Deck 7: Noninvasive Positive Pressure Ventilation

Question 1

NPPV has three primary pressure settings.

Answer 1

False

Question 2

Conservative therapies for the treatment of OSA, such as weight loss and patient positioning, have been successful.

Answer 2

False

Question 3

NPPV can be used in apneic patients.

Answer 3

False

Question 4

When positive airway pressure is used to treat or relieve OSA the initial CPAP is started at 4 cm H₂O, and titrated to a desired endpoint.

Question 5

A bilevel positive airway pressure setting of 8 and 4 means that the EPAP is 8 cm H₂O and the IPAP is 4 cm H₂O.

Question 6

____ is a technique of providing ventilation without the use of an artificial airway.

A) Bilevel PAP
B) IPAP
C) NPPV
D) CPAP

Question 7

NPPV has been used successfully in the management of airflow obstruction in sleep apnea and in the ____.

A) treatment of polio
B) reduction of respiratory workload in gross obesity
C) reduction of ventilator-associated pneumonia occurrence
D) reduction of prolonged hospital stays

Question 8

Which of the following is used as PEEP when IPAP > EPAP?

A) EPAP
B) IPAP
C) Bilevel PAP
D) CPAP

Question 9

Along with its ability to improve oxygenation by increasing the ____, EPAP also relieves upper airway obstruction with its splinting action.

A) functional residual capacity
B) minute ventilation
C) tidal volume
D) residual volume

Question 10

PaO₂, PaCO₂, ____, and P_ETCO₂ may be used for titration of IPAP and EPAP.

A) pH
B) HCO₃
C) O₂CT
D) SpO₂

Question 11

Which of the following is an indication for CPAP therapy?

A) claustrophobia
B) fatigue of respiratory muscles
C) progressive hypoventilation
D) obstructive sleep apnea

Question 12

If untreated, OSA can lead to hypertension, ____, sudden cardiovascular death, and increased risk for brain infarction.

A) right ventricular hypertrophy
B) heart valve thrombosis
C) left and right ventricular hypertrophy
D) heart valve hematoma

Question 13

Two indications for bilevel PAP are acute respiratory failure and ____.

A) apnea
B) acute hypercapnic exacerbations of COPD
C) progressive hypoventilation
D) facial trauma

Question 14

The ____ is the most common interface used in NPPV for obstructive sleep apnea.

A) nasal mask
B) oro-nasal mask
C) nasal pillows
D) full-face mask

Question 15

Which of the following is a disadvantage of the nasal mask?

A) asphyxiation in power or gas outage
B) alarm and monitor may be necessary
C) gas leaks
D) regurgitation and aspiration

Question 16

If a patient is experiencing skin breakdown or irritation due to an interface, which of the following might be a possible solution?

A) Try a chin strap.
B) Increase room humidity.
C) Try nasal saline or water-based lubricant.
D) Use spacers, foam pads, or topical ointments.

Question 17

If a patient was experiencing nasal airway drying due to an interface, which of the following would be a possible solution?

A) Increase fluid intake.
B) Resize the mask.
C) Use a nasogastric tube sealing pad.
D) Adjust the pressure setting.

Question 18

Common initial bilevel positive airway pressure settings are IPAP from ____ cm H₂O and EPAP from ____ cm H₂O.

A) 2 to 6; 1 to 2
B) 4 to 8; 2 to 3
C) 6 to 10; 3 to 4
D) 8 to 12; 4 to 5

Question 19

Which of the following is Step 4 of the procedure to titrate bilevel positive airway pressure, taking place after setting the IPAP maximum time?

A) Start the IPAP at 8 cm H₂O and the EPAP at 4 cm H₂O.
B) Attach mask to patient, ensure proper fit, and start machine.
C) Increase IPAP in 1 to 2 cm H₂O increments to provide more ventilatory assistance and larger tidal volume.
D) Use supplemental oxygen if baseline saturation remains low with appropriate IPAP and EPAP settings.

Question 20

____ provides positive airway pressure during the entire spontaneous breath and it does not include any mechanical breaths.

A) NPPV
B) Bilevel Positive Airway Pressure
C) PEEP
D) Continuous positive airway pressure

Question 21

A higher IPAP level will result in a larger _______________ and minute ventilation.

Question 22

The severity of OSA is quantified by the _______________.

Question 23

_______________ is an interface that resembles a nasal mask but smaller.

Question 24

_______________ is a feature in which the starting pressure gradually increases over time until the desired pressure is reached.

Question 25

_______________ describes the average number of oxygen desaturations of 4% or more from baseline (measured by pulse oximeter) in each hour of sleep during a test.

Question 26

Describe negative pressure ventilation and positive pressure ventilation. What are the disadvantages of both?

Question 27

What are some contraindications to autotitration?

Question 28

Describe the full-face mask interface.

Question 29

What are the risk factors and major clinical signs and symptoms of OSA?