Respiratory: Mechanical Ventilation

25 July 2022
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37 test answers

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question
What parameters regarding respiratory rate might indicate the need for mechanical ventilation?
answer
greater than 35 or less than 10
question
What parameters regarding pressure of arterial O2 and FIO2 might indicate the need for mechanical ventilation?
answer
PaO2 less than 60mmHg with FIO2 greater than 60%
question
What parameters regarding PaCO2 and pH might indicate the need for mechanical ventilation?
answer
PaCO2 greater than 50mmHg with pH less than 7.35
question
Besides respiratory rate, PaO2, FIO2, PaCO2, and pH what other two factors might indicate the need for mechanical ventilation?
answer
absent gag or cough reflex
question
Positive pressure ventilation implies what? What's absent?
answer
air is being forced into the patient's lungs, thorax expansion
question
PEEP can be applied to what two kinds of patients?
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mechanical ventilation patient and spontaneously breathing patient
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PEEP increases what two factors?
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oxygenation and lung compliance
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PEEP decreases what two factors?
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work of breathing and shunt fraction
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PEEP is primarily used in what type or types of patients?
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Hypoxic Respiratory Failure
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COPD patients may benefit from how many cm H2O PEEP to prevent airway collapse?
answer
3-5
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What is the goal in using PEEP for COPD patients?
answer
PaO2 greater than 60mmHg with an FIO2 less than 60%
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What are the three aspects/steps of ventilation therapy?
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initiation, management, weaning
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What are the two general types of ventilation?
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pressure-targeted and volume-targeted
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What are the four settings you need to know to setup the mechanical ventilator in VOLUME-TARGETED therapy?
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Mode, Tidal Volume, Rate, FIO2%, Peak Flow, PEEP (Manage Their Respiratory Fill Pronto Peeps)
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What are the six settings you need to know to setup the mechanical ventilator in PRESSURE-TARGETED therapy?
answer
Mode, Peak Pressure, Rate, I:E Ratio, FIO2, PEEP (Manage Pressure of Respiration In Failing Peeps)
question
What disease process commonly needs PEEP?
answer
ARDS
question
Which ventilatory setting, which can automatically deliver air or can be triggered by the patient's effort, delivers a set tidal volume to the patient on a given interval?
answer
Assist Control Mode Ventilation (ACMV)
question
A patient in the ICU is on assist control ventilation mode with a rate of 14 and has became very nervous about his current condition. This anxiety causes him to increase his respiratory rate to nearly 28 times per minute. What is this most immediate concern? What should we do to alleviate this issue?
answer
The most immediate concern is hyperventilation leading to respiratory alkalosis. We should give the patient a sedative to slow his respiratory rate.
question
What ventilatory setting gives a set amount of breaths per minute at a certain volume or pressure regardless of what the patient does?
answer
intermittent mandatory ventilation
question
Unlike assist control mode ventilation, this mode of ventilation will give the patient a set volume of air at a set interval but not beyond what the physician has ordered. As such, the risk for hyperventilation and respiratory alkalosis is minimized.
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Synchronized Intermittent Mandatory Ventilation
question
This mode of ventilation requires the patient to initiate effort in order to trigger the machine. When the patient provides effort the machine will give them assistance.
answer
Pressure Support
question
What two modes are often combined to help a patient wean off the ventilator?
answer
SIMV and Pressure Support
question
Which ventilator mode negates the resistance of the tubing and supports the patient in taking a full breath on their own?
answer
pressure support
question
A patient who previously coded has arrived at the ICU and is bagged. You need to begin ventilation on this patient and know almost nothing about their care up to this point. What four values should you begin the patient on?
answer
rate of 10, tidal volume of 10ml per kg of ideal body weight, 100% O2, and PEEP of 5
question
If a patient is on 10,10,100,5 ventilatory management and their ABG comes back with a PCO2 of greater than 50 what do we need to do?
answer
increase rate or volume (note: we need them to blow off more CO2 so we need to either have them breath faster or expel more volume)
question
If a patient is on 10,10,100,5 ventilatory management and their ABG comes back with a PaO2 that is remarkably low. What can we do?
answer
Increase PEEP
question
What two diseases might indicate the need for less than 10ml/kg of ideal body weight?
answer
COPD and ARDS
question
How long should we maintain the patient at 100% PaO2?
answer
As short a duration as possible since oxygen toxicity is a major concern
question
Peak inspiratory pressures should never be above what measure?
answer
40 cm H2O
question
What condition might require you to have a I:E ratio of less than 1?
answer
COPD
question
Correction to O2 values is made by adjusting what two settings?
answer
PEEP and FIO2
question
Correction to CO2 values is made by adjusting what two settings?
answer
RR and Tidal Volume
question
What's the normal range for pH?
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7.35-7.45
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What's the normal range for PaCO2?
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35-45 mmHg
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What's the normal range for PaO2?
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80-95 mmHg
question
What's the normal range for bicarb levels?
answer
22-26 mEq/L
question
What's the normal range for O2 sat?
answer
95-100%