Deck 23: Special Techniques in Ventilatory Support

Question 1

Which of the following ventilators is unaffected by the use of heliox,whatever the FɪO₂?

A) Dräger E-4
B) Servo 300
C) Hamilton Galileo
D) Puritan Bennett 840

Answer 1

B

Question 2

The PₐCO₂ can be reduced during HFOV by doing which of the following?

A) Decreasing the amplitude
B) Increasing the frequency
C) Increasing the Tɪ%
D) Decreasing the cuff leak

Answer 2

C
The PₐCO₂ can be reduced during HFOV by increasing the amplitude,decreasing the frequency,increasing the TI% to 50%,and increasing the cuff leak.

Question 3

An 80% He:20% O₂ mixture is being delivered to an asthmatic patient by a nonrebreather mask through an oxygen flow meter set at 8 L/min.What is the actual flow delivered to the patient?

A) 10 L/min
B) 12 L/min
C) 14 L/min
D) 18 L/min

Answer 3

C
The conversion factor for an 80:20 heliox mixture is 1.8.8 × 1.8 = 14.4 L/min.

Question 4

A patient being ventilated with APRV has the following settings: pʜɪɢʜ = 24 cm H₂O; Tʜɪɢʜ = 5 sec; pʟᴏᴡ = 4 cm H₂O; Tʟᴏᴡ = 1 second,FɪO₂ = 0.3.The patient's spontaneous respiratory rate is 10 breaths/min.The current arterial blood gas values are: PₐO₂ = 91 mm Hg; PₐCO₂ = 62 mm Hg.What should the respiratory therapist recommend for this patient?

A) Increase the Pʜɪɢʜ to 5.5 cm H₂O.
B) Decrease the Tʟᴏᴡ to 0.5 sec.
C) Increase the Pʜɪɢʜ to 40 cm H₂O.
D) Decrease the Pʜɪɢʜ to 0 cm H₂O.

Question 5

Which variable in APRV is responsible for the removal of CO₂ from the body?

A) Tʟᴏᴡ
B) Tʜɪɢʜ
C) Pʟᴏᴡ
D) Pʜɪɢʜ

Question 6

When Tʜɪɢʜ is set at 5.5 seconds,and the Tʟᴏᴡ is set at 0.5 second,what is the set ventilator rate?

A) 8
B) 10
C) 14
D) 16

Question 7

The key property of helium that makes it useful as a therapeutic gas is its ____________.

A) low cost
B) low density
C) low solubility
D) abundance in nature

Question 8

The variable that allows for an unimpeded expiratory gas flow is which of the following?

A) Tʟᴏᴡ
B) Tʜɪɢʜ
C) Pʟᴏᴡ
D) Pʜɪɢʜ

Question 9

In the APRV mode,which of the following is considered baseline?

A) Plow
B) Phigh
C) Tlow
D) Thigh

Question 10

Weaning from APRV includes which of the following?

A) Increasing the Pʜɪɢʜ and decreasing the Tʜɪɢʜ
B) Decreasing the Pʜɪɢʜ and increasing the Tʜɪɢʜ
C) Increasing the Pʜɪɢʜ and decreasing the Tʟᴏᴡ
D) Decreasing the Pʜɪɢʜ and increasing the Tʟᴏᴡ

Question 11

An adult patient with ARDS is being ventilated with VC-CMV.The settings are: f = 14 breaths/min; Vᴛ = 375 mL; PEEP = 16 cm H₂O; and FɪO₂ = 0.8.The patient's ABG values are: pH = 7.40; PₐCO₂ = 56 mm Hg; PₐO₂ = 48 mm Hg; and SₐO₂ = 83%; the mean airway pressure is 18 cm H₂O.The patient's physician decides on a trial of HFOV.What initial ventilator settings should be used?

A) Bias flow = 30 L/min; mPₐᴡ = 23 cm H₂O; set power to obtain ΔP = 76 cm H₂O; f = 6 Hz; TI = 33%; FɪO₂ = 1.0
B) Bias flow = 35 L/min; mPₐᴡ = 76 cm H₂O; set power to obtain ΔP = 33 cm H₂O; f = 10 Hz; TI = 50%; FɪO₂ = 1.0
C) Bias flow = 20 L/min; mPₐᴡ = 18 cm H₂O; set power to obtain ΔP = 76 cm H₂O; f = 8 Hz; TI = 33%; FɪO₂ = 1.0
D) Bias flow = 30 L/min; mPₐᴡ = 30 cm H₂O; set power to obtain ΔP = 56 cm H₂O; f = 6 Hz; TI = 50%; FɪO₂ = 1.0

Question 12

The most common concentration of heliox is ______________________________.

A) 50% helium:50% oxygen
B) 60% helium:40% oxygen
C) 70% helium:30% oxygen
D) 80% helium:20% oxygen

Question 13

Which of the following is an alternative method of respiratory support for patients with ARDS?

A) IPV
B) ILV
C) HFOV
D) Heliox therapy

Question 14

The advantage of APRV over VC-CMV or PC-CMV is which of the following?

A) It enhances CO₂ elimination.
B) Volume delivery is consistent.
C) Independent lung regions are better ventilated.
D) It reduces the risk of ventilator-induced lung injury.

Question 15

Compared with pressure-controlled inverse ratio ventilation,APRV does which of the following?

A) Decreases the cardiac index
B) Reduces the need for sedation
C) Increases the peak airway pressure
D) Increases the central venous pressure

Question 16

The HFOV setting that directly affects PₐO₂ is the _____________.

A) power
B) mPₐᴡ
C) amplitude
D) bias flow

Question 17

The chest radiograph of a patient just placed on HFOV shows the diaphragm at the level of the seventh rib.Which of the following parameters should be adjusted?

A) mPₐᴡ
B) Power
C) Bias flow
D) Amplitude

Question 18

What is the maximum pressure setting for pʜɪɢʜ?

A) 25 cm H₂O
B) 30 cm H₂O
C) 35 cm H₂O
D) 40 cm H₂O

Question 19

A patient with ALI is being ventilated using APRV with the following settings: pʜɪɢʜ = 30 cm H₂O; pʟᴏᴡ = 2 cm H₂O; Tʜɪɢʜ = 6 seconds; Tʟᴏᴡ = 0.8 sec; FɪO₂ = 0.4.The patient's spontaneous rate is 12 breaths/min.The current ABG values are: PₐO₂ = 61 mm Hg; PₐCO₂ = 43 mm Hg.What change should the respiratory therapist recommend for this patient?

A) Decrease the Pʜɪɢʜ to 25 mm Hg.
B) Increase the Tʜɪɢʜ to 8 seconds.
C) Decrease the Tʟᴏᴡ to 0.5 second.
D) Increase the Pʜɪɢʜ to 5 cm H₂O.

Question 20

Observation of chest wall movement,or the "chest wiggle factor," is used to assess the appropriateness of the ___________.

A) mPₐᴡ
B) frequency
C) bias flow
D) power setting

Question 21

The NAVA mode can be used in which of the following situations?

A) Paralysis
B) Heavy sedation
C) Injury to the respiratory brain centers
D) Spontaneous breathing