Deck 4: Operating Modes of Mechanical Ventilation

Question 1

Positive pressure ventilation creates a transairway pressure gradient by decreasing the alveolar pressures to a level below the airway opening pressure.

Answer 1

False

Question 2

Pressure support ventilation is a closed-loop system in which the input (set pressure) is constant and the output (flow) is variable.

Answer 2

True

Question 3

Since SIMV breaths are delivered at a frequency independent of the patient's spontaneous frequency, breath stacking may occur.

Answer 3

False

Question 4

PRVC is used primarily to achieve volume support while keeping the peak inspiratory pressure (PIP) at a lowest level possible.

Question 5

Pressure-controlled breaths are time triggered, pressure limited, and time cycled.

Question 6

Which of the following refers to how the ventilator uses a mathematical model to alter the set points to achieve a target goal?

A) set point
B) servo
C) adaptive
D) optimal

Question 7

____ is not commonly regarded as a "stand-alone" mode, rather it is applied in conjunction with other ventilator modes.

A) PSV
B) PEEP
C) CPAP
D) CMV

Question 8

Complications and hazards associated with PEEP include decreased venous return and cardiac output, barotrauma, increased intracranial pressure, and alterations of ____.

A) neurologic functions and hyperventilation
B) gastrointesinal functions
C) hepatic functions
D) renal functions and water metabolism

Question 9

Although each patient is different, a PEEP greater than ____ cm H₂O is associated with an increased incidence of alveolar rupture or barotrauma.

A) 10
B) 15
C) 20
D) 25

Question 10

____ appears to be of value in preventing intubation of the end-stage COPD patient and in supporting patients with chronic ventilatory failure.

A) CPAP
B) SIMV
C) VAPS
D) BiPAP

Question 11

Which of the following should only be used when the patient is properly medicated with a combination of sedatives, respiratory depressants, and neuromuscular blockers?

A) controlled mandatory ventilation
B) mandatory minute ventilation
C) proportional assist ventilation
D) inverse ratio ventilation

Question 12

When using synchronized IMV, ____.

A) every breath is time triggered
B) breaths are patient triggered
C) breaths are pressure or flow triggered
D) mandatory breaths may be either time triggered or patient triggered

Question 13

Which of the following is especially useful in preventing hypoventilation and respiratory acidosis in the final stages of weaning with SIMV when the patient's spontaneous breathing is assuming a significant portion of the total minute volume?

A) PRVC
B) MMV
C) VV+
D) PAV

Question 14

____ uses the Otis equation to calculate the optimal frequency that corresponds with the lowest work of breathing.

A) ASV
B) BiPAP
C) CMV
D) IRV

Question 15

The advantage of ____ is its ability to track changes in breathing effort over time.

A) mandatory minute ventilation
B) pressure support ventilation
C) assist control
D) proportional assist ventilation

Question 16

During VS, the ventilator frequency and ____ are determined by the triggering effort of the patient.

A) tidal volume
B) inspiratory time
C) minute ventilation
D) respiratory rate

Question 17

Which of the following is a characteristic of the airway pressure release ventilation mode?

A) Each breath delivers a mechanical tidal volume.
B) The mandatory breaths are volume cycled.
C) The breaths are patient-triggered.
D) Time-triggered mandatory breaths will continue in this mode and the patient is allowed to breathe spontaneously between mandatory breaths.

Question 18

In conventional mechanical ventilation, the I time is traditionally lower than the E time so that the I:E ratio ranges from about 1:1.5 to ____.

A) 1:2
B) 1:2.5
C) 1:3
D) 1:4

Question 19

In HFOV, ventilation can be increased by ____.

A) decreasing inspiratory time
B) decreasing the amplitude of the oscillations
C) decreasing bias flow
D) decreasing the oscillation frequency.

Question 20

Volume ventilation plus is an option that combines two different dual mode breath types: _______________.

A) volume control plus and pressure support
B) volume-assured pressure support and volume support
C) volume control plus and volume support
D) volume-assured pressure support and pressure support

Question 21

Regardless of which operating mode is selected, modern ventilators should achieve four main goals: provide adequate ventilation and oxygenation, avoid ventilator-induced lung injury, provide patient-ventilator synchrony, and allow successful _______________ from mechanical ventilation.

Question 22

_______________ ventilation is a safety feature incorporated with the spontaneous breathing mode.

Question 23

The indications for CPAP are essentially the same as for PEEP with the additional requirement that the patient must have adequate lung functions that can sustain _______________ ventilation documented by the PaCO₂.

Question 24

_______________ incorporates pressure support ventilation with conventional volume-assisted cycles to provide stable tidal volume in patients with irregular breathing patterns.

Question 25

Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation in which the patient's electrical activity of the _______________ is used to guide the optimal functions of the ventilator.

Question 26

Discuss the disadvantages and complications associated with the iron lung type of negative pressure ventilator.

Question 27

What are the three major indications for PEEP?

Question 28

Explain the advantages of AC mode.

Question 29

Why are pressure-supported breaths considered spontaneous?

Question 30

What are the adverse effects of IRV?