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Respiratory > Study Questions > Flashcards

Study Questions Flashcards

1
Q

What happens when ventilation decreases from 4 to 1Liter’s per minute as perfusion remains constant?

A

There will be a decrease in the v/q ratio there by creating a shunt.

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2
Q

What level of perfusion goes with three liters per minute of ventilation?

A

3.75 L

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3
Q

What happens when perfusion decreases from 5 to 1 liters per minute? As alveolar ventilation remains constant?

A

The v/q ratio will increase. This can potentially create dead space

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4
Q

How can you measure the FRC?

A

The FRC can be measured through methods such as plethsmography, nitrogen washout, and helium dilution.

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5
Q

Define FRC

A

The functional residual capacity is the amount of air left in the lungs at the end of a normal tidal exhalation.

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6
Q

What is Poisseuille’s law equation?

A

Flow equal pressure divided by resistance.

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7
Q

What is the main determinant of oxygen saturation?

A

Partial pressure of oxygen

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8
Q

List the COPD diseases

A

Chronic bronchitis, Emphysema, Asthma, Bronchiectasis and cystic fibrosis

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9
Q

Is all arterial blood the same in terms of oxygenation?

A

Yes

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10
Q

What are the ways that oxygen is carried?

A

Dissolved In plasma and combined to hemoglobin

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11
Q

1 gram of hemoglobin can combine to how much oxygen? Include units

A

1.34 mL of Oxygen

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12
Q

What disease caused pulmonary hypertension?

A

Interstitial pulmonary fibrosis

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13
Q

What treatment can we give to reduce inflammation

A

Steroids

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14
Q

Does interstitial pulmonary fibrosis affect the diffusion rate of CO2?

A

No

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15
Q

If a person has right axis deviation , what are some of the causes of the right hypertrophy?

A

Pulmonary hypertension and
hypoxic vasoconstriction

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16
Q

Where does the oxygen mixes together in the venous system?

A

The pulmonary artery

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17
Q

The flow versus time wave form shows the flow rate decelerating. What does this represent?

A

As the pressure in the lungs begins to equilibrate with the pressure from the ventilator, the gradient decreases, which cause the flow to decrease over time.

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18
Q

Explain compliance, including the units of measure. Include the formula for compliance.

A

Compliance is the relationship between volume and pressure as well as the lungs’ ability to stretch.
Units= mL/ cmH20

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19
Q

What parameter or data would you measure to avoid ventilator associated long injury? Name two parameters and the units of measure to target.

A

Perform inspiritory hold
The two parameters are driving pressure and plateau pressure
Units = cmH20

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20
Q

How does a pressure support breath terminate?

A

It terminates by flow. The percentage of peak flow has to be set by using a cycling criteria

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21
Q

What is a clinical scenario that would require a respiratory therapist to adjust the rise time.

A

The respiratory therapist can adjust the rise time with asthma patience by decreasing it.

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22
Q

Define static compliance

A

Static compliance is a measure of the distensability of the lungs and chest wall. It is the relationship between changes in lung volume for a given pressure during a breath holding maneuver.

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23
Q

Define dynamic compliance

A

The compliance of the respiratory system during conditions of air flow such as doing normal breath or mechanical ventilation

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24
Q

What is the difference between the V60 and the mechanical vents such as drager or hamilton?

A

The V60 has a single limb that comes with a DEP and
the mechanical vent comes with a double limb circuit.

25
Q

What is the purpose of the DEP?

A

It allows the patient to exhale CO2

26
Q

What color elbow do we use on the single limb circuit?

A

Clear

27
Q

What is special about the clear elbow?

A

It has an anti asphyxia valve

28
Q

What is the hospital term for skin breakdown?

A

H.A.P.I
Hospital acquired pressure injury

29
Q

What does it mean when a mask is not vented?

A

The mask does not have anywhere for the patient to exhale

30
Q

Which elbow belongs to the double limb circuit?

