mechanical Ventilation exam 1 questions with answers, Exams of Nursing

Download mechanical Ventilation exam 1 questions with answers and more Exams Nursing in PDF only on Docsity! mechanical Ventilation exam 1 questions with answers what is pip? - ANSWER: ✔✔total pressure required to deliver the breath what is Auto Peep? - ANSWER: ✔✔air trapping in lung during mechanical ventilation What is Plateau pressure? - ANSWER: ✔✔pressure that required to keep alveoli inflated indication for mechanical ventilation - ANSWER: ✔✔- apnea - acute ventilatory failure/ arrest - impending ventilatory failure - severe hypoxemia hazards and complication of PEEP - ANSWER: ✔✔- barotrauma - pneumothorax - ICP - negative cardiovascular effects contraindications for PEEP/CPAP - ANSWER: ✔✔- hypovolemia - Barotrauma - increase ICP - untreated pneumothorax - unilateral lung disease what is Optimal PEEP? - ANSWER: ✔✔PEEP levels that have acceptable parameters indications for ABG - ANSWER: ✔✔- Sudden unexpected dyspnea - cyanosis - abnormal breath sounds - heavy use of accessory muscles or sever tachypnea - diffuse infiltrate in CXR - CPR Changes in Vent settings steady state for ABG - ANSWER: ✔✔- when pts is placed on O2 or vent, Sites for ABG - ANSWER: ✔✔- Radial - Brachial - Femoral ( physicians only) modified Allen Test? - ANSWER: ✔✔Pt asked to clench fist; then put pressure with fingures on their radial and ulnar aa; should see blanching(white); then release ULNAR artery and hand should flush pink approx 5-15 seconds; means ulnar circulation is good; (+allens test) Monitoring on ABG - ANSWER: ✔✔- FiO2 - Proper application of O2 device - Mode and Vent settings - Pulsatile blood setting plateau - ANSWER: ✔✔pressure measured where there is no gas flow functional residual capacity - ANSWER: ✔✔total amount of gas remaining in the lung after resting expiration the cause of mechanically ventilated patients PIP increase from 20 to 40cmH2O while the static compliance remains relatively unchanged is which of the following? 6 permit sedation and/or paralysis, 7 reduce systemic or myocardial oxygen consumption, 8 minimize associated complications and reduce mortality. 10 signs of respiratory distress - ANSWER: ✔✔1. Tachypnea; 2.nasal flaring; 3. diaphoresis; 4. accessory muscle use; 5.retractions of suprasternal, supraclavicular, and intercostal spaces; 6. paradoxical or abnormal movement of the thorax and abdomen; 7. abnormal breath sounds; 8. tachycardia; 9. arrhythmia; 10. hypotension. what pulmonary disease result in increase work of breathing? - ANSWER: ✔✔Asthma, emphysema, chronic bronchitis, croup, acute epiglottitis, and acute bronchitis what is another name for MIP? - ANSWER: ✔✔Negative inspiratory force (NIF) when a patients lung compliance worsens during PVC, what will happen to the tital volume being delivered? - ANSWER: ✔✔it will decrease a patient has increased sections while being ventilated in volume control will the pressure increase or decrease? - ANSWER: ✔✔increase If the ventilator is in pressure control, what will the pressure waveform look like? - ANSWER: ✔✔square form If the ventilator is in volume control, which waveform will be a square form? 1) pressure 2) flow 3) volume - ANSWER: ✔✔2) flow Clinical signs of Hypoxia - ANSWER: ✔✔Respiratory (tachypnea, dyspnea) Cardiovascular ( tachycardia -- brady,--arrhythmias paleness-- cyanosis) Neurological ( restlessness, disorientation, headaches,--confussion, loss of consciousness) Clinical signs of hypercapnia - ANSWER: ✔✔Respiratory ( tachypnea--- bradypnea) Cardiovascular ( hypertension, vasodilation) Neurological ( headaches-- hallucination, drowsiness) A patient may developed alkalosis in what mode? - ANSWER: ✔✔Mandatory because hyperventilation What parameters regarding respiratory rate might indicate the need for mechanical ventilation? - ANSWER: ✔✔greater than 35 or less than 10 PEEP increases what two factors? - ANSWER: ✔✔oxygenation and lung compliance PEEP decreases what two factors? - ANSWER: ✔✔work of breathing and shunt fraction What disease process commonly needs PEEP? - ANSWER: ✔✔ARDS A patient in the ICU is on assist control ventilation mode with a rate of 14 and has became very nervous about his current condition. This anxiety causes him to increase his respiratory rate to nearly 28 times per minute. What is this most immediate concern? What should we do to alleviate this issue? - ANSWER: ✔✔The most immediate concern is hyperventilation leading to respiratory alkalosis. We should give the patient a sedative to slow his respiratory rate. How long should we maintain the patient at 100% PaO2? - ANSWER: ✔✔As short a duration as possible since oxygen toxicity is a major concern Peak inspiratory pressures should never be above what measure? - ANSWER: ✔✔40 cm H2O types of positive pressure vent - ANSWER: ✔✔BiPAP (bilevel positive airway pressure), CPAP (continuous positive airway pressure) I:E Ratio - ANSWER: ✔✔Normal I:E Ratio 1:2 - Exhalation time should double inhalation time - Allows complete lung emptying - Determined by the rate, flow, volume * when rate control is used, inspiratory and expiratory times will vary according to other control settings, such as flow and volume Minute Ventilation - ANSWER: ✔✔Respiratory rate times tidal volume RR x Vt = Ve Intermittent Mandatory Ventilation - IMV - ANSWER: ✔✔- Ventilator delivers ONLY set number of "machine" breaths; Patient only receives the number of machine breaths that are set on vent - If tidal volume of 500mL is set and a respiratory rate of 10, patient gets 500mL every 6 seconds- no more from vent - Patient can breathe spontaneously between machine breaths Mean airway pressure (MAP) - ANSWER: ✔✔-Average pressure exerted on the airway and lungs -Measured from the beginning of inspiration until the beginning of the next inspiration -Electronically measured by most ventilators -Most powerful influence on O2 -Best indicator of balance between adequate ventilation -High levels lead to -Decreased CO, pulmonary hypoperfusion, increased risk of barotrauma