Determining the need for ventilatory support

Question 1

What kind of intervention is mechanical ventilation?

Answer 1

Supportive

Question 2

When should ventilator support be initiated?

Answer 2

Before the patient’s condition becomes compromised by hemodynamic instability

Question 3

When should a patient be placed on acute ventilatory failure?

Answer 3

PaCO2 greater than 50 mmHg, pH less than 7.30

Question 4

What classifies a patient as acute oxygenation failure (hypoxemia)?

Answer 4

PaO2 less than 60mmHg

Question 5

What must a patient be demonstrating in terms of respiratory rate in order to qualify for ventilator support?

Answer 5

greater than 35 breaths/min and increased work of breathing

Question 6

What is the vital capacity for a patient that is being considered for ventilatory support?

Answer 6

less than 10-15 mL/kg (normal is 65-75)

Question 7

What is normal vital capacity for a patient without respiratory distress?

Answer 7

65-70 mL/kg

Question 8

What maximum inspiratory pressure for a patient being considered for ventilatory support?

Answer 8

less than -25cm to 0 cm H2O (normal: -100 to -50 cm H2O)

Question 9

What is the normal maximum inspiratory pressure for a patient not experiencing respiratory distress?

Answer 9

-100 to -50 cm H2O

Question 10

What are the 4 categories of pulmonary mechanics that are looked at when considering ventilatory support?

Answer 10

respiratory rate (f). vital capacity (VC), maximum inspiratory pressure, chest retractions Assymetrical chest motions

Question 11

What can acute respiratory failure be indicative of?

Answer 11

failure of ventilation, failure of oxygenation, or a combination of both

Question 12

What is the most common indicator for ventilator support?

Answer 12

acute ventilatory failure

Question 13

What is acute ventilatory failure?

Answer 13

the inability of the lungs to maintain adequate alveolar ventilation

Question 14

What would conditions such as asthma, pneumonia, COPD, and atelectasis cause?

Answer 14

a low V/Q ratio which may lead to hypoxemic respiratory failure

Question 15

What is a low V/Q ratio associated with?

Answer 15

shunting

Question 16

What is shunting?

Answer 16

the state in which pulmonary capillary perfusion is normal but alveolar ventilation is lacking

Question 17

What does vital capacity refer to?

Answer 17

the maximum amount of air that is expired after a maximal inspiration, indicating a person’s greatest breathing capacity

Question 18

What does negative inspiratory force reflect?

Answer 18

the strength of the respiratory muscles

Question 19

What may cause a low NIF level?

Answer 19

A sustained respiratory rate above 35

Question 20

What are changes in older adults that put them at risk for respiratory failure?

Answer 20

include decreased chest wall compliance, which increases the work of breathing; decreased oxygenation because of structural lung changes; and decreased lung volume and strength, which reduce cough effectiveness and increase the risk for infection

Question 21

The term acute ventilatory failure refers to the inability of the lungs to do what?

Answer 21

Maintain adequate alveolar ventilation

Question 22

Acute respiratory acidosis is defined clinically as:

Answer 22

PaCO2 greater than 50 mmHg and pH less than 7.30

Question 23

A low V/Q exists when what occurs?

Answer 23

Perfusion is in excess of ventilation