Exam 8: Initial Patient Assessment

The first step in the assessment and documentation of patient-ventilator interaction following placement of a patient on a mechanical ventilator is which of the following?

A 31-year-old woman is admitted to the emergency department following a motor vehicle accident.The paramedics brought her into the ER in respiratory distress.She was intubated in the field and started on mechanical ventilation as soon as she arrived.Breath sounds were clear on the left and absent on the right.Percussion revealed resonance on the left and hyperresonance on the right.The patient's trachea was shifted to the left.The most likely cause of this patient's clinical presentation is which of the following?

The normal airway resistance range is which of the following?

To help prevent inflated alveoli from collapsing and reexpanding with each breath,the positive end-expiratory pressure (PEEP)level should be set at which point on the deflation part of the loop?

The pressure at which large numbers of alveoli become overinflated in a patient with acute respiratory distress syndrome (ARDS)is located on the static pressure-volume curve at which of the following?

A female patient who is 5'7" tall and weighs 68 kg is being mechanically ventilated with volume-controlled continuous mandatory ventilation (VC-CMV),set rate 12,patient trigger rate 25 breaths/min,tidal volume (Vᴛ)500 mL,set flow rate 60 L/min,fractional inspired oxygen (FɪO₂)40%,positive end-expiratory pressure (PEEP)5 cm H₂O.The patient is currently in distress using accessory muscles of inspiration.The respiratory therapist performs a patient-ventilator system check.The flow-time waveform shows a failure of the expiratory flow to return to zero before the next breath is triggered.The most appropriate action for the respiratory therapist to take includes which of the following?

A pathophysiologic condition that causes an increase in peak inspiratory pressure (PIP)while transairway pressure (PPᴛᴀ)remains the same is which of the following?

The respiratory therapist is performing a physical assessment of a patient receiving pressure support ventilation.The patient is short of breath,has a respiratory rate of 28 breaths/min,a dull percussion note over the right base that becomes resonant over the right upper lobe,and resonance over the left lung.Chest movement on the right side is decreased.The STAT chest X-ray reveals a blunting of the right costophrenic angle.The pulmonary disorder that is causing this clinical presentation is which of the following?

Identify the plateau pressure (Pₚₗₐₜₑₐᵤ)for the pressure-controlled continuous mandatory ventilation (PC-CMV)breaths in the figure.

The respiratory therapist is monitoring the cuff pressure of a tracheostomy tube inserted in a patient who is receiving mechanical ventilation.The cuff pressure is measured at 41 cm H₂O.The respiratory therapist should immediately do which of the following?

To reduce the risk of tracheal damage associated with overinflated tube cuffs,cuff pressures should not exceed what range of pressures?

The respiratory therapist observes the volume-time curve shown in the figure.What action should the respiratory therapist take at this time?

The respiratory therapist is evaluating the following ventilator flow sheet.The recommendation that is most appropriate in this situation is which of the following? Time PIP ( ( ( Exhaled () Flow rate (/) 0800 35 30 5 1000 60 1000 39 34 5 1000 60 1100 45 39 5 1000 60 1130 50 44 5 1000 60

The volume-time curve is demonstrating which of the following?

The operational verification procedure (OVP)involves checking the ventilator circuit for leaks.Ventilator settings that could be used to perform this procedure include which of the following?

Before a ventilator is used,an operational verification check is performed.A simple variation of this procedure is also performed under which of the following circumstances?

An increasing PIP may indicate which of the following?

How often should the fractional inspired oxygen (FɪO₂)of an adult be measured?

A 49-kg female patient intubated with a size 7 mm inner diameter (ID)endotracheal tube is being mechanically ventilated in the volume-controlled continuous mandatory ventilation (VC-CMV)mode.During patient rounds,both the low-pressure and low-volume alarms are sounding persistently on the ventilator.Upon observation of the patient,the respiratory therapist hears murmuring from the patient,with audible sounds during inspiration.The cause of this condition is which of the following?

An 87-kg male patient,orally intubated with a size 7.5 mm inner diameter (ID)endotracheal tube,is being mechanically ventilated in the pressure-controlled continuous mandatory ventilation (PC-CMV)mode.During patient rounds,both the low-pressure and low-volume alarms are sounding persistently on the ventilator.Upon observation of the patient,the respiratory therapist hears murmuring from the patient,with audible sounds during inspiration.The respiratory therapist notes the position of the endotracheal tube is 21 cm at the gum line,measures the cuff pressure,and adds 3 mL of air to the cuff.To make an appropriate seal,it requires 44 cm H₂O.The respiratory therapist should do which of the following?