Noninvasive Ventilation Techniques in Nursing

<p>It consistently delivers a set level of positive pressure to keep airways open. (C)</p> Signup and view all the answers

<p>Patients requiring additional ventilation assistance, such as those with COPD. (C)</p> Signup and view all the answers

<p>It can be performed faster and easier. (B)</p> Signup and view all the answers

<p>Reoxygenate the client before attempting another intubation. (B)</p> Signup and view all the answers

<p>Through the use of a chest x-ray. (C)</p> Signup and view all the answers

<p>To ensure the seal between the cuff and tracheal wall prevents air leak. (A)</p> Signup and view all the answers

<p>End-tidal carbon dioxide levels. (A)</p> Signup and view all the answers

<p>21% to 100% (C)</p> Signup and view all the answers

<p>Decreased work of breathing (C)</p> Signup and view all the answers

<p>Pacemaker (B)</p> Signup and view all the answers

<p>Positive pressure (A)</p> Signup and view all the answers

<p>To ensure adequate oxygen saturation of 95% or greater (C)</p> Signup and view all the answers

<p>Dehydration (B)</p> Signup and view all the answers

<p>A method for yes/no questions (B)</p> Signup and view all the answers

<p>Decrease workload (B)</p> Signup and view all the answers

<p>While managing acute pulmonary edema (A)</p> Signup and view all the answers

<p>Risk of volutrauma and decreased cardiac output (C)</p> Signup and view all the answers

<p>Independent Lung Ventilation (ILV) (D)</p> Signup and view all the answers

<p>Allows alveolar gas to be expelled through natural recoil (A)</p> Signup and view all the answers

<p>High-Frequency Ventilation (D)</p> Signup and view all the answers

<p>Respiratory alkalosis (D)</p> Signup and view all the answers

<p>To enhance gas exchange and prevent atelectasis (A)</p> Signup and view all the answers

<p>Sedation and/or neuromuscular blocking agents are usually necessary (B)</p> Signup and view all the answers

<p>Client-initiated breaths can vary in volume (C)</p> Signup and view all the answers

<p>To prevent accidental extubation and ensure oxygenation (D)</p> Signup and view all the answers

<p>Every 8 hours (B)</p> Signup and view all the answers

<p>Excess secretions or kinks in the tubing (C)</p> Signup and view all the answers

<p>Propofol (D)</p> Signup and view all the answers

<p>20 mm Hg (A)</p> Signup and view all the answers

<p>To ensure complete relaxation of respiratory muscles (A)</p> Signup and view all the answers

<p>Check settings hourly (D)</p> Signup and view all the answers

<p>The patient exhibits decreased oxygen saturation (C)</p> Signup and view all the answers

<p>Heart rate changes exceeding 20% of baseline (B)</p> Signup and view all the answers

<p>Prepare to reintubate if necessary (C)</p> Signup and view all the answers

<p>To promote mobility of secretions (D)</p> Signup and view all the answers

<p>Manual resuscitation bag and face mask (B)</p> Signup and view all the answers

<p>Decreased respiratory muscle strength (C)</p> Signup and view all the answers

<p>Oxygen toxicity (A)</p> Signup and view all the answers

<p>Keep the head of the bed elevated at least 30° (D)</p> Signup and view all the answers

<p>Tachycardia and hypotension (A)</p> Signup and view all the answers

<p>Volutrauma (C)</p> Signup and view all the answers

<p>Activation of renin-angiotensin-aldosterone system (B)</p> Signup and view all the answers

A method of providing positive pressure to the lungs without an invasive tube.

A type of NPPV that delivers a constant positive pressure to the airway.

A type of NPPV that delivers different pressure levels during inspiration and expiration.

CPAP is highly effective in treating sleep apnea by keeping airways open during sleep.

BiPAP is frequently used to assist ventilation for people with COPD.

Inserting a tube through the nose or mouth into the trachea to manage an emergency airway.

The most common and fastest way to intubate, usually done in the emergency department.

Used when there's facial or oral trauma, but not for clients with clotting problems.

Verifying correct placement of the ET tube using a chest x-ray and checking end-tidal carbon dioxide levels.

A cuff on the ET tube that is inflated to create a seal, preventing air leaks and ensuring proper ventilation.

A medical procedure that provides breathing support to individuals experiencing respiratory failure, delivering 100% oxygen that is warmed and humidified.

Ventilators that deliver air to the lungs under pressure during inspiration to keep the alveoli open and prevent collapse during expiration.

Forced/enhanced lung expansion, improved gas exchange (oxygenation), and decreased work of breathing.

Mechanical ventilation can be delivered via ET tube or a tracheostomy tube.

