exam 2 Flashcards
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?
reintubate the patient
based on the ABGs what are two ways you can improve oxygenation?
- FIO2
- PEEP
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?
auto cycling
In high frequency oscillatory ventilation CO2 elimination depends mainly on?
pressure amplitude
a peds pt is being volume ventilated in the A/C mode., ABGs show resp alkalosis. What ways can you fix the ABGs?
- decrease VT
- decrease RR
- switch to SIMV
cause is hyperventilation
after initiating volume control A/C ventilation the inverse I:E ratio alarm is triggering. What should be increased to fix the problem?
Insp. Flow
ABGs for a patient on HFOV show resp. alkalosis. What adjustment would you make to vent?
decrease amplitude/ delta P/ power
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?
add PS (SIMV always add PS)
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?
PIP
Hyaline membrane disease (RDS), uncomplicated by air leak. is best treated with HFOV by doing?
optimizing lung volume by increasing MAP in 1 cm steps until oxygenation improves
what are three things that cause increased resistance in ventilated neonates?
- small ETT
- small airways
- small vent tubing
- intersistial fluid
what is a hazard with assist control ventilation?
hyperventilation and resp alkalosis
if neonate is receiving HFOV and Paw is reading less then what is set what should RT do?
check the circuit connections
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?
high pressure
an infant is being mechanically ventilated and the low pressure alarm is sounding. what should the RT do next?
manually ventilate the pt and check the circuit
the first parameter weaned on mechanically ventilated infant is?
FIO2
a 32 week gestational neonate is being pressure ventilated in A/C mode, develops RDS. which is true regarding the decrease in compliance?
volumes will decrease
a child is receiving NIPPV. ABGs reveal resp acidosis and hypoxemia, how would you fix this?
increase the IPAP
with over expansion of the lungs caused by air trapping lung compliance is?
reduced
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?
nutritional status
what parameters affect mean airway pressure?
PEEP, Ti ,PIP
what is true regarding CPAP?
improves oxygenation by increasing FRC. applies stent to floppy airways, useful in weaning
a neonate is receiving TCPL, what parameter would have to be adjusted following surfactant?
pressure
what are three things taken into consideration when switching from conventional to oscillatory ventilation
CXR
Disease
Vent Settings
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?
0.3 seconds
what is jet ventilator rate usually set at?
420
where do you initially set jet vent pressure
26
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?
reintubation
optimal use of high frequency ventilation in the patient with meconium aspiration
early intervention
