Ch 21 Respiratory Care Modalities
When weaning a client from the tracheostomy tube the nurse initially should plug the opening in the tube for..
5 to 20 minutes
Histotoxic Hypoxia occurs when?
A toxic substance, such as cyanide, interferes with the ability of tissues to use available oxygen
How to assess for the need for oxygen?
ABGs Pule Ox Clinical eval
Clinical manifestions that indicate the necessity for Mechanical Ventilation..
Apnea/bradypnea Resp. distress with confusion Circulatory shock
Which ventilator mode provides full ventilatory support by delivering a present tidal volume and respiratory rate?
Assist control
Signs of Hypoxemia..
Change in mental status Dyspnea Increase in BP Change in HR Dysrhythmias Central cyanosis Disphoresis Cool extremities
Early signs that a pt may need oxygen..
Change in respiratory rate or pattern
Hypoxia..
Decrease in oxygen to tissues and cells *Can be life threatening**
Circulatory Hypoxia (inadequate capillary circulation) is caused by.
Decreased cardiac output, local vascular obstruction, low flow states (shock, cardiac arrest)
Anemic Hypoxia is a result of?
Decreased effective hemoglobin concentration, which causes a decrease in the oxygen-carrying capacity of the blood
Hypoxemia..
Decrese in arterial oxygen tension in the blood.
ABGs should be obtained how often after initiating continuous mechanical ventilation?
Every 20 minutes
Circulatory Hypoxia , how to correct?
Identifying and treating the underlying cause
Hypoxemic Hypoxia, how to correct?
Increasing alveolar ventilation or providing supplemental oxygen
Which ventilator mode provides a combination of mechanically assisted breaths and spontaneous breaths?
Intermittent mandatory ventilation (IMV)
Which oxygen administration device has the advantage of providing a high oxygen concentration?
Nonrebreathing mask (provides high oxygen but usually fits poorly)
If drainage from chest tube is > or = to 150 mL per hour, you need to?
Notify MD
Lab values that indicate the necessity for Mechanical Ventilation..
PaO2<55 PaCO2>50 pH<7.32
After pneumonectomy how should you position your patient?
Pt. is turned every hour from the back to the operative side (should not be completely turned to the unoperated side)
PEEP therapy has which effect on the heart?
Reduces cardiac output by increasing intrathoracic pressure and reducing the amount of blood delivered to the left side of the heart
Signs and symptoms of Oxygen Toxicity.
Substernal discomfort, paresthesias, dyspnea, restlessness, fatigue, malaise, progressive respiratory difficulty, refractory hypoxemia, alveolar atelectasis
What are indicators that a client is ready to be weaned from a ventilator?
Vital capacity of 13 mL/kg PaO2 of 64 mm Hg Tidal volume 8.5 mL/kg
An adult client with cystic fibrosis should have chest PT done?
at bedtime to reduce secretions in the clients lungs during the night
If chest tube drain is bubbling it is..
functioning properly
Hypoxemic Hypoxia is cause by..
hypoventilation, high altitudes, ventilaiton-perfusion mismatch, shunts (collapsed alveoli), pulmonary diffusion defects.
Endotracheal cuff pressure should be
maintained between 20 and 25 mmHg
Patient with endotracheal tube, cuff pressure...
needs to be checked every 6-8 hours
