Deck 12: Management of Mechanical Ventilation

Question 1

CPAP is only suitable for patients who have adequate respiratory mechanics and can sustain prolonged spontaneous breathing.

Answer 1

True

Question 2

When compared to more frequent circuit changes, weekly circuit change does not increase the incidence of nosocomial infection, including ventilator-associated pneumonia.

Answer 2

True

Question 3

Ventilator circuits should be changed routinely for infection control purposes.

Answer 3

False

Question 4

Patients who are intubated and on mechanical ventilation are less prone to develop nosocomial pneumonia than nonintubated patients.

Question 5

The concentrated source of energy in fat emulsion is preferred for fluid-restricted patients.

Question 6

The best measure of a patient's ventilatory status is the ____ level.

A) F_IO₂
B) V_T
C) PaO₂
D) PaCO₂

Question 7

In HFOV, the PaCO₂ ____ with a higher amplitude or a ____ frequency.

A) increases; lower
B) decreases; lower
C) increases; higher
D) decreases; higher

Question 8

CPAP and PEEP increase the functional residual capacity and are useful to correct hypoxemia due to ____.

A) V/Q mismatch
B) deadspace ventilation
C) diffusion defect
D) intrapulmonary shunting

Question 9

Three major causes of metabolic acidosis are ____, diabetic ketoacidosis, and lactic acidosis.

A) renal failure
B) hypokalemia
C) hypocalcemia
D) heart failure

Question 10

Which of the following is a condition that could trigger the high pressure alarm?

A) premature termination of inspiratory phase
B) patient's need to increase ventilation
C) decrease in lung or chest wall compliance
D) excessive expiratory time

Question 11

To reduce the likelihood of auto-PEEP, the ____ or frequency may be reduced.

A) tidal volume
B) F_IO₂
C) pressure gradient
D) mechanical deadspace

Question 12

Studies have shown that the optimal interval for ventilator circuit change is ____.

A) every other day
B) once per week
C) once every other week
D) once a month

Question 13

Which of the following is a strategy to decrease ventilator-associated pneumonias?

A) preoxygenating the patient with oxygen prior to suction
B) change of ventilator circuit only when visibly soiled
C) instilling a saline solution directly into the airway for the purpose of thinning the secretions
D) using manual ventilation bags when needed

Question 14

____ analysis can identify the microbes in the sputum and the most suitable antibiotics for the infection.

A) Gram stain
B) Acid-fast sputum
C) Silver stain
D) Culture and sensitivity

Question 15

Which of the following is a sign of ECF deficit?

A) oliguria
B) increased pulmonic P₂ heart sound
C) bounding pulse
D) pulmonary edema

Question 16

Sodium and ____ are the two major electrolytes that must be monitored.

A) magnesium
B) potassium
C) chloride
D) calcium

Question 17

____ is a sign of hyperkalemia.

A) Arrhythmia
B) Flattened T wave and depressed ST segment on ECG
C) Elevated T wave and depressed ST segment on ECG
D) Decreased muscle function

Question 18

Hypophosphatemia decreases tissue ____ level, and in severe form it may cause the patient to experience confusion, muscle weakness, congestive heart failure, and respiratory failure.

A) glycogen
B) hydrous dextrose
C) adenosine triphosphate (ATP)
D) triglyceride

Question 19

Use of low tidal volume ventilation should be done with care as it may lead to complications such as acute hypercapnia, increased work of breathing, dyspnea, severe acidosis, and ____.

A) barotrauma
B) decreased lung compliance
C) lung collapse
D) hemodynamic instability

Question 20

_______________ is a strategy used to minimize the incidence of ventilator-induced lung injuries caused by positive-pressure ventilation.

Question 21

The blood gas report pH 7.52, PaCO₂ 30 mm Hg HCO₃^- 24 mEq/L is typically interpreted as acute _______________.

Question 22

_______________ of the ET tube can only be ensured with adequate humidification and prompt removal of retained secretions.

Question 23

_______________ is commonly related to ECF deficit (hypovolemia).

Question 24

_______________ is a technique that uses a small catheter to provide a continuous or phasic gas flow directly into the endotracheal tube during mechanical ventilation.

Question 25

What are five strategies for improving a patient's ventilation?

Question 26

What are the four precautions that must be followed to ensure patient safety if an intravenous route of potassium replacement is used?

Question 27

Explain the anion gap and how it is calculated.

Question 28

List the effects of undernutrition.

Question 29

What are the physiologic goals of prone positioning?