establishing needs

Question 1

The primary purpose of ventilation

Answer 1

Homeostasis

Question 2

Mechanical ventilation is indicated when a person cannot achieve an appropriate level of _____ to maintain adequate gas exchange ____-____ balance

Answer 2

ventilation; acid-base

Question 3

Maintain adequate oxygen delivery (CaO2 × Cardiac output)

Answer 3

Alveolar oxygenation

Question 4

Physiological Objectives of Mechanical Ventilation

Answer 4

Support or manipulate pulmonary gas exchange:
Increase lung volume
Reduce the work of breathing

Question 5

signs of respiratory distress are the result of the person experiencing a “panic attack.

Answer 5

Respiratory distress in this type of patient can usually be relieved simply by calming the person and questioning him or her about the distress

Question 6

defined as the inability to maintain Pao2, Paco2, and pH at acceptable levels

Answer 6

ARF

Question 7

A patient with ARF may experience the following clinical symptoms.

I) PaO2 below the predicted normal range for the patient’s age under ambient (atmospheric) conditions
II) Bicarb within ranges of 25-30
III) Paco2 greater than 50 mm Hg and rising
IV) a falling pH of 7.25 and lower.

Answer 7

I, III, IV

Question 8

Two forms of ARF

Answer 8

hypoxemic respiratory failure

and hypercapnic respiratory failure

Question 9

Type II ARF

Answer 9

Hypercapneic Respiratory Failure

Question 10

Type I ARF

Answer 10

Hypoxic Respiratory Failure

Question 11

(Lung failure accompanied by hypoxemia)

Hypoxic Lung Failure) (Ventilatory Failure

Answer 11

Hypercapneic Respiratory Failure (type II)

Question 12

(Pump failure accompanied by hypercapnia) (Hypoxic Respiratory Failure)

Answer 12

Hypoxic Respiratory Failure (type I)

Question 13

Hypoxic Respiratory Failure (type I) result from the following.

I) severe ventilation/perfusion (V/Q) mismatching.
II) diffusion defects,
III)  right-to-left shunting,
IV) alveolar hyperventilation
V) aging
VI) inadequate inspired oxygen

Answer 13

I, II, III, V, VI

IV is wrong because it’s Alveolar HYPOventilation

Question 14

acute life-threatening or vital organ–threatening tissue hypoxia

Answer 14

acute hypoxemic respiratory failure

Question 15

Hypoxemic respiratory failure can be treated with oxygen or in combination
with ?

Answer 15

positive end-expiratory pressure (PEEP) or continuous positive airway pressure (CPAP)

Question 16

The ventilatory pump consists of

Answer 16

the respiratory muscles
thoracic cage

nerves that are controlled by respiratory centers in the brainstem

Question 17

Three types of disorders can lead to pump failure

Answer 17

Central nervous system disorders
•Neuromuscular disorders
•Disorders that increase the work of breathing (WOB)

Question 18

T/F Tachycardia and tachypnea are specific ways to indicate a paitients needs and help the clinician in deciding when to intubate and ventilate a patient

Answer 18

FALSE

Tachycardia and tachypnea are nonspecific and mostly subjective signs that may provide only limited help in deciding when to intubate and ventilate a patient

Question 19

Any condition when respiratory activity is inadequate to maintain O2 uptake and CO2 clearance. Sudden

Answer 19

ACUTE RESP. FAILURE

Question 20

(Lung failure accompanied by hypoxemia)

Hypoxic Lung Failure) (Ventilatory Failure

Answer 20

Hypercapneic Respiratory Failure (Type II)

Question 21

Hypercapneic Respiratory Failure (Type II)

PaO2 =

Answer 21

Low (only because it is displaced by carbon dioxide

Question 22

Hypercapneic Respiratory Failure (Type II)

PaCO2 =

Answer 22

high

Question 23

Hypercapneic Respiratory Failure (Type II)

a/A ratio

Answer 23

Normal

Question 24

Hypercapneic Respiratory Failure (Type II)

A-a gradient

Answer 24

Normal

Question 25

What’s the equation for PAO2

Answer 25

(760-47)xFio2 - (PaCo2 x 1.25)

Question 26

Hypercapneic Respiratory Failure (Type II)

What should the treatment be?

Answer 26

Rx: Mechanical ventilation, oxygen

Question 27

Hypercapneic Respiratory Failure (Type II)
Causes

\_\_\_\_\_\_ \_\_\_\_\_\_\_
Problem with respiratory muscles, 
diseases that increase the WOB.
 Primary defect is ventilation.
 Severe \_\_\_ \_\_\_\_,
 R-L shunt,
 Diffusion defect, 
\_\_\_\_\_,
 VD

Answer 27

Pump failure.
low V/Q
aging

Question 28

Hypercapneic Respiratory Failure (Type II)
Causes

Pump failure. 
Problem with\_\_\_\_\_\_ \_\_\_\_\_\_\_ 
diseases that \_\_\_\_ WOB.
 Primary defect is ventilation.
 Severe low V/Q ,
\_\_\_\_\_ \_\_\_\_\_,
 Diffusion defect, 
aging,
 VD

Answer 28

respiratory muscles,

increase

R-L shunt

Question 29

Hypercapneic Respiratory Failure (Type II)
Causes

Pump failure. 
Problem with respiratory muscles, 
diseases that increase the WOB.
 Primary defect is ventilation.
 Severe low V/Q ,
 R-L shunt,
\_\_\_\_\_ \_\_\_\_, 
aging,
\_\_

Answer 29

Diffusion defect

VD

Primary defect is ventilation

Question 30

Hypercapneic Respiratory Failure (Type II)

CNS – Depressed Drive

Answer 30

Depressant Drugs
Head Trauma
Sleep Disorders
Acid/Base Abnormals
Inappropriate Oxygen Therapy
Hypothyroidism

Question 31

What are some of the Acid/Base abnormals for Type II ARF

Answer 31

Metabolic Alkalosis
Respiratory Acidosis
Increased Metabolic Rate

Question 32

Hypercapneic Respiratory Failure (Type II)

CNS-Increased Drive

Answer 32

Increased metabolic rate
Metabolic Acidosis
Anxiety associated with dyspnea

Question 33

Normally WOB % to% of total oxygen consumption. Can go as high __% to __%.

Answer 33

1 - 4%

35- 40%

Question 34

Normally WOB 1% to 4% of total oxygen consumption. Can go as high 35% to 40%.
This category includes increased ______ of COPD and increased Raw in____.

Answer 34

deadspace

asthma

Question 35

Normal pH

Answer 35

7.35-7.45

Question 36

abnormal pH ARF

Answer 36

<7.25

Question 37

abnormal PaCO2 ARF

Answer 37

<50, pt not a co2 retainer

Question 38

ARF

VD/VT ratio normal

Answer 38

0.3-0.4

Question 39

ARF

VD/VT abnormal

Answer 39

VD/VT >.60

Question 40

VD/VT not usually done watch for

Answer 40

increasing MV with no change in CO2

Question 41

ARF

Abnormal VT

Answer 41

<5 ml/kg

Question 42

ARF

Normal VC

Answer 42

65-75 ml/kg

Question 43

PaO2

abnormal

Answer 43

PaO2 < 70 O2

PaO2 <50 RA