Mechanical Ventilation

These flashcards cover key concepts and practical knowledge related to mechanical ventilation, including indications, types of ventilators, modes of support, and nursing considerations.

What is Mechanical Ventilation?

A process by which fraction inspired oxygen (FIO2) at ≥21% is moved into and out of the lungs by a mechanical ventilator, supporting patients until they can breathe independently.

What indicates the need for mechanical ventilation?

Evidence of respiratory failure or compromised airway, corroborated by continuous decrease in PaO2, increase in PaCO2, and persistent acidosis.

What are the two general categories of mechanical ventilators?

Negative-pressure and positive-pressure ventilators.

What is Positive-Pressure Ventilation (PPV)?

A method where the ventilator pushes air into the lungs under positive pressure during inspiration.

Describe Volume-Cycled Ventilators.

They deliver a preset tidal volume of air with each inspiration, cycling off once the volume is delivered, ensuring consistent breaths.

What is a significant disadvantage of using volume-cycled ventilators?

Patients may experience barotrauma due to excessive pressures required to deliver breaths.

What is the function of High-Frequency Oscillatory Support Ventilators?

They deliver very high respiratory rates with low tidal volumes and are used to open closed small airways.

What must patients receiving High-Frequency Oscillatory Ventilation (HFOV) be?

Sedated and may need paralysis to suppress spontaneous respiration.

What is Noninvasive Positive-Pressure Ventilation (NIPPV)?

A method that provides positive pressure via masks, eliminating the need for intubation and decreasing risk of infections.

What are the criteria for patients to be candidates for NIPPV?

Acute or chronic respiratory failure, pulmonary edema, COPD, or sleep-related breathing disorders.

What is the primary purpose of Continuous Positive Airway Pressure (CPAP)?

To keep the airways open throughout the respiratory cycle, effectively treating obstructive sleep apnea.

What is the key characteristics of the Synchronized Intermittent Mandatory Ventilation (SIMV)?

It delivers preset tidal volume breaths while allowing spontaneous breathing between these ventilator breaths.

How does Pressure Support Ventilation (PSV) assist patients?

By applying a pressure plateau to the airway during patient-triggered inspiration to decrease resistance.

What is Assisted-Control (A/C) Ventilation?

A mode providing full ventilator support where each breath has a preset tidal volume or pressure.

Describe the significance of PEEP in mechanical ventilation.

Positive end-expiratory pressure helps maintain or improve oxygenation while limiting O2 toxicity.

What is the main goal during weaning a patient from mechanical ventilation?

To allow gradual independence from the ventilator while maintaining adequate spontaneous ventilation.

What assessments are critical before, during, and after the weaning process?

Monitoring vital signs, oxygen saturation levels, respiratory pattern, and adjusting ventilator settings as needed.

What is the goal of using neuromuscular blocking agents in ventilated patients?

To ensure synchrony with the ventilator and manage high airway pressures while providing adequate sedation.

How does the nurse ensure effective sedation for patients on mechanical ventilation?

By regularly assessing the patient's sedation level and adjusting medications to prevent pain or anxiety without suppressing respirations.

What nursing interventions help prevent Ventilator-Associated Pneumonia (VAP)?

Elevation of the head, daily sedation assessments, proper oral care, and cleaning of ventilator equipment.

What is the purpose of mechanical ventilation?

The purpose of mechanical ventilation is to support or replace spontaneous breathing in patients who are unable to breathe adequately on their own.

What are the indications for mechanical ventilation?

Indications for mechanical ventilation include respiratory failure, severe hypoxemia, hypercapnia, neuromuscular disorders, and airway protection.

What is the nursing process framework in caring for mechanically ventilated patients?

The nursing process framework includes assessment, diagnosis, planning, implementation, and evaluation to provide comprehensive care for mechanically ventilated patients.

What are the modes of ventilatory assistance?

Modes of ventilatory assistance include Assist-Control (AC), Synchronized Intermittent Mandatory Ventilation (SIMV), Continuous Positive Airway Pressure (CPAP), and Bilevel Positive Airway Pressure (BiPAP).

What are the physiological effects of Positive Pressure ventilation?

Positive Pressure ventilation can increase intrathoracic pressure, reduce venous return, impact cardiac output, and influence gas exchange.

What are major complications of mechanical ventilation?

Major complications of mechanical ventilation include ventilator-associated pneumonia (VAP), barotrauma, volutrauma, and prolonged sedation.

What nursing interventions can decrease or prevent complications associated with mechanical ventilation?

Nursing interventions include maintaining proper ventilation settings, regular oral care, proper positioning, and monitoring for signs of infection or complications.

How is sedation/neuromuscular blockade used in mechanically ventilated patients?

Sedation/neuromuscular blockade is used to facilitate ventilation, improve comfort, and prevent discomfort or movement in patients on mechanical ventilation.

What is the process for weaning a patient from mechanical ventilation?

The weaning process involves gradual reduction of ventilatory support, monitoring patient response, and assessing for readiness to breathe independently.