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CHA-Ventilators-Becky
Complex Health Alterations
16
Nursing
Undergraduate 3
07/10/2013

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Cards

Term
Type of ventilator used for the client who is breathing inadequately on his own.
Definition
assisted breathing ventilator
Term
Type of ventilator used on the client for whom a specific rate is needed.
Definition
controled breather ventilator
Term
delivers a concise volume of air with each breath
Definition
volume-controled ventilator
Term
Similar to the volume-controlled ventilator, but not always as effective.
Definition
pressure-controlled ventilator
Term
Intubation
Definition
  1. Explain procedure to pt
  2. Equipment - intubation kit & suction equipment
  3. Hyperoxygenate - prior to intubation
  4. Limit length of insertion attempt - stop and reoxygenate between attempts
  5. Verify ET tube placement
  6. Secure ET tube - to upper lip & nose to prevent mvmt; if taped to lip, remove daily and reposition
  7. Document - placement (confirmation of), how pt tolerated, resp status
Term
Complications of intubation
Definition
  • Tube displacement
  • Obstruction - if unable to clear, replace tube
  • Air leak - cuff not fully inflated
  • Infection
  • Tracheal necrosis
  • Oral or nasal necrosis
  • Sinusitis
  • Aspiration
Term
Extubation
Definition
  1. Have oxygen device ready
  2. Suction pt immediately prior (mouth and ET tube)
  3. Remove tube at MAXIMAL INSPIRATION - deflate and pull out to prevent aspiration
  4. NPO except ice chips (in case of reintubation)
  5. Cough and deep breathe frequently
  6. Monitor resp status
Term
Types of Mechanical Ventilators
Definition
Negative pressure - uncommon
Positive pressure - pressure limited (infants, children, adults with chronic illness, fragile lung tissue) & volume limited
Term
Modes of positive pressure ventilation
Definition

The way the pt receives the breath:

  • CMV (controlled mandatory vol)
  • AC (assist controlled)
  • IMV/SIMV (intermittent vol)
  • CPAP
Term
CMV
Definition

Most controlled mode

Controls rate and vol pt gets per min

Term
AC
Definition
Will be set vol and rate but pt may breathe over that rate (but they always receive the same volume of air)
Term
IMV
Definition
  • Ventilator gurantees min rate and volume
  • ANY BREATHS TAKEN OVER WILL BE AT PATIENT'S OWN VOLUME (unlike AC
Term
CPAP
Definition
  • No set rate or vol
  • Keeps alveoli inflated
  • Helps determine pt ability to be extubated
Term
Ventilator settings
Definition
  • PEEP (positive end expiratory pressure)- prevents alveolar collapse so that it's easier to take the next breath)
  • PS (pressure support) - used most commonly with CPAP
  • FiO2 (fraction of inspired O2)
  • TV - amt of each breath in mL
Term
Common Ventilator Alarms
Definition

Silence the alarm to prevent anxiety, give 100% O2 for 3 min (button, allows to hyperoxygenate b4 suctioning); If you can't figure it out, manually ventilate and call RT.

  • High rate- pt breathing over
  • High pressure- resistance; kink, pt biting, ET tube, secretions in a/w, pneumothorax
  • Low pressure - if cuff deflated, d/c'ed tubing, pt pops off ventilator (same for low vol)
  • Low vol
  • Apnea
Term
Ventilator Weaning
Definition
  • Weaning parameters - awake, alert, cooperative
  • Limit or withhold sedation
  • LT ventilator facilities
  • ET tube (7-10 days) vs. trach (pt comfort, hygiene, no sedation, restraints)
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