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TMC
Tutoring TMC
| Question | Answer |
|---|---|
| Levophep | Vasopressor, increases B/P Decreases Pressures First RT has to establish a CVP to administer |
| Norepinephrine | Decreases B/P |
| CVP | 2-6 mmHG Measures RA pressure Increased Cor Pul decreased Vaso dilation |
| Plat | <30 Alveoli Compliance drops PLAT would increases Measured at end Inspiration |
| PIP | <40 Upper Airway + Alveoli Compliance Drops PIP would increases |
| Low Pressure Alarms | Leak, Low Vt, Rupture in ETT or Cuff Withdraw of ETT |
| High Pressure Alarms | Bitting ETT, Kinking , Secretions, Mucus plug, Pnemo Right mainstem, Increased/too much Vt due to decreased compliance |
| Pneumothorax | B/P decrease's Radiolucent-black Hyperlucency-Black Tracheal Deviation to opposite side from affected side Tympanic/Hyyperreasonce Unequal breath sounds Unstable- Needle Depression Midclavicular 2-3 Stable- Chest Tube |
| Continuous Bubbling only acceptable in | Drainage seal In-active Inhalation and exhalation |
| If there is continuous bubbling | Replace Tubing Notify Physician |
| SBT | Ps/CPAP -30min- 2hrs HR. RR, WOB, B/P, signs of resp distress RR >35 for 5 mins (D/C SBT) HR >130/20% increase for 5 mins or (D/C SBT) |
| RAW | 0.6-2.4 cmH20 (up to 6 for vented pts) Secretions/Bronchoconstriction Pip-Plat/Flow (L/S) Secretions- SXN Bronchoconstriction- Bronchodilator If effective PIPS would decrease |
| Pre/Post Bronchodilator Test | Assess for revisability of disease 1st- Get baseline 2nd- Get post measurement assess increase of 12% in FEV1 & FVC 200 ml |
| Flow loops | if they don't get back to baseline -Airdropping/Obstruction/Decreased Exhalation |
| Secretions | Course crackles BS Flow wave form (Snake) Increased PIP Vibrations in the chest Q4 CPT |
| Pul. E | Sudden Desat Young Kids Long bone fracture Rib Fractures Chest pain Post Ob pt in long periods of bed rest Cough Nonproductive if productive it would be hemoptysis Cyanotic |
| ARDS | P/f ratio <200 Increased PLAT Refectory Hypoxemia Ground glass / Honey combing Increase PEEP Low VT ARDS net Low Fio2 at 60% and High PEEP |
| when weaning off ARDs net | Drop first FIO2 then Drop PEEP |
| Normal PEEP | PEEP 4-6 ml/Kg |
| VC | Pressure is SET MG/GB |
| PC | Volume is SET ARDS |
| Insp Flow | Increased insp flow it fix air trapping (autoPEEP) and air hunger it will then Decreased i-Time |
| Increase PIP | Increase VT |
| Decrease MAP | Decrease itime, and Increase PIP (improves Oxygenation and Improves Distribution of ventilation) |
| IPV | Hyperinflation/High freq pulse delivery Improves ventilation, Mobilize secretions Promoter Bronchial Hygiene Vent Patients (Unconscious Patients) But if they are in floors they don't qualify ( Unconscious patient) |
| IPPB | Correct Atelectasis Improves & promotes Cough Mechanism Follow commands Surgical Patients |
| Cd | 40-60 cmH20 Measured at Inspiratory Hold and Expriatory |
| Cs | 60-100 cmH20 Measured at Inspiratory Hold |
| ICP | 5-10 to Decease ICP hyperventilate |
| CBC | Hb, Hct, RBC, Platelets |
| Auscultation of the chest | Asses for breathrng Pattern SOB, Increased RR Fever |
| Blood Cult | Asses for sepis |
| Confirm ETT | EZ-Cap 5% yellow |
| Position ETT | |
| Placement ETT | |
| Chest Xray findings | Broken Ribs, Diseases, |
| Toxicology Screen | Overdose/Alcohol Use/Pt fall down-Unresponsive |
| LOC | Mental Status Orientation Can they Follow commands GCS >9 |
| Integrity of ET and Airway | To asses patency Increase PIP, Decrease PIP -Proper placement |
| Nasal SX | Weak/nonproductive cough IF they are desating and large of continuous of secretion consider Intubation |
| Patient on 3L NC smoking leads to fire brought in brought by ambulant | NRB Co-ximetry /hemoximeterr Pink Cherry Red Sp02 100% inaccurate |
| 12 ECG | Chest Pain Increased HR Cardiac Arrthtymias |
| Check electrolytes in what type of patients | Weak patients /nuromuscular disorders |
| If PIPs are high what do you give | Bronchodilator |
Created by:
Fabian.559
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