Non-Invasive Ventilation

Question 1

Which statement related to improving patient comfort with NPPV is correct?

Answer 1

A rise in pressure at the end of inspiration in a pressure-controlled breath indicates an increased work of breathing.

Question 2

A patient is being ventilated with a nasal mask to relieve dyspnea. This patient has a long history of COPD/hypercarbia. What is the goal of NIV with regards to the ABGs of this patient?

Answer 2

Return the PaCo2 to less than 60 mmHg.

Question 3

What are the 4 contraindications for NIV?

Answer 3

Uncooperative patient, Lack of financial resources, Non-supportive family, Copious secretions.

Question 4

What is S/T mode on a BiPAP?

Answer 4

The patient determines the tidal volume. If the patient does not breath, the machine cycles to IPAP when time has elapsed.

Question 5

Why would you adjust IPAP?

Answer 5

For ventilation problems.

Question 6

Why would you adjust EPAP?

Answer 6

For oxygenation problems.

Question 7

If there is an increase in the patient’s PaCO2, what should you do?

Answer 7

Adjust the IPAP in order to create greater pressure differences between IPAP and EPAP. This increases alveolar ventilation.

Question 8

Describe BIPAP ventilator breaths?

Answer 8

They are flow triggered and require patient effort to be greater than 40 ml/sec to initiate an inspiration.

Question 9

What are 3 benefits gained by NPPV in Restrictive Thoracic Diseases?

Answer 9

(1) Improved lung compliance, volume/FRC, and dead space, (2) Rest for the muscles of inspiration, and (3) lower PaCO2.

Question 10

What condition must be present to add NPPV therapy with CPAP in Acute Pulmonary Edema?

Answer 10

Hypercarbia (ventilatory failure).