Questions from Homework

Question 1

Explain how negative Pressure ventilators

Answer 1

Negative pressure ventilators work by applying intermittent negative pressure to the entire body, below the neck or just above the upper region of the chest wall, into the pleural space, and into the intraalveolar space, resulting in an increase in transpulmonary pressure causing air to enter the lungs

Question 2

What is the primary goal of NIV in the acute care setting?

Answer 2

To avoid ETT intubation and invasive ventilation

Question 3

List 3 clinical benefits of NIV in the chronic care setting

Answer 3

• Alleviates symptoms of chronic hypoventilation
• Improves duration and quality of sleep
• Prolongs survival

Question 4

Describe how the use of NIV in acute respiratory failure improves gas exchange.

Answer 4

by resting the respiratory muscles and increasing alveolar ventilation

Question 5

List 4 clinical disorders that manifest in chronic respiratory failure and require NIV as supportive therapy

Answer 5

• Acute exacerbation of COPD
• Cardiogenic Pulmonary Edema
• Hypoxemia Respiratory Failure
• Community-acquired PNA

Question 6

List 5 symptoms of hypoventilation

Answer 6

• fatigue
• morning headache
• daytime hypersomnolence
• cognitive dysfunction
• dyspnea

Question 7

What role does NIV play in “end of life” situations

Answer 7

• May relieve serve dyspnea
• reduce sedation requirement
• preserve pt comfort

Question 8

What are the typical ranges for inspiratory and expiratory settings on the BiPAP?

Answer 8

IPAP range- 2 to 30 cm H2O
EPAP range- 2 to 20 cm H2O

Question 9

What clinical indicators demonstrate improvement in pt comfort?

Answer 9

• decreased RR
• reduced inspiratory muscle activity
• synchronization w/ the vent

Question 10

What tidal volume range should be used w/ NIV and how is it manipulated

Answer 10

Vt range is 6 to 8 mL/kg of pt’s IBW.
Pt ventilator synchrony may be improved by adjusting rise time, inspiratory sensitivity, fully increasing EPAP to offset possible intrinsic PEEP. If EPAP is increased, IPAP may need to be increased to maintain the same gradient between IPAP and EPAP and thus ensuring adequate Vt delivery

Question 11

The highest pressure recorded at the end of inspiration is called ________________ or _________________

Answer 11

• Peak pressures (Ppeak)
• Peak Inspiratory Pressure (PIP)

Question 12

The pressure at which expiration ends is called _____________.

Answer 12

baseline pressure

Question 13

When end-expiratory pressure is above atmospheric pressure, this is called ____________.

Answer 13

Positive End-Expiratory Pressure (PEEP)

Question 14

The pressure required to overcome the elastic recoil of the lungs is known as ________________ and is measured on a mechanically ventilated patient by __________

Answer 14

Plateau pressure;
To obtain the measurement, the vent operator selects “inflation hold” or “inspiratory pause”

Question 15

What are the two types of forces that oppose inflation of the lungs

Answer 15

• Elastic forces
• Frictional forces

Question 16

List two factors that determine the way the inspiratory volume is delivered.

Answer 16

The structural design of the ventilator and the ventilator mode set by the clinican

Question 17

List two synonyms for pressure-controlled ventilation

Answer 17

• Pressure-targeted ventilation
• Pressure ventilation

Question 18

List two synonyms for volume-controlled ventilation

Answer 18

• Volume- targeted ventilation
• Volume ventilation

Question 19

During pressure-controlled breaths, the compliance and resistance of a patient’s lungs change. What happens to volume and flow?

Answer 19

volume and the flow waveforms will vary based the pt‘s lung compliance during pressure- control ventilation

Question 20

If during volume-controlled breaths the patient’s lung compliance decreases, what will happen to the peak inspiratory pressure?

Answer 20

It will increase