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Apex Review > Anesthesia machine 5 > Flashcards

Anesthesia machine 5 Flashcards

1
Q

The piston ventilator (select 2):
a. relies on fresh gas flow coupling
b. preserves tank oxygen in the event of oxygen pipeline failure
c. allows for more precise delivery of tidal volumes
d. removes the risk of barotrauma

A

b. preserves tank oxygen in the event of oxygen pipeline failure
c. allows for more precise delivery of tidal volumes

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2
Q

Piston ventilators utilize

A

an electric motor to compress a piston that generates positive pressure in the breathing circuit

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3
Q

Since the piston ventilator doesn’t use a drive gas, it won’t

A

consume tank oxygen in the event of an oxygen pipeline failure

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4
Q

The piston ventilator decouples

A

fresh gas flow from the ventilator

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5
Q

The piston ventilator delivers a consistent tidal volume regardless of changes made in

A

the fresh gas flow, respiratory rate or the I:E ratio

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6
Q

With the piston ventilator, a collapsed bag signals

A

a circuit disconnect

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7
Q

What happens to the breathing bag with inspiration and expiration with a piston ventilator?

A

it inflates during inspiration and deflates during expiration

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8
Q

The piston ventilator has _____ pressure relief valves

A

two

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9
Q

What are the two pressure relief valves of the piston ventilator?

A

the negative pressure valve guards against negative end-expiratory pressure
the positive pressure valve guards against excessive pressure in the breathing circuit

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10
Q

When does the positive pressure relief valve open in the piston ventilator?

A

when circuit pressure exceeds 75 +/- 5 cm H2O

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11
Q

When does the negative pressure relief valve open in the piston ventilator?

A

when circuit pressure is less than -8 cmH2O

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12
Q

The negative pressure relief valve protects the patient against

A

negative end-expiratory pressure

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13
Q

If the negative pressure relief valve is activated in the piston ventilator, the mixing of

A

room air with fresh gas will cause a dilution of oxygen and anesthetic agents

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14
Q

Describe what will happen to the bag with spontaneous breaths on the piston ventilator.

A

the bag will not move when a patient initiates spontaneous breaths while on the ventilator

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15
Q

Which statement regarding pressure control ventilation is true? (choose 2)
a. the risk of ventilator-associated lung injury is decreased
b. increased lung compliance will decrease tidal volume
c. gas flow decelerates during inspiration
d. the ventilator switches to expiration after a preset pressure is achieved

A

a. the risk of ventilator-associated lung injury is decreased
c. gas flow decelerates during inspiration

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16
Q

Pressure controlled ventilation reduces the risk of

A

ventilator-associated lung injury in select patients

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17
Q

Pressure controlled ventilation delivers

A

a preset inspiratory pressure (with a decelerating flow pattern) over a predetermined time

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18
Q

The tidal volume in pressure controlled ventilation

A

varies as a function of the patient’s compliance

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19
Q

If a patient’s compliance changes when in pressure control ventilation, you must adjust

A

the ventilator settings to prevent unintended changes in minute ventilation and PaCO2

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20
Q

Volume controlled ventilation delivers

A

a preset tidal volume over a predetermined time

21
Q

With volume controlled ventilation, the peak inspiratory pressure

A

will vary as a function of the patient’s compliance

22
Q

With VCV, if airway resistance rises or lung compliance decreases, then

A

the PIP will increase

23
Q

The _____________ is held constant during inspiration with VCV

A

inspiratory flow

24
Q

With PCV, if airway resistance rises or lung compliance decreases, then

A

the Vt will decrease

25
Q

What is fixed with VCV?

A

tidal volume
inspiratory flow rate
inspiratory time

26
Q

What is variable with VCV?

A

peak inspiratory pressure

27
Q

What is fixed with PCV?

A

peak inspiratory pressure
inspiratory time

28
Q

What is variable with PCV?

A

tidal volume
inspiratory flow

29
Q

PCV is useful if the patient has

A

low compliance where high PIP is dangerous or to compensate for leaks

30
Q

When you’re using PCV, intraoperative events

A

can change the Vt you’re delivery to the patient

31
Q

With PCV, Vt is decreased by

A

decreased compliance- pneumoperitoneum, trendelenburg position
increased resistance- bronchospasm, kinked ETT

32
Q

With PCV, Vt is increased by

A

increased compliance- release of pneumoperitoneum, going from Trendelenburg to supine
decreased resistance- bronchodilator therapy
removing airway secretions

33
Q

Situations in which PCV is better than VCV can be broken down to these three categories:

A

patient has low compliance
high PIP would be dangerous
need to compensate for a leak

34
Q

When might PCV be advantageous for patients with low compliance?

A

pregnancy
obesity
laparoscopy
ARDs

35
Q

When might PCV be advantageous for patients where PIP would be dangerous?

A

LMA
neonate
emphysema

36
Q

When might PCV be advantageous to compensate for a leak?

A

LMA
uncuffed ETT in children

37
Q

Which modes of mechanical ventilation are BEST suited for a laryngeal mask airway? (select 2)
a. synchronized intermittent mandatory ventilation
b. inverse ratio ventilation
c. pressure support ventilation
d. controlled mandatory ventilation

A

a. synchronized intermittent mandatory ventilation
c. pressure support ventilation

38
Q

No matter what mode of ventilation is used, __________________ indicates a patient triggered a breath

A

a negative deflection just before the breath

39
Q

What is controlled mandatory ventilation?

A

machine initiated breath delivers a preset Vt & RR on a fixed schedule

40
Q

Controlled mandatory ventilation does not

A

compensate for patient initiated breaths (risk of patient-ventilator asynchrony)

41
Q

Controlled mandatory ventilation is best for

A

apneic patients

42
Q

What is assist control ventilation?

A

machine initiated breath delivers a preset Vt and RR
-spontaneous breaths receives the full preset tidal volume

43
Q

For patients on assist control ventilation, a patient that over breathes the ventilator is

A

at risk for hyperventilation and respiratory alkalosis

44
Q

SIMV is useful for

A

weaning or with an LMA

45
Q

Synchronized intermittent mandatory ventilation is a

A

machine initiated breath delivers a preset Vt and RR but this mode allows the patient to breath spontaneously between machine initiated breaths

46
Q

What is PCV-VG?

A

gives the benefits of pressure control ventilation but it also guarantees a predetermined tidal volume while applying the minimum pressure required to achieve it

47
Q

What does the pro in PSV pro stand for?

A

“protect”

48
Q

When is PSV pro useful?

A

weaning or with an LMA

49
Q

PSV Pro allows

A

a spontaneously breathing patient to receive pressure-support ventilation and will convert to pressure-control ventilation if the patient becomes apneic

Apex Review (224 decks)

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