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Patient in the ICU
Res 250 Monitoring and Management of the Patient in the ICU
| Question | Answer |
|---|---|
| In low-perfusion patients, what site would be best for monitoring SpO2? | Finger |
| Strategies for reducing the risk for colonization and VAP include all of the following except ____. | saline instillation into the ET tube during suctioning. |
| Which of the following is NOT a cause of increased airway resistance? | Suctioning |
| Although an SaO2 of 97% is considered to be normal, maintaining an oxyhemoglobin saturation of at least 90% is considered acceptable for adult patients. At a normal pH this represents a PaO2 of ____ mm Hg. | 60 |
| Capnometry describes the continuous display of carbon dioxide concentrations as a graphic waveform, whereas the term capnography suggests measurement of exhaled CO2 without a written record or waveform. | False |
| Pulse oximeter saturations less than 80% should be confirmed with laboratory analysis of ABGs, including CO oximetry. | True |
| ____ occurs when an alveolus that is normally expanded is adjacent to one that is collapsed (atelectasis) and unstable. As airway pressure increases during inspiration, the normal alveolus inflates, but the collapsed unit does not. | Shear stress |
| What is the average total work of breathing for healthy persons? | 0.3 to 0.5 J/L |
| Mechanical ventilation is not benign and may cause lung injury. Treating patients with lung-protective strategies includes all of the following except ____. | low FIO2 |
| You patient has a P(A-a.O2 of 200 mm Hg while breathing 100% oxygen. What is the estimated percentage shunt? | 10% |
| Hypoxemic events in mechanically ventilated patients are most often associated with all of the following except ____. | increased peak pressures |
| Ventilator-associated pneumonia (VAP) refers specifically to a pneumonia acquired by a patient receiving mechanical ventilation 48 hours after intubation. | True |
| Which of the following is NOT associated with a decreased end-tidal PCO2? | Increase in lung perfusion |
| The term ____, in general, is used when referring to lung injury occurring in humans that has been identified as a consequence of mechanical ventilation. | VALI |
| The easiest way to detect air trapping or auto-PEEP is to evaluate ____. | the flow-time curve on the ventilator graphic |
| The correlation of PtcO2 and PaO2 (PtcO2/PaO2 index) has been shown to be good for both neonates and critically ill adult patients. | False |
| Which of the following conditions is associated with an increased lung compliance measurement? | Emphysema |
| In which of the following disorders would an increased VDS/VT ratio not be likely? | Hypothalamus tumor |
| Prolonged alveolar over-distention from mechanical ventilation leads to the release of inflammatory mediators from the lungs that can cause failure of other organs of the body. This response has been termed ____. | biotrauma |
| Transcutaneous oxygen electrodes are attached to the skin surface with a double-sided adhesive ring. The electrode is heated to ____. | 42° to 45° C |
| What is the normal range for VDS/VT? | 0.20 to 0.40 |
| Both physiological and technical factors can influence the accuracy of pulse oximetry measurements. These include all of the following except ____. | variations in patients' pulse rate |
| It is generally considered important in mechanical ventilation of patients with ALI and/or ARDS to open alveoli with a recruitment maneuver and keep them open with an appropriate level of PEEP. | True |
| Although it is generally used to trend oxygen saturations in neonates, pulse oximetry is not used to prescribe oxygen therapy in neonates because most neonatologists prefer to base oxygen therapy decisions on PaO2 rather than oxygen saturation. | True |
| Which of the following parameters is NOT used in calculating the Murray lung injury score of a patient with acute lung injury? | Cardiac output |
| More recent evidence demonstrates that the repeated opening and closing of lung units generates shear stress, with direct tissue injury at the alveolar and pulmonary capillary level as well as the loss of surfactant from these unstable lung units. | atelectrauma |
| What is the normal range for P(A-a.O2 in a healthy 30-year-old person breathing room air? | 5 to 15 mm Hg |
| What parameter is considered to be the most accurate and reliable measure of oxygenation efficiency? | Qs/Qt |
| What is the upper limit for plateau airway pressure that is recommended during mechanical ventilation? | Less than 30 cm H2O |
| Transcutaneous monitoring provides a noninvasive method of indirect measurement of the oxygen and carbon dioxide tensions at the skin surface. | True |
| Which of the following breathing patterns suggests respiratory muscle decompensation? | Rapid and shallow breaths |
| A vital capacity (Vc. value below what value indicates significant muscle weakness? | 10 to 15 ml/kg |
| What is considered normal for the PaO2/FIO2 ratio? | Greater than 400 |
| Chemical mediators produced in the lung during ventilator mismanagement can leak into the blood vessels. The pulmonary circulation then carries these stimulating substances to areas the body sets up an inflammatory reaction to the kidneys, gut, and liver. | True |
| A condition that can be accelerated by mechanical ventilation is ____. It can be detected by a hyperresonant percussion note and absence of breath sounds on the affected side of the thorax. | pneumothorax |
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Cam1228
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