Mechanical ventilation Exam 2 Questions with
Answers 100% Correct
What symptoms may indicate NPPV? ✔✔ - paradoxal breathing
- RR >28
- use of accessory muscles
Mechanical Dead space ✔✔ anything that coming out of the exhalation side of the tubing on
machine
To normalize PCO2 ✔✔ adjust RR & Vt
To normalize PO2 ✔✔ adjust FiO2 & Paw
A female with ideal body weight 55kg. In ventilatory failure because of drug overdose
pH: 7.31 PCO2: 68 PO2: 59 HCO3: 24
what VT, mode, rr, fiO2, and peep would you set? ✔✔ Vt: 220-440
mode: AC
RR: 10-20 bpm
FiO2: 40-60%
PEEP: 3-5 cmH2O
A male patient in the emergency room having increased WOB, decreased BS with diffused
wheezing and hight 5'5".
4L N/C
pH: 7.29 PaCO2: 68 PaO2:62 HCO3: 32
,what Vt, mode, RR, FIO2,and PEEP would you set? ✔✔ Vt: 248-496mL
Mode: A/C or SIMV
RR: 10-20 bpm
FiO2: 36% (4l n/c)
PEEP: 3-5 cm H2O
I:E ration for asthma , head trauma, and COPD ✔✔ use a shorter I-time and longer E-time
I:E ration for ARDS ✔✔ use longer I-time and shorter E-time
Hazards of permissive hyoercapnia ✔✔ - elevated CO2 and love pH and affect:
-skeletal smooth muscle function
- nervous system activity
- renal function
- may decrease blood flow
What is purpose of Inflation hold? ✔✔ - keep alveoli open at end inspiration
- provides optimum V/Q matching
- reduse dead space to Vt ratios
When adjusting the flow rate control to a higher setting, what happens to I-time and to the E-
time ✔✔ I- time: shortens
E-time: lengths
When alveolar ventilation is increased, what happens to PaCO2? ✔✔ decreases
, Describe a clinical situation that would increase NIV not trigger from (EPAP) to (IPAP) or cycle
IPAP to EPAP? ✔✔ When IPAP and EPAP are equal, or set at the same setting, the ventilator
does not deliver a timed or spontaneously triggered breath. The pressure remains constant in
the circuit at the set pressure, supplying CPAP.
What are the issues that lead to patient noncompliance with NIV, and how can they be
alleviated? ✔✔ Drying of the nasal mucosa can be prevented with use of a heated humidifier;
improper interfaces that allow leakage can be avoided by ensuring that the mask is not too
large; and skin irritation from tight straps may be prevented by minimizing headgear tension as
much as possible and using forehead spacers.
The most appropriate type of humidifier to use with NIV is which of the following?
a)wick-type humidifier
b)heat moisture exchanger
c) heat bubble humidifier
d) heated pass over- type humidifier ✔✔ d) heated pass over- type humidifier
A patient with chronic hypercapnic respiratory failure is currently using NIV on one night, with
following parameters: assist mode, IPAP: 9 cmH2O, EPAP: 4 cmH2O. The patient is noted to be
short of breath a spontaneous rate 25 bpm. The action that will alleviate this problem which of
the following?
a)switch to control mode
b) increase the IPAP to 35%
c) decrease the EPAP to 2 cmH2O
d) increase the IPAP to 11 cmH2O ✔✔ d) increase the IPAP to 11 cmH2O
AN increase in the peak inspirationy flow rate would increase which of the following?
a) tidal volume
b) total cycle time
Answers 100% Correct
What symptoms may indicate NPPV? ✔✔ - paradoxal breathing
- RR >28
- use of accessory muscles
Mechanical Dead space ✔✔ anything that coming out of the exhalation side of the tubing on
machine
To normalize PCO2 ✔✔ adjust RR & Vt
To normalize PO2 ✔✔ adjust FiO2 & Paw
A female with ideal body weight 55kg. In ventilatory failure because of drug overdose
pH: 7.31 PCO2: 68 PO2: 59 HCO3: 24
what VT, mode, rr, fiO2, and peep would you set? ✔✔ Vt: 220-440
mode: AC
RR: 10-20 bpm
FiO2: 40-60%
PEEP: 3-5 cmH2O
A male patient in the emergency room having increased WOB, decreased BS with diffused
wheezing and hight 5'5".
4L N/C
pH: 7.29 PaCO2: 68 PaO2:62 HCO3: 32
,what Vt, mode, RR, FIO2,and PEEP would you set? ✔✔ Vt: 248-496mL
Mode: A/C or SIMV
RR: 10-20 bpm
FiO2: 36% (4l n/c)
PEEP: 3-5 cm H2O
I:E ration for asthma , head trauma, and COPD ✔✔ use a shorter I-time and longer E-time
I:E ration for ARDS ✔✔ use longer I-time and shorter E-time
Hazards of permissive hyoercapnia ✔✔ - elevated CO2 and love pH and affect:
-skeletal smooth muscle function
- nervous system activity
- renal function
- may decrease blood flow
What is purpose of Inflation hold? ✔✔ - keep alveoli open at end inspiration
- provides optimum V/Q matching
- reduse dead space to Vt ratios
When adjusting the flow rate control to a higher setting, what happens to I-time and to the E-
time ✔✔ I- time: shortens
E-time: lengths
When alveolar ventilation is increased, what happens to PaCO2? ✔✔ decreases
, Describe a clinical situation that would increase NIV not trigger from (EPAP) to (IPAP) or cycle
IPAP to EPAP? ✔✔ When IPAP and EPAP are equal, or set at the same setting, the ventilator
does not deliver a timed or spontaneously triggered breath. The pressure remains constant in
the circuit at the set pressure, supplying CPAP.
What are the issues that lead to patient noncompliance with NIV, and how can they be
alleviated? ✔✔ Drying of the nasal mucosa can be prevented with use of a heated humidifier;
improper interfaces that allow leakage can be avoided by ensuring that the mask is not too
large; and skin irritation from tight straps may be prevented by minimizing headgear tension as
much as possible and using forehead spacers.
The most appropriate type of humidifier to use with NIV is which of the following?
a)wick-type humidifier
b)heat moisture exchanger
c) heat bubble humidifier
d) heated pass over- type humidifier ✔✔ d) heated pass over- type humidifier
A patient with chronic hypercapnic respiratory failure is currently using NIV on one night, with
following parameters: assist mode, IPAP: 9 cmH2O, EPAP: 4 cmH2O. The patient is noted to be
short of breath a spontaneous rate 25 bpm. The action that will alleviate this problem which of
the following?
a)switch to control mode
b) increase the IPAP to 35%
c) decrease the EPAP to 2 cmH2O
d) increase the IPAP to 11 cmH2O ✔✔ d) increase the IPAP to 11 cmH2O
AN increase in the peak inspirationy flow rate would increase which of the following?
a) tidal volume
b) total cycle time
