SiPAP correct answers Biphasic non-invasive support
What is NCPAP for correct answers adjunct to prevent intubation/re-intubation
How is noninvasive support given through correct answers 1. nasal prongs
2. nasopharyngeal airway
3. mask
NCPAP pressures usually applied are _____-_____cmH2...
What is NCPAP for correct answers adjunct to prevent intubation/re-intubation
How is noninvasive support given through correct answers 1. nasal prongs
2. nasopharyngeal airway
3. mask
NCPAP pressures usually applied are _____-_____cmH2O correct answers 3-6
Physiological considerations for neonates correct answers 1. preferential nose breathers
2. Flow & pressure in the airway can stimulate breathing (apnea spells)
3. predisposed to alveolar collapse at end exhalation
4. chest wall compliance is greater than lung compliance
5. abdominal breathing
What serves to stent airways open correct answers continuous pressures
What is NCPAP correct answers constant positive pressure increases the FRC & improves lung
compliance
What is the result of NCPAP correct answers improved oxygenation & decreased WOB
NCPAP is initiated for correct answers respiratory distress with refractory hypoxemia
WITHOUT ventilatory failure
What are the indications for NCPAP correct answers 1. decreased/unstable FRC
2. airway collapse
3. weaning from mechanical ventilation
4. inability to maintain PaO2 >50 mmHg w/ FiO2 <60%
5. PaCO2 50 mmHg or less with pH >7.25
6. Post extubation adjunct, prevent failure
What is the expected outcome of NCPAP correct answers 1. decreased WOB as evidenced by
reduction in grunting, retractions and/or nasal flaring
2. improvement in FRC as evidenced by CXR
3. improvement of gas exchange
Hazards & complications for NCPAP correct answers 1. Obstruction of interface
2. pulmonary over distention
3. gastric insufflation
4. air leak syndrome
5. nasal irritation w/ septal distortion
6. Skin irritation w pressure necrosis (most common)
7. nasal mucosa damage
What is considered failure of NCPAP correct answers 1. no response to oxygenation to increase
level of NCPAP
2. rise in PaCO2 level or drop in PaO2 level
3. Persistent acidosis pH <7.25
4. increased FiO2 requirements (>15%)
5. Need for PIP >20 cm H2O
6. Need for CPAP >8 cmH2O
7. severe apnea
Excessive flow/ pressure may do what correct answers impede ventilation
What equipment is necessary for NCPAP correct answers -interface (nasal prongs or mask)
-infant ventilator or stand alone CPAP unit
-securing device or headgear
-5-8 french feeding tube
-transcutaneous monitor and/or pulse ox
too small of prongs may result in what correct answers the need for increased flow setting
requirement
Too large of prongs will lead to correct answers pressure sores & necrosis
Procedure for putting a neonate on NCPAP correct answers 1. Connect prongs to generator
set/ventilator circuit.
2. Position prongs as appropriate into nares.
3. Secure prongs with appropriate securing device or headgear.
4. Re-assess patient for response to therapy.
5. Make adjustments to interface or settings as necessary.
6. Obtain ABG/CBG within one hour following initiation of CPAP.
7. Have RN insert feeding tube. (If applicable)
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