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Mechanical Ventilation Exam #3
Terms in this set (39)
What is the primary mechanism by which PEEP aids in reducing shunting and improving oxygenation in conditions such as adult respiratory distress syndrome (ARDS)?
Beneficial effects of PEEP are achieved through recruitment of collapsed alveoli
The following data are obtained from an intubated and mechanically ventilated patient: PIP=50 cmH20, Plateau=25 cmH20, PEEP=5 cmH20, VT=600 ml. The respiratory therapist should conclude
the patient has increased airway resistance
A patient who is in respiratory failure requires immediate intubation. For initial assessment of endotracheal tube placement the respiratory therapist should recommend
The plateau pressure should be
< 30 cmH20
A ventilator may malfunction during use. When this occurs, the clinician must first _______________.
ensure that the patient is being ventilated
What is the first parameter that should be measured after the administration of PEEP?
A patient is receiving mechanical ventilation and shows signs of refractory hypoxemia. Which of the following should be increased first to increase the patient's PaO2?
When excessive levels of PEEP are applied to the respiratory system, what is the effect on static compliance (CS) and cardiac output?
Both C.S. and C.O. decrease
Which waveform gives the shortest TI
what prevents the flow curve from returning to zero at the end of exhalation?
Which of the following causes auto-PEEP?
High minute ventilation
A 26 year old patient is receiving volume ventilation due to status asthmatics. Current vent settings yield a 1:1.5 I:E ratio and a PaCO2 of 51 torr. Which of the following should the therapist decrease?
Heat moisture exchangers are contraindicated in all of the following except
a. in patients with tracheostomies
b. patients with thick, copious, or bloody secretions
c. patients with body tempertures of <32 degrees celsius (hypothermia)
d. when exhaled VT is less than 70% of inhaled VT
in patients with tracheostomies
Humidifiers for mechanical ventilation should provide at least 30 mg H20/L of absolute humidity at a range of about 31 degrees celsius to 35 degrees celsius for all available flows up to 20 to 30 L/min
Which two factors determine the volume delivered from a mechanical ventilator?
flow and pressure
For which of the following reasons is hypovolemia considered a relative contraindication for the use and application of PEEP or CPAP therapy?
Application of PEEP or CPAP in this setting may cause a severe decrease in C.O.
All of the following will cause a right shift in the oxyhemoglobin dissociation curve except
a. increased temp
b. alkalosis (increased pH)
c. increased 2.3 DPG
d. acidosis (decreased pH)
alkalosis (increased pH)
Which of the following statements suggests that a patient's lungs are responsive to PEEP therapy in a positive way?
Shunt decreases, lung compliance increases, and C.O. is not adversely affected
As lung compliance increases, the pressure required to deliver the volume to the patient increases
Scalars displayed during mechanical ventilation include all of the following except
a. flow vs. time
b. pressure vs. time
c. volume vs. time
d. flow vs. volume
flow vs. volume
When PC CMV is the mode of ventilation, the resulting flow scalar will be configured as a(n)
If the PF for a PS breath 45 L/min and the flow cycle time is set at 20%, at what flow rate will inspiration end?
Another type of ventilator graphic is called a loop. These are displays of two variables plotted on the x-y coordinates
To assure safety when cuffed artificial airways are in use, how often should cuff pressure be checked, and what is the limit that should not be exceeded for pressures within the cuff?
Every 8 hours and +20 to +25 cmH20
Why is permissive hypercapnea allowed for some patients who are receiving ventilatory support?
Permissive hypercapnea is allowed to avoid lung overinflation (damage)
If auto-PEEP occurs in a mechanically ventilated, spontaneously breathing patient with a airflow obstruction (e.g., COPD), setting the PEEP level to equal about 80% of the patient's auto-PEEP level may alleviate the problem
The pressure at which large numbers of alveoli become overinflated in a patient with ARDS is located on the static pressure-volume curve at which of the following?
Upper inflection point
A duck-billed appearance on a pressure volume loop indicates
The high pressure alarm could be activated by all of the following except
a. decreasing lung compliance
b. increased atelectasis
c. increased airway resistance
d. leak in the ventilator circuit
PEEP therapy is indicated for patients with which of the following
PaO2 of 100 mmHg with an FIO2 of 0.85
Which of the following is an absolute contraindication for the use of PEEP or CPAP therapy
untreated significant pneumothorax or tension pneumothorax
During initial ventilator setup, the pressure sensitivity is commonly set between
-1 and -2 cmH20
A sustained increase in pressure in the lungs with the goal of opening as many collapsed lung units as possible is called
With a constant flow, the flow time curve is represented as a
straight line parallel to the x-axis
A 50 year old man is admitted to the ICU for treatment of refractory hypoxemia. He is intubated and receiving pressure support ventilation (PSV) at 8cmH20 and an FIO2 of 0.60. Additional clinical data are presented below
HR= 128, RR= 24, pH=7.48, PaCo2= 31 PaO2= 58
Which of the following should the respiratory therapist recommend at this time?
Initiate the A/C mode
Which of the following types of hypoxia must have a low PaO2?
Which of the following disorders represents a contraindication to permissive hypercapnea?
Which of the following strategies should be used to prevent ventilator associated pneumonia (VAP)?
frequent circuit changes
elevating the head of the bed
A patient was intubated in the emergency department just after arrival at the hospital from home. This patient develops pneumonia 50 hours after intubation. What type of pneumonia is this considered?
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