Management of Mechanical Ventilation
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| The primary strategy to improve ventilation include all of the following except: A. increase mechanical deadspace B. increase ventilator tidal volume C. increase ventilator frequency D. increase in pressure support for spontaneously breathing patient | show 🗑
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| Dr McFarland ask the therapist to adjust the ventilator in order to improve the oxygenation status of the patient with normal V/Q status. Which of the following ventilator adjustments would have the most direct effect on oxygenation? | show 🗑
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| show | increase
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| Permissive hypercapnia, intentional hypo-ventilation by reducing ventilator tidal volume to a range of 4-7mL/kg(normally 10mL/kg). It is done to lower pulmonary pressures | show 🗑
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| A recent arterial blood gas report of a patient with chronic bronchitis shows mild hypoxemia. The initial method to improve the patient's oxygenation status is to: | show 🗑
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| show | -the alveolar-capillary oxygen pressure gradient across the A-C membrane
-oxygen
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| show | simple V/Q mismatch
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| Refractory hypoxemia is usually caused by_____, and it ______respond very well to oxygen therapy alone. | show 🗑
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| Refractory hypoxemia responds____to supplemental oxygen when used with CPAP and PEEP. | show 🗑
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| show | intrapulmonary shunting
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| Optimal PEEP can be titrated by using different indicators using pulse oximetry saturation (SpO2). Based on these data, the optimal PEEP is (0,4,7,10)cm H2O | show 🗑
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| show | to minimize cardiovascular complications
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| Permissive hypercapnia is a technique in which the mechanical________is reduced. This change is done intentionally to increase a patient's______volume range 4-7mL/kg (normally 10mL/kg) | show 🗑
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| show | -FIO2
-40%
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| show | -renal failure
-diabetic ketoacidosis
-lactic acid
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| show | -renal failure
-diabetic ketoacidosis
-lactic acid
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| show | -should not
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| The pressure alarms are triggered when the circuit pressure (exceeds, drops below) the preset low pressure limit. | show 🗑
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| Factors that trigger the low pressure alarm usually (will, will not) trigger the low volume alarm | show 🗑
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| show | obstruction of ventilator circuit
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| show | -high
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| show | disconnection of ventilator circuit
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| What are some mechanical factors that may trigger the high pressure alarm due to an increase of airflow resistance | show 🗑
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| What are three patient factors that may trigger the high pressure alarm due to an increase of airflow resistance | show 🗑
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| A patient's low pressure alarm is triggered persistently. The likely cause of this condition include all the following except: disconnection of ventilator circuit kinking of endotracheal tube power failure leakage of endotracheal tube cuff | show 🗑
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| During patient rounds in the ICU, the high pressure alarm of the ventilator is triggered. This condition is likely caused by: disconnection of ventilator of circuit low pressure limit set too high loose ventilator humidifier fitting patient coughing | show 🗑
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| The high respiratory frequency alarm is triggered when the total frequency exceeds the high frequency limit set on the ventilator except for: respiratory distress excessive sensitivity setting high frequency alarm set too low circuit disconnect | show 🗑
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| show | coughing
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| The high PEEP alarm is triggered when the actual PEEP level (exceeds,drops below) the preset PEEP limit | show 🗑
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| show | inadequate inspiratory time
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| Auto-PEEP may be reduced by (increasing,decreasing) the tidal volume or mandatory frequency, or (increasing, decreasing) the inspiratory flow rate on the ventilator | show 🗑
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| show | MDI must be placed between the HME and patient
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| A heat and moisture exchanger (HME) may be used as a ________humidification device for intubated patients | show 🗑
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| The optimal interval for ventilator circuit change is all of the following except: changed when visibly soiled once per week everyday | show 🗑
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| show | -True
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| show | -4 to 7 mL/kg
-10 mL/kg
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| The (pH,PaCO2,PaO2) levels are allowed to increase beyond the normal limits of 10 mL/kg when permissive hypercapnia is used to reduced the patient's _____during mechanical ventilation tidal volume pH pulmonary pressures frequency | show 🗑
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| show | -CPAP
-PEEP
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| show | -increases
-oxygen
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| show | -circuit disconnection
-exhalation valve drive-line disconnection
-endotracheal tube cuff leak
-loose circuit connection
-loose humidifier connection
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| show | -Tension pneumothorax
-Atelectasis
-ARDS
-Pneumonia
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| show | -hypoxia
-closed inline
-preoxygenating
-use lukens trap to collect sputum samples
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| ________________is more time-consuming, but it can identify the microbes and the most suitable antibiotics for the infection | show 🗑
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| There are several potential sources of pathogens that can lead to pneumonia in the mechanically ventilated patient. match likely sources patient manual ventilation bag health care provider oropharynx equipment and supplies hands | show 🗑
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| Excessive nutrition or high caloric intake can cause respiratory distress due to(increased,decreased) oxygen consumption and (increased, decreased) carbon dioxide production | show 🗑
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| Use of low tidal volume, prone positioning (PP), VT range from 5-9 mL/kg and trachea gas sufflation are ( routine, adjuntive) management strategies in mechanical ventilation. | show 🗑
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| For patients with normal lung functions, traditional tidal volumes used during mechanical ventilation range from (5-9, 10-12, 15-18) mL/kg | show 🗑
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| show | -acute hypercapnia
-increase WOB
-dyspnea
-severe acidosis
- actelectasis
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| show | -increase
-absence of
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| After one hour of PP, a(n) (increase, decrease) of OI by 20% or greater from baseline value suggest a beneficial respons. | show 🗑
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| For optimal beneficial effect, pediatric patients should remain in the PP for a period of at least (3,6,12) | show 🗑
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| For adult patients, they should remain in the PP for a period of at least (3,6,12) hours s loreated | show 🗑
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