Test 2 Ch. 4

Question 1

The inability to maintain either the normal delivery of o2 to the tissues or the normal removal of co2 from the tissues is defined as

Answer 1

Respiratory failure

Question 2

What is the criteria for respiratory failure

Answer 2

PaCO2 > 50 mm Hg
PH < 7.25 and falling

Question 3

What is another term for elevated PaCO2 results in uncompensated Respiratory acidosis

Answer 3

Hypercapnic Respiratory Failure

Question 4

Hypercapnic Respiratory Failure akas

Answer 4

“pump failure” or “ventilatory failure”

Question 5

Chronically elevated PaCO2 leads to

Answer 5

Acute ventilatory failure superimposed on chronic ventilatory failure

Question 6

Ventilatory drive most commonly deminished by (5 diseases)

Answer 6

-Drug overdose
-Brainstem session
-Diseases of CNS (multiple sclerosis or Parkinson)
-Morbid obesity
-sleep apnea

Question 7

Ventilatory failure may occur if

Answer 7

imposed workload cannot be overcome

Question 8

increased WOB most commonly occurs secondary to

Answer 8

COPD
Asthma

Question 9

Increased WOB can also be caused (3 disease)

Answer 9

• Pneumothorax rib fractures
• pleural effusion
• hypermetabolic states such as burns

Question 10

Over months and years acute respiratory failure will become

Answer 10

Chronic Respiratory Failure

Question 11

What is another term for acute hypercapnia failure

Answer 11

Acute Ventilation failure, Uncompensated respiratory acidosis

Question 12

PH- 7.31
Paco2- 70
Hco3- 25

Answer 12

acute hypercapnia failure

Question 13

Indications for Ventilatory Support (3)

Answer 13

• Constant therapy until underlying problem resolves
• provide long term support for its w/ chronic ventilatory failure
• support aimed at pt’s specific needs

Question 14

Physiologic Indications for Vent support (5)

Answer 14

• Inadequate alveolar ventilation
• Inadequate lung expansion
• Inadequate muscle strength
• Increased WOB
• Very severe Hypoxemia

Question 15

_______________ ______________ is a common indication for intubation and MV

Answer 15

Refractory Hypoxemia

Question 16

Not responding to oxygen

Answer 16

refractory hypoxemia

Question 17

Hypoxemia and hypercapnia respiratory failure occur

Answer 17

simultaneously

Question 18

Elevated PaCO2 may or may not indicate for ventilatory support

Answer 18

Hypercapnia Respiratory failure

Question 19

PaCO2 > 50 w/ ph falling below 7.25 =

Answer 19

acute process probably requires ventilation

Question 20

PaCO2 > 50 w/ PH near normal =

Answer 20

chronic failure w/ renal compensation, probably does not require MV

Question 21

The trend of PaCO2 and PH is very

Answer 21

useful

Question 22

Diminished b/s in young asthmatic is known as

Answer 22

ominous — not moving adequate air

Question 23

signs of worsening hypercapnia

Answer 23

Irritability, confusion, and coma

Question 24

Respiratory muscle fatigue presents

Answer 24

• Tachypnea:cardinal sign of increased wob
• Worsening fatigue rr starts failing bradypnea occurs & apnea

Question 25

Full ventilatory failure ABG

Answer 25

hypercapnia w/ acidosis

Question 26

The primary purpose of ventilation is to maintain

Answer 26

homeostasis

Question 27

Mechanical ventilation is indicated when a person

Answer 27

cannot achieve an appropriate level of ventilation to maintain adequate gas exchange and acid- base balance

Question 28

Hypoxemia respiratory failure is a result of

Answer 28

server v/q mix match

Question 29

Test to asses respiratory muscle strength

Answer 29

Maximum Inspiration Pressure (MIP)

Question 30

Is the lowest (most negative) pressure generated during a forceful inspiratory effort against an occluded airway

Answer 30

MIP (PImax)

Question 31

Device that Measures MIP, assess muscle strength and weakness

Answer 31

pressure monometer

Question 32

MIP normal and critical ranges

Answer 32

-100 to -50 -20 - 0

Question 33

normal and critical ranges maximul expiratory pressure (MEP)

Answer 33

100 <40

Question 34

Vital Capacity normal and critical ranges

Answer 34

65- 75 <10- 15

Question 35

Respiratory frequency normal and critical ranges

Answer 35

12- 20 <5

Question 36

Forced expiratory volume at 1 second (FEV1) normal and critical ranges

Answer 36

50-60 <10

Question 37

Peak expiratory flow (PEF) normal and critical ranges

Answer 37

350- 600 75-100

Question 38

_____________ _____ is the most common cause of respiratory failure muscle fatigue and failure to wean from MV

Answer 38

Excessive WOB

Question 39

Pts with _____________ ___________ usually require intubation an mv

Answer 39

profound hypoxemia

Question 40

Indications for intubation where NIV may be poorly tolerated (4)

Answer 40

- Upper airway obstruction - Inability to clear secretions and protect airway - Inability to achieve proper mask fit - Intolerance of the intervention