Ventilators can be cycled based on pressure, volume, time, and/or flow.

Noninvasive Positive Pressure Ventilation (NPPV) is used to maintain an open airway and adequate oxygen saturation (95% or greater) in patients with conditions like hypoxemia, hypoventilation, exacerbations of COPD, and acute pulmonary edema.

Before starting NPPV, it's crucial to explain the procedure to the patient and ensure they can communicate effectively. This might involve using yes/no questions, writing or picture boards, or lip reading.

NPPV is frequently used for patients with conditions like hypoxemia (low blood oxygen), hypoventilation (inadequate breathing), exacerbations of Chronic Obstructive Pulmonary Disease (COPD), and pulmonary edema (fluid in the lungs).

Neurological disorders like multiple sclerosis, myasthenia gravis, and Guillain-Barré can affect breathing, making NPPV a potential treatment option.

NPPV is used not only for acute respiratory problems but also for respiratory support after surgery (to decrease workload), during general anesthesia or sedation, and to treat obstructive sleep apnea.

AC ventilation provides a preset rate and tidal volume. The client initiates each breath, and the ventilator takes over to deliver the set volume. This is commonly used for intubated clients.

SIMV sets a preset rate and tidal volume for machine breaths. The client can also initiate breaths, with the tidal volume depending on their effort. The ventilator breaths are synchronized to avoid conflicting with the client's attempts.

IRV aims to maximize oxygenation by extending the inspiratory phase. Useful for hypoxemia that doesn't respond to PEEP. However, it can be uncomfortable for clients, requiring sedation or muscle relaxants due to potential for air trapping and cardiovascular issues.

APRV allows natural lung recoil to expel air, with time-triggered, pressure-limited breaths. It can be initiated either spontaneously by the client or by the ventilator. APRV promotes better lung health and minimizes cardiovascular side effects compared to other modes.

ILV uses a double-lumen endotracheal tube to ventilate each lung independently. This is helpful for clients with unilateral lung disease. ILV requires two ventilators, sedation, and possibly muscle relaxants.

High-frequency ventilation delivers small amounts of gas at very high rates (60 to 3,000 cycles/min). While often used in children, sedation and muscle relaxants are essential. Assessing breath sounds can be challenging due to the rapid cycles.

PEEP adds pressure during expiration, preventing alveoli collapse and improving oxygenation. It's typically added to ventilator settings in increments of 5 to 15 cm H2O to address persistent hypoxemia.

These alarms signal when there's a problem with the client's ventilation, alerting the nurse to act quickly.

This alarm sounds when the exhaled volume is low, possibly due to a disconnection, cuff leak, or tube displacement.

This alarm occurs when the ventilator faces resistance, indicating excess secretions, biting the tubing, kinks, coughing, edema, bronchospasm, or pneumothorax.

This alarm alerts when the ventilator doesn't detect spontaneous breaths within a set time.

This pressure needs to maintained within a specific range to prevent tracheal necrosis.

Sedation helps relax the client, preventing them from fighting the ventilator and allowing for better breathing.

These medications paralyze muscles, but don't sedate or relieve pain, often paired with sedatives for ventilation.

This means keeping the breathing tube clear and open for effective ventilation.

Signs of weaning intolerance include increased respirations (over 30/min or less than 8/min), significant changes in vital signs (BP or HR greater than 20% of baseline), low SaO2 (below 90%), dysrhythmias, elevated ST segment, decreased tidal volume, labored breathing, increased accessory muscle use, diaphoresis, restlessness, anxiety, and decreased consciousness.

During weaning, keep a manual resuscitation bag with a face mask and oxygen, reintubation equipment, and suction tools readily available at the bedside.

After extubation, monitor for signs of respiratory distress or airway obstruction (ineffective cough, dyspnea, stridor), assess SpO2 and vital signs every 5 minutes, encourage coughing, deep breathing, and use of the incentive spirometer.

Older adults have weaker respiratory muscles and less chest wall compliance, making them more susceptible to aspiration, atelectasis, and pulmonary infections. They require frequent position changes to mobilize secretions.

Regularly repositioning older adult clients helps move secretions and prevent complications like aspiration and atelectasis.

Damage to the lungs caused by positive pressure, often due to a pneumothorax, subcutaneous emphysema, or pneumomediastinum.

Lung damage caused by excessive volume delivered from one lung to the other, often during mechanical ventilation.

Damage to the lungs caused by high concentrations of oxygen for extended periods.

Decreased blood flow due to increased pressure in the chest caused by mechanical ventilation.

Ulcers that can develop in the stomach of clients receiving mechanical ventilation due to stress.