Review Questions Flashcards
On the Sensormedics 3100B the distance the piston travels determines:
a. The frequency
b. The amplitude
c. The mean airway pressure
d. All of the above
b.The amplitude
The frequency will be determined by how fast the piston is moving as it is the RR, which is determine and set with Hertz (RRx60). The mean airway pressure will be set and is held constant.
You are ventilating a patient on the Sensormedics 3100B. The control that determines the FRC of a patient is:
a. Amplitude
b. Frequency
c. Mean airway pressure
d. Ti%
c.Mean Airway Pressure
You amplitude in a way is like you tidal volume but as it is the area under the curve it will also be affected by frequency. However tidal volumes in HFV are so small that the lung are practically unmoving which is why amplitude and frequency will not affect the FRC. What does determine the FRC is mean airway pressure which is the pressure that is held in the lung constantly in order to keep them open.
Frequceny and Vt Relationship
Inverse
Frequency and Alkalosis
To deal with alkalosis you should increase frequency
Respiratory Alkalosis Management
When you are in respiratory alkalosis you want increase CO2, and by increasing frequency you are decreasing tidal volume and increasing what is considered the RR. Be increasing the RR you are spending less time in exhalation so you are holding onto more CO2.
You are ventilating your patient on the Sensormedics 3100B. Their recent ABG shows an acute respiratory alkalosis. Which of the following changes would most likely return the ABG to normal values:
a. Increase Ti%
b. Increase frequency
c. Increase MAP
d. Increase the bias flow
b. Increase frequency
When you are in respiratory alkalosis you want increase CO2, and by increasing frequency you are decreasing tidal volume and increasing what is considered the RR. Be increasing the RR you are spending less time in exhalation so you are holding onto more CO2.
When the adjustable MAP alarm (ie. The one set by the operator) is activated on the Sensormedics 3100B, the following occurs:
a. AV alarm
b. Bias flow stops
c. Oscillations cease
d. Dump valve opens
e. All of the above
a.AV alarm
When the alarm sound no changes will be made automatically by the ventilator rather you have to insect the machine and see what is happening.
You are at the bedside of an oscillated patient when they become disconnected from the circuit. The oscillations have stopped and the vent is alarming. The steps you would take to resume oscillations would be:
- reconnect patient, depress the start/stop button
- depress the start/stop button, reconnect patient, press and hold the power fail/reset button
- reconnect patient, press and hold the power fail/reset button, depress start/stop button
- reconnect patient, depress the power fail/reset button
- reconnect patient, press and hold the power fail/reset button, depress start/stop button
PPHN and Oxygenation
You want to give high oxygen to these babies
You are ventilating the patient using a NPB 7200 with the following settings. What is the approximate size of the spontaneous breath?
Mode: SIMV(VC)+PS
Set RR: 8
Vt: 550 mL
Plateau: 0.5 sec
PS: 10 cmH2O
PEEP: 8 cmH2O
FiO2: 0.60
Measured RR: 22
Measure MV: 8.9
PIP: 28 cmH2O (Mechanical Breaths)
First solve for the set minute ventilation
Set Minute Ventilation= 8 x 0.55
Set Minute Ventilation= 4.4
Next subtract the set minute ventilation from the measured minute ventilation
8.9-4.4=4.5
Finally solve for tidal volume with the minute ventilation equation
4.5=(22-8) x Spontaneous Vt
Spontaneous Vt=321 mL
Which of the following statement is/are correct in regards to APRV/BiLevel
a. When set up it is similar to inverse ratio pressure control
b. Meant to be used on sedated comatose patient
c. Breathing on two CPAP levels
d. All of the above
e. A and C
a.A and C
What you are setting is essentially pressure control on a high CPAP level with a low pressure release time. This is setting up a long inspiration and short expiration with an inverse ratio of 4:!. To get the most benefit out of APRV you will want to use it where the patient is able to breath spontaneously (not sedated and comatose.
During ASV ventilation which of the following is true
a. This mode is designed for partial ventilatory support only
b. A setting of 120% minute volume would mean that the ventilator would deliver and 8.4 LPM for a 70 kg patient
c. A patient with a minute volume percent setting of 80%; has 100% spontaneous breathing receiving a Pinsp of 5, FiO2 0.35, PEEP 5, Frequency of 18, Vt of 400mL, Should be considered for ventilator disconnection
d. All of the above
e. B and C
e.B and C
Which of the following mode is appropriate for a comatose patient?
I. ASV
II. CMV PC
III. SIMV APV
IV. PSV
V. Volume Support
I, II, III, V
Which of the following is the true statement in regards to PAV+
PAV+ is based on the equation Pmus = Palveolar + Ptransairway
The breath delivered is a constant set pressure
PAV+ is indicated for neuromuscular patient
PAV+ can be used when there are leaks in the circuit
PAV+ is based on the equation Pmus = Palveolar + Ptransairway
Which of the following is an acceptable method of SBT?
a. SIMV with low respiratory rate, CPAP of 5 cmH2O, and pressure support of 5 cmH2O
b. PEEP of 5 cmH2O and pressure support of 5 cmH2O
c. Volume support, CPAP of 5 and Vt target of 8ml/kg
d. CPAP of 5 cmH2O and tube compensation
e. B and C
B and C
Which of the follow is a goal of ventilation for a patient with pulmonary edema
Decreased workload of the heart
Decreased hypoxemia
Decrease circulating volume
All of the above
.A and B
.A and B
Which of the following is the most appropriate ventilator strategy for a paralyzed and sedated patient with a closed head injury?
Hyperventilate the patient
Keep PaCO2 between 35-45 and SpO2 88-92%
Keep PaCO2 between 35-40 mmHg and well oxygenation
Permissive hypercapnia strategy
Keep PaCO2 between 35-40 mmHg and well oxygenation
We only hyperventilate the patient as a short term treatment to decrease ICP. You want to keep this patient population well oxygenated (PaO2 80-120 mmHg). We are more focused on keeping the patient well oxygenated than we are focused on permissive hypercapnia.
Which of the following is not a goal of NPPV in the acute care setting
Avoid intubation
Decreased incidence of VAP
Decrease length of stay
.Improve mobility
.Improve mobility