A

The blue elbow

31
Q

If you have a vented mask . How can we place it onto a single circuit limb.

A

Remove the DEP and attach the pressure line tubing to the mask

32
Q

What is one way we can determine what size mask is appropriate for the patient?

A

We can use a sizing gauge to measure patient’s face

33
Q

The physician wants to improve the patient’s oxygenation without increasing the FIO2. What would you recommend?

A

Increase the EPAP

34
Q

After increasing the EPAP to 6 cmH2O, the Tidal Volume dropped to 350 mL, and the physician requested a target Tidal volume of 600 mL. Explain why this occurred and what parameter changes you would recommend?

A

The EPAP Increasing with no increase of IPAP caused the pressure support to decrease. So, therefore, we have to increase the IPAP.

35
Q

If IPAP is increased, why would the leak rate increase?

A

More pressure going into the system can increase leak

36
Q

What’s the range for normal P/F ratio?

A

Greater than 400

37
Q

what are the parameters of cardiac output.

A

Heart rate and stroke volume

38
Q

How do you measure static compliance?

A

You measure static appliance by performing an inspiratory hold maneuver In order to get the plateau pressure.

39
Q

What does the acronym APRV mean?

A

Airway Pressure Release Ventilation

40
Q

simply describe the concept of APRV/Bilevel/Bivent/Biphasic mode of ventilation.

A

Delivers 2 levels of PEEP, allowing spontaneous breath at both levels

41
Q

In the APRV/ Bilevel/Bivent/Biphasic modes, how would a clinician increase the patient’s contribution to the total minute volume?

A

Increase the PS levels for spontaneous breaths.

42
Q

What is a clinical Contraindication for using the APRV /Bilevel/ Bivent / Biphasic modes?

A

Increased airway resistance which could create severe air trapping.
OR
An obstructive lung disease patient that is unable to empty their lungs in 2 secs.

43
Q

What is the main clinical indication for implementing the APRV/ Bilevel/ Bivent) Biphasic modes?

A

Low PaO2 levels
OR
Hypoxia

44
Q

What are the 2 options for setting the PEEP high pressures?

A

Setting PEEP at 0.
Setting PEEP above 0

45
Q

What does the acronym TCAV mean?

A

Time Controlled Adaptive Ventilation

46
Q

What does the acronym OLA mean?

A

Open Lung Approach

47
Q

Alveolar recruitment is not only a function of the amount of pressure applied to the lung, but also__________________

A

the time during which the pressure is applied.

48
Q

State a simple explanation why one would set the P-Low time very short, possibly 0.3 seconds.

A

To ensure that the expiratory flow rate falls to 75% of its maximal value
* short P-low times create autopeep

49
Q

What does the acronym AVAPS means?

A

Average Volume Assured Pressure Support.

50
Q

What is the purpose Of C-Flex?

A

A brief drop in CPAP during exhalation.

51
Q

What does it mean When pt leak is being displayed on V-6o?

A

It means that the vent is aware of the presence of a DEP.

52
Q

What does it mean when the V-60 is displaying total leak?

A

The vent is unable to differentiate whether the leak is from the pt mask or the DEP.

53
Q

What does the pt trigger percentage means?

A

It represents the percentage of time that the patient is initiating a breath

54
Q

Where do you set the low rate alarm?

A

1 to 2 breaths above the set rate

55
Q

Inspiratory trigger set is called what on the ventilator?

A

Sensitivity

56
Q

What are the 3 types of triggers?

A

NAVA
Pressure
Flow

57
Q

What does the acronym NAVA means?

A

Neurally Adjusted Ventilatory Assist

58
Q

How does NAVA work?

A

Ventilators utilize the electrical activity of the diaphragm to generate appropriate breaths and assist ventilated patients.

59
Q

What does the acronym DME means?

A

Durable Medical Equipment

Respiratory (3 decks)

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