Respiratory Therapy CRT Exam questions

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What is changed when a pat is on PV?

Change the set pressure increased or decreased to adjust Vt

What equation is used to reduce PaCo2 on a pat vented with VC ventilation when the rate is needing to be changed due to volume being high enough?

Desired F= known F X PaCo2/desired PaCo2

What is the equation to find desired Vt in VC ventilation?

Desired Vt= known Paco2 X Known Vt/desired PaCo2

What is increased to increase Vt with a PVC time cycled ventilation?

With pressure control ventilation PCV the set pressure is generally increased to obtain the targeted Vt. PCV is Time cycled If It is short increasing it will increase volume delivery without increasing pressure.

What do you change if Vt and pressure plateu are already high to improve PaCo2?

frequancy

What will need to be changed on a ventilated pat on VC and PV to decrease the PaCo2?

minute volume Ve

What are the causes of respiratory acidosis in a nonventilated patient?

pulmonary edema
pneumonia
asthma
chest wall abnormalities
neuromuscular disorders
central nervous system problems

What two values are effected if patient has respiratory acidosis and Va is not adequante on volume ventilation and pressure ventilation?

PaCo2 elevated above >45mmhg and pH decreased <7.35

What two things can be adusted when a patient is on PCV with respiratory acidosis?

Inspiratory time set pressure reaches alveolar level if this doesnt work set pressure increased to improve volume

What change in ventilation is made to ventilator to correct respiratory alkalosis or acidosis?

Vt or rate

What change is made right away when a patient is on mechanical ventilatio?

minute volume Ve

What should a therapist do if the heart rate increased during suctioning?

immediately stop suctioning and provide 100% O2

For above the cuff suctioning, what pressure is left on to continuously suction?

20mmHg

What is the correct size of catheter used to suction?

1/2 the size of the ET tube. equation for a size 8 ET tube 3x8=24 24/2=12Fr Size 12Fr is used

A patient with CHF has what type of secretions?

Thin white or pink frothy secreations but won't block the airway

What is the normal ratio of Vd to Vt (Vd/Vt)?

0.2 to 0.4

Where does the contraction start of the ventricle?

Starts at Q

What is pip?

Peak inspiratory pressure, this is the peak at which the flow is given at an inspiration

What is SpO2?`

Saturation of O2 on the Hb

What is an HME?

artificial nose humidity, filter,warms

What is slope (aka rise)?

Inspiratory rise time, it slows or speeds the rate at which pressure and flow exit the ventilator for a specific period of time

What is trigger?

The sensativity set too low can also cause auto peep

What is FIO2?

% of O2 to improve Oxygenation. A way to measure O2 to the tissues. Check ABG's to keep PaO2 ath 60-90mmHg below 0.4 to 0.5

What is minimal occluding volume?

volume of air measured to seal the cuff at 1 to 2%

What is minimal leak?

It allows a small amount of air to leak out of cuff

How do we check for the level of consciouness?

wake up the patient (if arousable) check for alertness, sleep, etc.

How does CPAP effect a patient on a ventilator?

It provides FiO2, inspiratory flow, peep, inflates alveoli

How is peep used to detect level of optimal peep?

static compliance, prevents atelectasis

What is plateau pressure

measures pressures needed to keep lungs extended less or equal to 35cmH2O

What wave does ventricular repolarization start?

T wave

What level is PIP set to on an alarm?

10cmH2O above and below

What is Ve set to on an alarm?

low Ve= 10% below
highVe= 10% above

What is the equation for MAP?

(PIPxIt) + (peepx Et)/total seconds

What is VC?

IRV, Vt, ERV

What is IC?

IRV, Vt

What is TLC?

IRV, Vt, ERV, RV

What is FRC?

ERV, RV

What is predicted FVC, FEV1, FEV1% for a restrictive patient?

<80% predicted FVC, normal or <80% predicted FEV1, > or equal to predicted FEV1%

What is predicted FVC, FEV1, FEV1% for obstructive patient?

normal or <80% predicted FVC, <80% predicted FEV1, <predicted FEV1%

What is a patients trigger, target and cycle? VC

trigger=time, target=flow, cycle=volume

What is a patients trigger, target, and cycle? VA

trigger=effort, target=flow, cycle=volume

What is a patients trigger, target, and cycle? PC

trigger=time, target=ins, cycle=time

What is a patients trigger, target, and cycle? PS

trigger=effort, target=ins, cycle=flow

What is a ptients trigger, target, and cycle? spontaneous

trigger=effort, target=ins, cycle=effort

What is one cuase of increased dead space?

pulmonary embolism or low cardiac output resulting in low pulmonary perfusion

What is the ABG values with mexed acid bases?

pH increased, PaCo2 increased, PaO2 increased, HcO3 increased

What are the two sure signs of metabolic acidosis on and ABG?

pH 7.45 to 7.70 and bicarbonate 26 to 48

What are the causes of metabolic acidosis

ketoacidosis
uremic acidosis (renal failure)
diarrhea
toxins ingested

What is decreased on VC when patient is breathing spontaneously?

switch ventilator to SIMV mode
or PS
could possibly sedate but a last resort if patient is anxious

On a PV what should be decreased to improve ventilation?

frequancy, and set the pressure second

To correct respiratory alkalosis in a vented patient, what should be decreased to correct ventilation on a VV vented patient?

frequancy first then Vt

What are the causes of respiratory alkalosis?

hypoxia with compensated hyperventilation
pneumonia
pulmonary edema
medications
mechanical ventilation
central nervous system disorders
anxiety
metabolicd problems

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