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neonatal final > exam 2 > Flashcards

exam 2 Flashcards

1
Q

18 y/o w/ ARDS being mechanically ventilated for several weeks. Depth of ETT consistently has been 22-23cm at the lip. CXR shows ET tube is 8 cm above the carina. Measurement at lip is 23cm for insertions. What should the RT recommend?

A

reintubate the patient

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2
Q

based on the ABGs what are two ways you can improve oxygenation?

A
  • FIO2
  • PEEP
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3
Q

what issue would most likely explain why an infants RR would increase from 40-100 breaths/min on a vent after pt was turned and an audible endotracheal tube leak was heard?

A

auto cycling

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4
Q

In high frequency oscillatory ventilation CO2 elimination depends mainly on?

A

pressure amplitude

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5
Q

a peds pt is being volume ventilated in the A/C mode., ABGs show resp alkalosis. What ways can you fix the ABGs?

A
  • decrease VT
  • decrease RR
  • switch to SIMV
    cause is hyperventilation
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6
Q

after initiating volume control A/C ventilation the inverse I:E ratio alarm is triggering. What should be increased to fix the problem?

A

Insp. Flow

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7
Q

ABGs for a patient on HFOV show resp. alkalosis. What adjustment would you make to vent?

A

decrease amplitude/ delta P/ power

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8
Q

10 year old on vent on VC-SIMV. Multiple weening attempts have been made. Each time she becomes tachycardic and diaphoretic. what would you recommend?

A

add PS (SIMV always add PS)

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9
Q

newborn with RDS is intubated and mechanically ventilated by a TCPL vent. Vent settings are SIMV- 30, PIP- 20, PEEP- 5, Flow- 10, IT- 0.4, FiO2- 0.50. what would you recommend increasing?

A

PIP

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10
Q

Hyaline membrane disease (RDS), uncomplicated by air leak. is best treated with HFOV by doing?

A

optimizing lung volume by increasing MAP in 1 cm steps until oxygenation improves

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11
Q

what are three things that cause increased resistance in ventilated neonates?

A
  • small ETT
  • small airways
  • small vent tubing
  • intersistial fluid
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12
Q

what is a hazard with assist control ventilation?

A

hyperventilation and resp alkalosis

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13
Q

if neonate is receiving HFOV and Paw is reading less then what is set what should RT do?

A

check the circuit connections

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14
Q

an RT is assisting with the pediatric pulmonologist performing a bronch on a 6 y/o intubated patient who is on VC/AC. the high pressure alarm sounds as bronch is inserted. what does this indicate?

A

high pressure

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15
Q

an infant is being mechanically ventilated and the low pressure alarm is sounding. what should the RT do next?

A

manually ventilate the pt and check the circuit

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16
Q

the first parameter weaned on mechanically ventilated infant is?

A

FIO2

17
Q

a 32 week gestational neonate is being pressure ventilated in A/C mode, develops RDS. which is true regarding the decrease in compliance?

A

volumes will decrease

18
Q

a child is receiving NIPPV. ABGs reveal resp acidosis and hypoxemia, how would you fix this?

A

increase the IPAP

19
Q

with over expansion of the lungs caused by air trapping lung compliance is?

A

reduced

20
Q

during assessment of a 2900 gram neonate who is being mechanically ventilated. which of the following should be evaluated in order to plan for extubation?

A

nutritional status

21
Q

what parameters affect mean airway pressure?

A

PEEP, Ti ,PIP

22
Q

what is true regarding CPAP?

A

improves oxygenation by increasing FRC. applies stent to floppy airways, useful in weaning

23
Q

a neonate is receiving TCPL, what parameter would have to be adjusted following surfactant?

A

pressure

24
Q

what are three things taken into consideration when switching from conventional to oscillatory ventilation

A

CXR
Disease
Vent Settings

25
Q

an intubated 600 g neonate is being pressure ventilated with the following settings: PIP- 24, PEEP- 4, FiO2- 0.45, RR- 40. what itime should the RCP recommend?

A

0.3 seconds

26
Q

what is jet ventilator rate usually set at?

A

420

27
Q

where do you initially set jet vent pressure

A

26

28
Q

baby has been on vent for weeks since birth when he was intubated with a 2.5 ETT. multiple attempts have been made to wean him off mechanical vent but none have been successful. currently he is on SIMV- 15. what should the RCP do?

A

reintubation

29
Q

optimal use of high frequency ventilation in the patient with meconium aspiration

A

early intervention

neonatal final (1 decks)

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