from ventilator
A’s
PaO2 - -partial pressure of oxygen in arterial blood, obtained using an ABG
80-100mmHG
PaO2 60=SpO2 90%
-SpO2 - -saturation of peripheral oxygen, obtained using pulse ox
90-100%
SpO2 90%=PaO2 60
-PaCO2 - -35-45
-respiratory acidosis - -low pH, high CO2
causes: CNS depression from drugs such as sedation, injury, or disease
breathe too slow, retaining CO2
-respiratory alkalosis - -high pH, low CO2
causes: pain, fever, sepsis
breathe too fast, not retaining enough CO2
-HCO3 - -22-26
-metabolic acidosis - -low pH, low HCO3
causes: diarrhea, DKA, hyperkalemia
-metabolic alkalosis - -high pH, high HCO3
causes: vomiting, suctioning, hypokalemia
-pH - -7.35-7.45
-reading ABGs - -1. evaluate pH to identify acidosis or alkalosis
2. match CO2 or HCO3 with pH state using ROME to determine respiratory or
metabolic
,3. assess whether CO2 or HCO3 state is opposite of pH to determine if it is
uncompensated, partially compensated, fully compensated, or corrected
-non-invasive ventilation - -CPAP/BiPAP
-CPAP - -continuous positive airway pressure; provides inspiratory pressure
-BiPAP - -bilevel positive airway pressure; provides inspiratory and
expiratory pressure
-intubation - -insertion of ETT into trachea
-RSI - -administration of induction agent and neuromuscular blockade agent
simultaneously
-intubation kit medications - -premeds - versed and fentanyl
sedatives - propofol, etomidate, ketamine
paralytics - succinylcholine, rocuronium
pressor - phenylephrine
-intubation preparation - --notify RT and pharmacist
-discuss need for intubation and obtain consent, ensure pt does not have DNI
order.
-evaluate whether pt has difficult airway
-verify equipment and PPE
-assure functioning IV access
-position pt
-ensure verbalization of procedural pause
-preoxygenate
-RN role during intubation - -monitor pt vital signs especially O2 sats,
administer medications, monitor time of intubation attempts, suctioning as
needed
-intubation process - --following sedation, bag mask ventilate the pt
-physician visualize ETT passing through cords
-anesthesia backup will be notified after 10 minutes or 2 attempts to secure
the airway
-post intubation care - --portable chest x-ray, ABGs
-obtain sedation and analgesia orders
-hourly RASS observation
-monitor for hemodynamic changes
, -ventilator settings - -FiO2
Tidal Volume
Respiratory Rate
PEEP
Mode
-FiO2 - -fraction of inspired oxygen; the concentration of oxygen in the air
we breathe
RA is 21%, maximum is 100%
lung protection FiO2 goal: maintain SpO2 target with FiO2 <60%
-PEEP - -positive end-expiratory pressure, provides positive pressure to
airways during expiration and helps keep alveoli open
common mechanical ventilator setting in which airway pressure is
maintained above atmospheric pressure
disadvantages: increased thoracic pressure decreases venous return to the
heart. high levels can cause barotrauma, tension pneumo
-respiratory rate - -minimum number of breaths per minute the vent will
ensure your pt takes
increase the rate to blow off CO2, decrease rate to retain
-tidal volume - -amount of air that moves in and out of the lungs during a
breath. calculated based on predicted body weight (height and gender)
6mL/kg is ideal
-minute ventilation - -tidal volume x respiratory rate
volume inspired during 1 minute
normal is 5-8L/min
-pressure support - --eases the work of breathing, helps to overcome airway
resistance of breathing through artificial airway
-cannot be used with AC or CMV
-CAN be used with SIMV
-Patient can take breaths between mandatory breaths
-used to wean from ventilator
