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Pulmonary Review for ICU

Presented by:  Karen Marzlin

Course Description:
Do you want increased expertise in managing patients in respiratory distress or with chronic pulmonary disease?  Do you want more confidence in V/Q ratios, the oxyhemoglobin curve, analyzing blood gases, and understanding modes of ventilation? If so this course if for you.

Karen will explore the concepts of ventilation, perfusion, and diffusion in a way that will allow you to evaluate these problems in your patients and confidently differentiate and treat ventilation and diffusion problems. You will master V/Q ratios, ABG interpretation skills, the oxyhemoglobin curve, and modes of ventilation.

You will be able to apply all the concepts you learn to the management of patients with pulmonary disease states. This course will cover acute respiratory failure, COPD, status asthmaticus, sleep apnea, pneumonia, pulmonary edema, pulmonary embolism, pulmonary HTN, abnormal forms of hemoglobin, and pleural space disorders.

This course will conclude with a discussion of ARDS, specific strategies for ventilating with lung protective strategies, sedation and neuromuscular blockade, and ICU specific therapies including ECMO.

You will gain insights during this class that you will be immediately able to apply in practice and you will gain expertise and confidence

 

Course Content:    

Pulmonary Physiology, Diagnostics, & Treatment

  1. Pulmonary Physiology Overview
  2. Ventilation
    1. Minute and alveolar ventilation
    2. Assessment and treatment of ventilation problems
  3. Perfusion
    1. Pulmonary and bronchial blood flow
    2. Zones of Perfusion
  4. Diffusion
    1. Barriers to the diffusion of oxygen
    2. Assessment and treatment of diffusion problems
  5. Ventilation and Perfusion Ratios

a.  Decreased V/Q ratio

b.  Increased V/Q ratio

  1. Assessment Tools
    1. PaO2/FIO2 ratios
    2. A-a gradient
    3. Using the PFT to differentiate obstructive and restrictive lung disease
    4. SpO2 monitoring
    5. End tidal CO2 monitoring
  2. Relationship Between Oxygen and Hemoglobin
    1. Oxyhemoglobin curve
    2. Shifts to the right and left
  3. Acid Base Balance
    1. Metabolic and respiratory disorders
    2. ABG Interpretation
  4. Pulmonary Treatments
    1. High flow and low flow oxygen delivery
    2. Noninvasive positive pressure ventilation
    3. Mechanical ventilation breaths, modes, and adjuncts
    4. Complications of mechanical ventilation
    5. Nursing care considerations in mechanical ventilation
    6. Tracheostomy

Pulmonary Pathophysiology and Patient Management

  1. Disorders Altering Relationship Between Oxygen and Hemoglobin

a.  Methemoglobinemia

b.  Carboxyhemoglobin

  1. Disorders Involving Perfusion
    1. Pulmonary Embolism
    2. Pulmonary HTN
  2. Disorders Causing Ventilation or Diffusion Problems
    1. Acute Respiratory Failure
    2. COPD
    3. Status Asthmaticus
    4. Sleep Apnea
    5. Pneumonia and Aspiration
    6. Pulmonary Edema
    7. Pulmonary Fibrosis
  3. Disorders Involving Pleural Space Abnormalities
    1. Pleural Effusion
    2. Empyema
    3. Closed Pneumothorax
    4. Open Pneumothorax
    5. Tension Pneumothorax
    6. Hemothorax
    7. Chest Tube Management

Pulmonary Pathophysiology and Patient Management

  1. ARDS

a.  Diagnosis

b.  Pathophysiology

c.  Implementation of Lung Protective Strategies

d.  Open Lung Ventilation

e.  Rescue Options

  1. ECMO

a.  Configuration for hemodynamic and pulmonary support

b.  Patient monitoring

  1. Rapid Sequence Intubation
  2. Analgesia / Sedation
  3. Neuromuscular Blockade
  4. Ventilator Weaning / Extubation Failure

 

Continuing Education:    
5.6 hours of continuing education (contact hours) will be offered with this program. CNEA is a provider approved by the California Board of Registered Nursing, provider number 15714.

Course Price:
Click here for course price

Course Objectives

  1. Compare the assessment of adequate ventilation to the assessment of adequate diffusion.
  2. Contrast conditions that alter ventilation with conditions that alter perfusion.
  3. Describe pathological conditions that result in ventilation and perfusion mismatching.
  4. Discuss clinical factors that alter the relationship between oxygen and hemoglobin.  
  5. Calculate and apply PaO2 / FIO2 ratios in ventilated patients.
  6. Accurately interpret an arterial blood gas.
  7. Compare and contrast noninvasive mechanical ventilation, assist control mode of ventilation, and SIMV mode of ventilation. 
  8. Identify potential complications of mechanical ventilation and nursing strategies to minimize these complications. 
  9. Synthesize information about the pathophysiology, presentation, and treatment considerations for patients with disorders that impact the relationship between oxygen and hemoglobin.
  10. Synthesize information about the pathophysiology, presentation, and treatment considerations for patients with disorders that impact pulmonary perfusion. 
  11. Synthesize information about the pathophysiology, presentation, and treatment considerations for patients with disorders that impact ventilation.
  12. Synthesize information about the pathophysiology, presentation, and treatment considerations for patients with disorders that impact the diffusion of oxygen.
  13. Synthesize information about the pathophysiology, presentation, and treatment considerations for patients with disorders that alter the normal pleural space. 
  14. Describe the risk factors for, unique features of and treatment strategies used in the ICU for patients with ARDS.
  15. Define patient monitoring required for safety in patients receiving ECMO.
  16. Apply critical care guideline recommendations for analgesia, sedation, and use of neuromuscular blockade. 

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Cardiovascular Nursing Education Associates

Exceptional Nurses, Exceptional Patient Care

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3324 SW 172nd St. Burien, WA 98166