flash cards

Hyper Exam 2

Question Answer
What is CPAP? maintains positive pressure throughout both inspiration and expiration
Physiological benefits CPAP? Recruitment of collapsed alveoli via increase FRC, decreased WOB, Improve distribution of ventilation through collateral ventilation (pores of kohn), increase secretion removal, improved oxygenation
CPAP indications? Post-op atelaectasis, cardiogenic pulmonary edema, sleep apnea, decreased O2 saturation- refractory hypoxemia (PaO2 less than 60 mmHg, FiO2 40-50% or greater)
CPAP Contradictions? hemodynamically unstable, hypoventilation, nausea, facial trauma, untreated pneumo, elevated ICP
CPAP hazards/complcations? hypoventilation, hypercapnia, increase WOB, barotrauma, gastric distention…to reduce risks: keep pressures less than 15 cmH20, NG tube, ETT
What is respiratory failure? inability to maintain either a normal delivery of O2 to tissues or the normal removal of CO2 from tissues
what is type I respiratory failure? acute hypoxemic respiratory failure (PaO2 less than 60 mmHg)
What is type II respiratory failure? acute hypercapnic respiratory failure (paCO2 greater than 55 mmHg)
Signs and symptoms of respiratory failure: NIF (MIP) less than -20cmH20 (measure of inspiratory muscle strength), VT less than 5ml/kg, VC less than 10ml/kg, RR greater than 30, PaCO2 greater than 55, tachycardia, arrythmias, hypertension, accessory muscle use, tachypnea, diaphoresis, cyanosis
RBC value: 4-6 million mm/3
NPPV benefits over intubation? fewer complications, shorter stay in an acute care setting
Hct value: 40-50%
Hgb value: 12-16g/dl
Wbc value: 5-10,000 mm/3
Normal ABG values: pH 7.35-7.45, PaCO2- 35-45 mmHg, biCarb 22-26meQ/L
Bilevel Pap: bilevel positive airway pressure (bipap=trademark)
IPAP term: inspiratory positive airway pressure
EPAP term: expiratory positive airway pressure
Physiological effects IPAP: improves ventilation, larger tidal volume
Physiological effects EPAP: improves O2 by increasing FRC, relieves upper airway obstruction
Goals of NPPV? Acute care setting: avoid complications of intubation, improve mortality, decrease incidence of VAP, relieve symptoms, enhance gas exchange, improve pt-ventilator synchronization, maximize pt comfort, decrease length of ventilation…
Goals Of NPPV Part 2? decrease length of hospitalization, CHRONIC CARE SETTING: improve or relive symptoms, quality of life, avoid hospitilazation, increase survival, improve mobility
Indications of NPPV (bipap)? Non-acute- osa not responsive to CPAP, central sleep apnea, neuromuscular disease needing assistance..Acute- avoid intubation pts with CO2 retention: pulmonary edema, COPD exacerbation
NPPV contraindications? apnea, unable to handle secretions, facial trauma, claustrophobia
CPAP & BIPAP MASKS- Nasal tight seal, must keep mouth closed breathe through nose
CPAP & BIPAP MASKS- facial regurgitation cant be problem, tight seal easier than nasal, possible asphyxiation in event failure
CPAP & BIPAP MASKS- nasal pillow small common CPAP, 2 small cushions under nose, more comfortable, leak is problem
NPPV term? positive pressure to upper airway
CPAP is used for? Oxygenation
Bipap is used for? Ventilation
Avg starting pressure CPAP? 5cmH2O
Pressure inspiration in lungs? -3cmH2O

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