Deck 29: Neonatal Mechanical Ventilation

Question 1

According to the AARC Clinical Practice Guidelines for application of CPAP to neonates which of the following are true?
I.CPAP maintains inspiratory and expiratory pressure above ambient
II.CPAP improves static lung compliance
III.CPAP can decrease airway resistance
IV CPAP increases mean airway pressure

A)I,II,III and IV
B)I,II and III
C)II and III
D)I and III

Answer 1

I,II,III and IV

Question 2

When mechanically ventilating a neonate,traditionally how is inspiration terminated?

A)After a preset volume is delivered
B)After a preset time interval has passed
C)After a preset pressure is reached
D)Once flow decreases to 25% of initial peak flow

Answer 2

After a preset time interval has passed

Question 3

Which of the following are true of time constants?
I.Indicate lungs' ability to receive or expel air
II.Are determined by airway resistance times compliance
III.Poor compliance with normal airway resistance results in long time constant.

A)I,II and III
B)II and III
C)I and II
D)II only

Answer 3

I and II

Question 4

A mode of ventilation which delivers an inspiration to a set pressure and typically ends when flow drops to 25% of its initial peak value is which of the following?

A)Volume Guarantee
B)Pressure Support
C)Pressure Assist Control
D)Volume Support

Question 5

According to the retired AARC Clinical Practice Guidelines the indication for time-triggered,pressure-limited,time-cycled neonatal ventilation is which of the following?
I.On CPAP and FIO₂ of 0.6 or more
II.pH greater than 7.45
III.PaO₂ less than 50 mmHg
IV.Apnea

A)I,II,III and IV
B)I,II and III
C)II,III and IV
D)I,III and IV

Question 6

The respiratory care practitioner wants to reduce or overcome the work of breathing due to the endotracheal tube and ventilator tubing.Which mode can be used for that purpose?

A)Volume me Support
B)Synchronized Intermittent Mandatory Ventilation
C)Pressure Regulated Volume Control
D)Pressure Support

Question 7

According to the retired AARC Clinical Practice Guidelines on time-triggered,pressure- limited,time-cycled neonatal ventilation,which is true of the use of PEEP?
I.Used to decrease FRC
II.Used to improve oxygenation
III.Typically set between 4-7 cm H₂O
IV.Above 7 cm H₂O can result in hyperinflation

A)I,II,III and IV
B)II,III and IV
C)II and III
D)I and II

Question 8

According to the retired AARC Clinical Practice Guidelines,which of the following is a hazard associated with use of time-triggered,pressure-limited,time-cycled neonatal ventilation?

A)Overinflation and/or barotrauma causing air leak syndrome
B)Failure to thrive syndrome
C)Cystic fibrosis
D)Apnea

Question 9

The respiratory care practitioner has a patient that has a good respiratory effort but he wants to control the inspiratory pressure while maintaining the patient's tidal volume and minute volume.The RCP should consider which of the following modes?

A)Pressure support
B)Pressure assist control
C)Volume support
D)Time cycled,pressure limited ventilation

Question 10

When a patient of any age cannot adequately provide enough oxygen for the body and sufficiently eliminate carbon dioxide,the term used is ______________

A)ventilatory insufficiency.
B)apnea.
C)respiratory failure.
D)CO₂ retainer.

Question 11

Which of the following are goals for mechanical ventilation?
I.Adequate alveolar gas exchange
II.Prevent ventilator induced lung injury
III.Reduce patient's work of breathing

A)I,II and III
B)II and III
C)I and III
D)I only

Question 12

According to the retired AARC Clinical Practice Guidelines for Patient Ventilator System checks,how often should patient ventilator checks be done?

A)Hourly
B)Every 2-4 hours
C)Every 2-4 hours until hs then every 6 hrs
D)No specific recommendations are given.

Question 13

Which of the following is true of a "lifespan" ventilator?

A)This is the term used when a ventilator is used on a comatose patient.
B)It provides pressure and volume ventilation.
C)It can be used on infants,pediatric,or adult patients.
D)It is the brand name of mechanical ventilators.

Question 14

Which of the following indicates poor ventilatory status?

