Deck 8: Initiation of Mechanical Ventilation

Question 1

Mechanical ventilation alone can be used to treat or reverse the underlying pathology leading to the need for ventilator support.

Answer 1

False

Question 2

Severe hypoxemia is present when the PaO₂ is less than 60 mm Hg on 50% or more of oxygen or less than 40 mm Hg at any F_IO₂.

Answer 2

True

Question 3

Initial ventilator settings should be exclusively based on a patient's pathophysiology and laboratory results.

Answer 3

False

Question 4

The low exhaled volume alarm should be set at about 100 mL lower than the expired mechanical tidal volume.

Question 5

The risk of barotrauma increases with the duration of positive pressure ventilation.

Question 6

____ is defined as a sudden increase in the PaCO₂ to greater than 50 mm Hg with an accompanying respiratory acidosis (pH <7.30).

A) Acute ventilatory failure
B) Impending ventilatory failure
C) Severe hypoxemia
D) Prophylactic ventilatory support

Question 7

Which of the following is an example of acute ventilatory failure?

A) spontaneous frequency >30/min
B) muscle fatigue
C) progressive acidosis and hypoventilation to pH <7.30 and PaCO₂ >50 mm Hg
D) apnea or bradypnea

Question 8

The ____ is a measure of the inspiratory muscle strength reflecting the patient's pulmonary reserves.

A) minute volume
B) maximum inspiratory pressure
C) vital capacity
D) tidal volume

Question 9

Which of the following is indicative of impending ventilatory failure?

A) spontaneous minute volume is greater than 5 L/min
B) spontaneous tidal volume of greater than 3 to 5 mL/kg
C) vital capacity is less than 15 mL/kg
D) spontaneous frequency of greater than 15/min

Question 10

Hypoxemia can be assessed by measuring the ____.

A) SaO₂
B) PaO₂
C) PaCO₂
D) R

Question 11

PAO₂ is mainly affected by changes of F_IO₂, PaCO₂, and ____.

A) PaO₂
B) R
C) PH₂O
D) P_B

Question 12

Mode, frequency, ____, F_IO₂, inspiratory:expiratory ratio (I:E ratio), inspiratory flow pattern, and various alarm limits are basic ventilator settings must be determined when it becomes necessary to provide mechanical ventilatory support for a patient.

A) tidal volume
B) MIP
C) PaCO₂
D) minute ventilation

Question 13

____ is achieved by any mode that provides less than the total amount of the work of breathing.

A) FVS
B) PVS
C) SIMV
D) PCV

Question 14

For patients with COPD, the ____ may reduce the peak inspiratory pressure, mean airway pressures, physiologic dead space, and PaCO₂.

A) square flow pattern
B) accelerating flow pattern
C) decelerating flow pattern
D) sine wave flow pattern

Question 15

Depending on the features available on the ventilator, the I:E ratio may be altered by manipulating any one or a combination of the following controls: (1) ____, (2) inspiratory time, (3) inspiratory time %, (4) frequency, and (5) minute volume.

A) expiratory time
B) MIP
C) expiratory time %
D) flow rate

Question 16

Common causes that trigger the ____ include water in the ventilator circuit, kinking or biting of the endotracheal tube, secretions in the airway, bronchospasm, mucus plugs, tension pneumothorax, decreases in lung compliance, increases in airway resistance, and coughing.

A) high inspiratory pressure alarm
B) low inspiratory pressure alarm
C) apnea alarm
D) high frequency alarm

Question 17

Triggering of which of the following alarms may indicate that the patient is experiencing respiratory distress?

A) apnea alarm
B) low F_IO₂ alarm
C) high frequency alarm
D) high F_IO₂ alarm

Question 18

During mechanical ventilation, atelectasis is an example of a condition related to ____.

A) positive pressure ventilation
B) patient condition
C) equipment
D) medical professionals

Question 19

Positive pressure ventilation has been implicated in the development of decreased ____ and arterial blood pressure.

A) end-diastolic volume
B) end-systolic volume
C) stroke volume
D) cardiac output

Question 20

During mechanical ventilation, ____ is an example of a condition related to positive pressure ventilation.

A) multiple organ failure
B) bronchopleural fistula
C) tissue damage
D) nosocomial pneumonia

Question 21

The clinical conditions leading to mechanical ventilation can be grouped into four areas: (1) acute ventilatory failure; (2) impending ventilatory failure; (3) _______________; and (4) prophylactic ventilatory support.

Question 22

_______________ = PAO₂ - PaO₂

Question 23

The three considerations in which mechanical ventilation should be terminated or should not be started are based on (1) patient's informed request, (2) _______________, and (3) reduction or termination of patient pain and suffering.

Question 24

Prospective studies of patient outcome during mechanical ventilation indicate that hazards and complications are related to (1) _______________, (2) patient condition, (3) ventilator and artificial airway, and (4) medical professionals.

Question 25

_______________ is the term used to describe lung tissue injury or rupture that results from the shearing force of alveolar overdistention.

Question 26

How is MIP measured?

Question 27

What are the five main goals of mechanical ventilation?

Question 28

How do changes in flow rate and tidal volume affect I time, E time, and I:E ratio?

Question 29

What are the five steps to determine circuit compressible volume?

Question 30

Explain why COPD patients benefit from a reduced tidal volume setting.