Mechanical Ventilation

Question 1

What is the definition of a ventilator?

Answer 1

functions as a substitute for the bellows action of the thoracic cage and diaphragm.

Question 2

What are some indications for the need of a ventilator?

Answer 2

extrapulmonary diseases and disorders affecting gas exchange.

Question 3

True or False Neg. pressure ventilators are opposite of normal physiology.

Answer 3

FALSE: similar too

Question 4

What is Fraction of Inspired Ox set too?

Answer 4

0.21(21% room air) to 1.00(100% oxygen).

Question 5

What does FiO2 need to maintain for PaO2? SpO2?

Answer 5

60-100 mm hg; 90%

Question 6

What is the tidal volume? (Vt)

Answer 6

the amount of air delivered with each present breath.

Question 7

What is the Vt setting of ideal body weight w. the lowest value recommended with Obstructive airway disease or ARDS?

Answer 7

6-8ml/kg

Question 8

What is respiratory rate(f)?

Answer 8

frequency of breaths set to be delivered by ventilator

Question 9

What is Inspiratory to Expiratory Ratio(I:E) set as? if have COPD?

Answer 9

1:2 normal; 1:3, 1:4;

Question 10

What is PEEP(positive end-expiratory pressure) ?

Answer 10

is the addition of positive pressure into the airways during expiration. 5-20 cm of water.

Question 11

What is sensitivity?

Answer 11

how easily the ventilator recognizes pts breaths

Question 12

What kind of problems can PEEP cause?

Answer 12

r/t increase in intrathoracic pressure: decreased CO, venous return, Increased ICP

Question 13

What type of PEEP gives the best O2 without causing other problems?

Answer 13

optimal PEEP

Question 14

What is exhaled tidal volume?(EVt)

Answer 14

amount of gas that comes out of the patients lungs on exhalation.

Question 15

What is peak inspiratory pressure (PIP)? don’t want higher than?

Answer 15

is the maximum pressure that occurs during inspiration; 40 cm of water

Question 16

What is the total respiratory rate? increased pt RR could mean?

Answer 16

number of breaths delivered by vent plus the number initiated by patient (increased pt RR could mean pt getting sicker)

Question 17

What are the 3 types of modes of mechanical ventilation?

Answer 17

vol, pressure, dual

Question 18

True or false in Intermittent Mandatory Ventilation (IMV) and Synchronized Intermittent Mandatory Ventilation (SIMV) spontaneous breaths are whatever vol the patient breathes.

Answer 18

TRUE

Question 19

True or false Pressure Support Ventilation (PSV) pressure is only applied during expiration.

Answer 19

FALSE: inspiration.

Question 20

In Pressure Assist Control (P-AC) what is set? who is it used in?

Answer 20

RR, pressure, but not tidal vol; ARDS or high PIP

Question 21

In SIMV with pressure support ventilation .. PSV is added only to ?

Answer 21

breaths

Question 22

What setting allows the mean airway pressure to increase, open and stabilize alveoli and improve oxygenation?

Answer 22

Pressure Controlled Inverse Ratio Ventilation (PC-IRV)

Question 23

In Pressure Controlled Inverse Ratio Ventilation (PC-IRV) what is I:E?

Answer 23

1:1 to 4:1 normal is 1:2

Question 24

What is special about PC-IRV?

Answer 24

uncomfortable, sedate pt and possibly paralyze

Question 25

BiPAP needs what to work?

Answer 25

spontaneous respirations.

Question 26

High Frequency Oscillatory Ventilation (HFOV) delivers a small tidal volume at ? often used in?

Answer 26

an extremely fast rate 100-420 per min; neonates and peds;

Question 27

True of False HFOV must be sedated and may be paralyzed.

Answer 27

TRUE

Question 28

What 4 things help you determine the readiness for weaning?

Answer 28

underlying cause resolved, adequate O2, hemodynamic stability, adequate respiratory strength.

Question 29

S/S of SBT (Spontaneous breathing tidal) failure?

Answer 29

tachypnea, dyspnea, tachycardia, sats

Question 30

What are some possible causes of high pressure alarm?

Answer 30

secretions, coughing, or gagging, biting tubing, increased resistance: bronchospasm, decreased compliance: pul. edema, pneumothorax, change in condition.

Question 31

What are some causes of low pressure alarm?

Answer 31

total or partial ventilator disconnect, hissing noise may be heard, loss of airway, ETT or trach leak

Question 32

What are some possible causes of apnea?

Answer 32

respiratory arrest, oversedation, change in pt condition, loss of airway.

Question 33

What are some possible causes of high tidal vol, minute ventilation or RR?

Answer 33

pain, anxiety, condensation tubing

Question 34

What are some possible causes of low tidal vol or minute ventilation?

Answer 34

change in breathing effort rate and vol, patient disconnection, loose connection or leak in circuit, ETT or trach cuff leak, insufficient gas flow.