A)PaO₂ less than 50 mmHg
B)SPO₂ below 60%
C)PaCO₂ greater than 55 mmHg
D)pH greater than 7.35

Question 15

According to the retired AARC Clinical Practice Guidelines,neurological conditions that can be an indication for time-triggered,pressure-limited,time-cycled neonatal ventilation are which of the following?
I.Apnea of prematurity
II.Intracranial hemorrhage
III.Pre-existing lung disease
IV.Congenital neuromuscular disorder

A)I,II,III and IV
B)II,III and IV
C)I,II and IV
D)I and II

Question 16

The practitioner notes that an infant is not ventilating sufficiently with the spontaneous breaths during SIMV with PEEP since there are periods of apnea.It is evident the infant should be changed to a different mode.Which mode should the therapist use?

A)VS
B)A/C
C)PS
D)CPAP

Question 17

According to the AARC Clinical Practice Guidelines for application of CPAP to neonates,which of the following is a contraindication for its use?

A)ROP
B)Need for intubation
C)Stable respiratory drive without apneas
D)Prematurity

Question 18

The respiratory care practitioner wants to use a spontaneous mode of ventilation that will provide a continuous flow of oxygenated gas at a pressure slightly above ambient pressure on both inspiration and expiration.The practitioner wants to use ________________

A)CPAP.
B)SIMV.
C)PRVC.
D)PS.

Question 19

The respiratory care practitioner is placing a Drager Babylog 8000 plus on a patient.What mode can she use to insure a steady tidal volume?

A)Pressure Control
B)SIMV
C)CPAP
D)Volume guarantee

Question 20

According to the retired AARC Clinical Practice Guidelines on time-triggered,pressure- limited,time-cycled neonatal ventilation,risk of ROP can be minimized by ___________________

A)keeping PaO₂ less than 60 mmHg.
B)keeping SPO₂ greater than 80%.
C)keeping PaO₂ less than 80 mmHg.
D)maintaining pH greater than 7.35.

Question 21

Describe how the initial newborn ventilator setting are determined for inspiratory time,I:E ratio and peak inspiratory pressure.

Question 22

In neonatal time-cycled,pressure-limited ventilation,the respiratory care practitioner will set the inspiratory gas flow rate at ______________

A)40-60 L/min.
B)6-10 L/min.
C)20-30 L/min.
D)1-5 L/min.

Question 23

Transillumination is which of the following?

A)Used to reduce bilirubin
B)A technique to detect a pneumothorax in newborns
C)The light reflecting from the ventilator
D)Used to identify pulmonary secretions

Question 24

Potential adverse problems that can occur with positive-pressure neonatal ventilation include which of the following?
I.Reduced cardiac output
II.Reduced venous return
III.Increased intracranial pressure
IV.Barotrauma to lungs and mediastinum

A)I,II,III and IV
B)I,II and III
C)II,III and IV
D)I,II and IV

Question 25

When using time-cycled,pressure-limited,IMV,the respiratory care practitioner will set the length of inspiratory time and pressure.What will happen if the pressure is reached before inspiratory time ends?

A)Pressure limiting will end inspiration
B)Pressure limiting will result in loss of tidal volume
C)The ventilator pressure alarm will sound
D)Pressure limiting will result in inspiratory plateau

Question 26

Which of the following has been the most common method of ventilating neonates with respiratory failure?

A)Volume assist control ventilation
B)Pressure support ventilation
C)Time-cycled,pressure-limited ventilation
D)Pressure regulated volume control

Question 27

Which of the following is a complication due to high PaO₂ levels?

A)Barotrauma
B)Retinopathy of prematurity
C)Reduced intracranial pressure
D)Subcutaneous emphysema

Question 28

Describe how the initial newborn ventilator setting are determined for tidal volume,oxygen percent and PEEP/CPAP

Question 29

Describe the point system used when determining an Apgar score.

Question 30

Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.

Question 31

Describe the 5 characteristics of the Apgar scoring system.

Question 32

What is the significance of urine output in neonatal ventilation?

A)Identifies the adequacy of oxygenation
B)Identifies metabolic function
C)Indicates function of vital organs
D)Decrease can indicate renal impairment due to ventilating pressures

Question 33

Which of the following is true of I:E ratio?

A)Refers to inspiratory flow to expiratory flow
B)Inspiration is always longer than expiration
C)Long time constants need greater than 1:2 ratio
D)Higher I:E ratios are better tolerated with short time constants

Question 34

Ventilator proximal gas temperature should be set at _________________

A)36-37 degrees C.
B)97 degrees C.
C)24-30 degrees C.
D)40-45 degrees C.

Question 35

Describe how the initial newborn ventilator alarm setting are determined.