NRNP 6566 final prep 6-12

NRNP 6566 final prep 6-12 Normal pH 7.35-7.45 <7.35 Acid >7.45 alkalosis respiratory aklalosis pH> 7.45, PaC02 low, HC03 low respiratory acidosis pH < 7.35 PaCO2 > 45 Hc03 normal 22-26 Metabolic alkalosis pH > 7.45 HCO3 > 26 PaC02 45-35 normal oxygen levle 80-100 mild hypoxemia 60-80 moderate hypoxemia 40-60 severe hypoxemia <40 A-a gradiatian calculation is a calculation of what? level of hypoxia PA02-Pa02 A-a gradiant varies with age, calculation 2.5 + 0.21 x age in years 5 causes of hypoxemia VQ mismatch shunt PNA, interstitial lung dz hypoventilation high altitude clinical symptoms that require intubation neuromuscular depression or failure. spinal cord injuries guillain barre syndrome trauma-spinal cord injuries, phrenic nerve injury myasthenia gravis shock status asthmaticus sustained apnea of any kind indications for weaning from vent underlying process that required the vent is corrected maintaining oxygen status no presser support- levophed, epinephrine, etc. Pa02 >80, FI02 of 0.5, and PEEP <8.0 cm H20 prior to seperation from the vent proceed with this ...... to determine if pt is able to dc vent trial of spontaneous breathing Volume targeted assist control (AC) mode the clinician determines tidal volume and rate/ pt can still breath over the vent. example: pt gets RR of 12 but has an additional 2 breaths on their own, pt will still breathe 14 breaths/min. tidal volume is based on the vent. Synchronized intermittent mandatory ventilation SIMV clinician sets rate, and tidal volume, and peak inflation pt can also have their own breaths. tidal volume is set based on the patient. VENT doesn't specify tidal volume. Pressure Control A mode of ventilation that is normally patient or time triggered, pressure targeted and time cycled. AC control vent settings how do you determine tidal volume? is based on ideal body weight. careful with obese patients. tidal volume Amount of air that moves in and out of the lungs during a normal breath peep positive end expiratory pressure Static Pressure the pressure of air at rest, or that portion in moving air, if the air stream were to stop Plateau pressure Measures the compliance the entire lung End inspiratory pause button Peak pressure Pressure required to get a volume of air into the lungs, fighting resistance increase in peak pressure is a complication from which patients? ARDS or restrictive airway patients. high peak pressures with normal plateau pressures indicate.... resistance, such as an ET obstruction or bronchospasm Minimal sedation relief of anxiety, minimal affection on sensorium, anti-anixety medications moderate sedation -Depression of consciousness is drug induced -Patient is able to respond to verbal commands -Cardiac and respiratory function not usually affected Deep sedation client cannot be easily aroused, but can respond after repeated stimulation. respiration may need to be supported general anesthesia