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NURS 470 > Commonly Monitored Ventilator Settings > Flashcards

Commonly Monitored Ventilator Settings Flashcards

1
Q

What is the goal tidal volume for a patient on a positive pressure ventilator?

A

the maximum volume allowed to keep the peak airway pressure less than 30 mmHg while maintaining adequate ventilation

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2
Q

What increases as tidal volume or peak alveolar pressure increases?

A

the risk of lung injury

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3
Q

What is plateau pressure?

A

a reflection of the lung compliance

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4
Q

What does low lung compliance mean?

A

the lung is stiff

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5
Q

What does high lung compliance mean?

A

the lung has less ability to recoil

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6
Q

What kind of lung compliance is seen with conditions such as: emphysema or COPD?

A

high lung compliance

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7
Q

What kind of lung compliance is seen in patients with fibrosis or ARDS?

A

low lung compliance

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8
Q

How high does the tidal volume have to be to cause barotrauma?

A

more than 10mL/kg

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9
Q

Why does a tidal volume greater than 10mL/kg cause barotrauma?

A

it may overdistend the alveoli, increasing pressure, which my result in injury or rupture the alveolar space

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10
Q

What happens when volutrauma occurs?

A

overstretching the alveolar cells triggers release of inflammatory mediators and stimulation of the inflammatory response

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11
Q

What does volutrauma increase?

A

the permeability of the lungs’ microvasculature, which may result in pulmonary edema

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12
Q

What plateau pressure needs to be maintained for ventilation of the lungs?

A

pressure of less than 30 cm H2O

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13
Q

If a patient has a pulmonary disease that prevents them from being adequately ventilated, what may be used?

A

permissive hypercapnia

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14
Q

How does permissive hypercapnia work?

A

This technique deliberately allows hypoventilation by using low tidal volumes, and the healthcare team must determine goals for the PaCO2 and pH

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15
Q

What is the FiO2 at sea level?

A

.21

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16
Q

What range of FiO2 can a ventilator provide?

A

.21-1

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17
Q

What is FiO2 commonly set at during an acute decompensation event?

A

.5 to 1

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18
Q

Prolonged use of FiO2 greater than __ may cause complications associated with oxygen toxicity?

A

.6

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19
Q

What drug can increase the risk of hyperoxia-mediated lung injuries?

A

amiodarone

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20
Q

What is the normal range for minute ventilation for ventilator settings?

A

5 to 7 L/min

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21
Q

How is normal minute ventilation calculated?

A

Tidal volume multiplied by respiratory rate

22
Q

Why is positive end expiratory pressure set?

A

to provide pressure at the end of expiration, to prevent alveolar collapse

23
Q

Why would cardiac output decrease as PEEP levels increase?

A

because of the increase in intrathoracic pressure and decreasing venous return

24
Q

What does the level of PEEP depend on?

A

the severity of the lung injury

25
Q

When is assist control mode commonly used?

A

as a resting mode, particularly in patients with acute respiratory failure or respiratory muscle fatigue

26
Q

What is the major disadvantage of using assist control mode on a ventilator?

A

it may cause muscle atrophy or ventilator-induced diaphragm dysfunction from the ventilator performing the work of breathing

27
Q

What occurs when synchronous intermittent mandatory ventilation mode is used?

A

the patient spontaneously breathes through the ventilator circuit, maintaining much of the work of breathing

28
Q

What are the benefits of using synchronous intermittent mandatory ventilation?

A

It decreases the risk of hyperventilation and provides a better ventilation-perfusion distribution, and it may reduce sedation needs as there is more synchrony with ventilation for the patient

29
Q

What does pressure support ventilation mode do?

A

it is an adjunct weaning mode that enhances spontaneous inspiratory effort by application of positive pressure

30
Q

How does pressure support ventilation decrease the work of breathing?

A

by overcoming increased airway resistance

31
Q

What are the factors that determine the patient’s tidal volume?

A

the preset pressure support level, the degree of patient effort, and the level of airway resistance and lung compliance

32
Q

Common range for PSV levels of cm H2O

A

5-15

33
Q

What is pressure regulated volume control mode?

A

a dual control mode of ventilation where the pressure readjusts on a breath-to-breath basis to achieve the set tidal volume

34
Q

If a patient is receiving ventilation that combines high respiratory rates, greater than 4 times the normal and tidal volumes smaller than anatomical dead spaces, what kind of ventilation is the patient receiving?

A

High-frequency oscillating ventilation

35
Q

What is a potential consequence of high-frequency oscillating ventilation?

A

the requirement of sedation and neuromuscular blockade

36
Q

When would a high frequency percussive ventilator be indicated?

A

with severe respiratory failure

37
Q

When is airway pressure release ventilation indicated?

A

ARDS

38
Q

When is the use of airway pressure release ventilation contraindicated?

A

in severe COPD

39
Q

Why is the use of airway pressure release ventilation contraindicated in patients with COPD?

A

the hyperinflation may induce barotrauma

40
Q

When is extracorporeal membrane oxygenation indicated?

A

severe lung injuries

41
Q

What is considered a desirable PIP (peak inspiratory pressure) in an adult?

A

less than 40 cm H2O

42
Q

Why are high PIP levels not ideal?

A

they greatly increase the risk of barotrauma and have negative effects on other body systems

43
Q

What does a low exhaled volume alarm indicate?

A

a loss of tidal volume or a leak in the system

44
Q

How can a cuff leak be checked?

A

by feeling for air leaking out of the nose and mouth

45
Q

What should precede cuff deflation and why?

A

deep oral suctioning to prevent flooding the airway with contaminated secretions from the upper airway

46
Q

What kind of alarm will sound in the event of coughing, biting on the ventilator tubing, secretions in the airway, or water in the tubing?

A

high pressure alarm

47
Q

What needs to be checked following the initiation of mechanical ventilation?

A

ABGs

48
Q

Barotrauma is associated with which ventilator setting?

A

High tidal volumes

49
Q

What can a low minute ventilation cause?

A

Acute respiratory acidosis

50
Q

PEEP affects the alveoli by doing what?

A

Maintaining them open at end expiration

51
Q

What does an increasing PIP most commonly indicate?

A

Increasing airway resistance and/or decreasing lung compliance

NURS 470 (33 decks)

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