CRT/RRT TMC REVIEW/ TUTORIAL
SYSTEMS GUIDE EXAM QUESTIONS
WITH COMPLETE SOLUTIONS
Pulmonary artery pressure - ANSWER-25/8 mmhg at rest, 14 mean
30 mmhg during exercise is a sign of HTN
Pulmonary Capillary Wedge Pressure (PCWP) - ANSWER-4-12 mmHg, left heart
failure, mitral valve stenosis, congestive heart failure (CHF)
cardiogenic pulmonary edema - ANSWER-Result of any condition that causes CHF.
Alveoli fill. Heart failure, cariogenic shock, increased bp & aspiration. Will show an
increase in PAP and PCWP
noncardiogenic pulmonary edema - ANSWER-"acute respiratory distress syndrome",
resulting from destruction of capillary beds that allows fluid to leak out, will show an
increase in PCP and normal PCWP.
capnography - ANSWER-A non-invasive method to quickly and efficiently provide
information on a patient's ventilatory status, circulation, and metabolism; effectively
measures the concentration of carbon dioxide in expired air over time.
Vital Capacity (VC) - ANSWER-PFT test done to determine and evaluate a restrictive
disease
forced expiratory volume - ANSWER-PFT flow test to determine and evaluate an
obstructive disease.
Decreased lung volumes indicates - ANSWER-a restrictive lung disease resulting in a
decreased lung compliance and distensibility.
decreased flow indicates - ANSWER-Obstructive diseases result in PFT studies,
showing an increase in airway resistance.
Methocholine Test - ANSWER-Gold standard for diagnosing Asthma, considered
positive if 20% of the threshold was reached after administration of a low dosage of
methocholine.
Thorpe Tube - ANSWER-Only accurate in the upright position
Attached to 50psig source
Preset pressure reducing valve
Bedside station outlet
, -variable orifice, constant pressure flow metering device.
-Key component is a tapered transparent tube with a float
Diameter increase from bottom to top
-Gas flow suspends the float against the force of gravity.
-Reading flow: Compare float position to an adjacent calibrated scale.
Normally L/min
-Compared to a bourdon gauge (which measures pressure) a Thorp tube measure flow.
-Float rises, more room (like increasing the orifice) for flow to get through thus higher
flow
Bourdon gauge - ANSWER-Good for patient transport
Measures high pressures (cylinder pressures)
Gauge pressure measure the pressure relative to atmospheric pressure NOT the
absolute pressure.
sweat chloride test - ANSWER-a test to measure the amount of chloride in the sweat by
stimulating the skin to produce a large amount of sweat that is then absorbed by a
special filter paper and analyzed for chloride content
Levels
Children - >60 mEq/L
Adults - >80 mEq/L
VC/ AC modes - ANSWER-A full preset volume is delivered on all breaths
VC-SIMV - ANSWER-Mandatory, Assisted and Spontaneous. Full preset Tidal volume,
with varying volume based on patient effort.
Peep - ANSWER-positive end-expiratory pressure - common mechanical ventilator
setting in which airway pressure is maintained above atmospheric pressure PaO2 < 50-
60 mmHg, FiO2> 40-50
Primary indication for Mechanical Ventilation - ANSWER-hypercapnic respiratory failure,
aka ventilator failure, MV will improve VE and thus VA (most important part) by which
PaCO2 will be normalized. Hypopoxemic Respiratory failure
Determining VT in pressure ventilation - ANSWER-6-8 ml/kg IBW w/ starting rates 12-
16 breathes per min.
Peak Inspiratory Pressure (PIP) - ANSWER-Maximum pressure measured during one
respiratory cycle, usually at end-inspiration.
20-25 cm H2O
A PIP > 25 cm H2O can contribute to barotruama
SYSTEMS GUIDE EXAM QUESTIONS
WITH COMPLETE SOLUTIONS
Pulmonary artery pressure - ANSWER-25/8 mmhg at rest, 14 mean
30 mmhg during exercise is a sign of HTN
Pulmonary Capillary Wedge Pressure (PCWP) - ANSWER-4-12 mmHg, left heart
failure, mitral valve stenosis, congestive heart failure (CHF)
cardiogenic pulmonary edema - ANSWER-Result of any condition that causes CHF.
Alveoli fill. Heart failure, cariogenic shock, increased bp & aspiration. Will show an
increase in PAP and PCWP
noncardiogenic pulmonary edema - ANSWER-"acute respiratory distress syndrome",
resulting from destruction of capillary beds that allows fluid to leak out, will show an
increase in PCP and normal PCWP.
capnography - ANSWER-A non-invasive method to quickly and efficiently provide
information on a patient's ventilatory status, circulation, and metabolism; effectively
measures the concentration of carbon dioxide in expired air over time.
Vital Capacity (VC) - ANSWER-PFT test done to determine and evaluate a restrictive
disease
forced expiratory volume - ANSWER-PFT flow test to determine and evaluate an
obstructive disease.
Decreased lung volumes indicates - ANSWER-a restrictive lung disease resulting in a
decreased lung compliance and distensibility.
decreased flow indicates - ANSWER-Obstructive diseases result in PFT studies,
showing an increase in airway resistance.
Methocholine Test - ANSWER-Gold standard for diagnosing Asthma, considered
positive if 20% of the threshold was reached after administration of a low dosage of
methocholine.
Thorpe Tube - ANSWER-Only accurate in the upright position
Attached to 50psig source
Preset pressure reducing valve
Bedside station outlet
, -variable orifice, constant pressure flow metering device.
-Key component is a tapered transparent tube with a float
Diameter increase from bottom to top
-Gas flow suspends the float against the force of gravity.
-Reading flow: Compare float position to an adjacent calibrated scale.
Normally L/min
-Compared to a bourdon gauge (which measures pressure) a Thorp tube measure flow.
-Float rises, more room (like increasing the orifice) for flow to get through thus higher
flow
Bourdon gauge - ANSWER-Good for patient transport
Measures high pressures (cylinder pressures)
Gauge pressure measure the pressure relative to atmospheric pressure NOT the
absolute pressure.
sweat chloride test - ANSWER-a test to measure the amount of chloride in the sweat by
stimulating the skin to produce a large amount of sweat that is then absorbed by a
special filter paper and analyzed for chloride content
Levels
Children - >60 mEq/L
Adults - >80 mEq/L
VC/ AC modes - ANSWER-A full preset volume is delivered on all breaths
VC-SIMV - ANSWER-Mandatory, Assisted and Spontaneous. Full preset Tidal volume,
with varying volume based on patient effort.
Peep - ANSWER-positive end-expiratory pressure - common mechanical ventilator
setting in which airway pressure is maintained above atmospheric pressure PaO2 < 50-
60 mmHg, FiO2> 40-50
Primary indication for Mechanical Ventilation - ANSWER-hypercapnic respiratory failure,
aka ventilator failure, MV will improve VE and thus VA (most important part) by which
PaCO2 will be normalized. Hypopoxemic Respiratory failure
Determining VT in pressure ventilation - ANSWER-6-8 ml/kg IBW w/ starting rates 12-
16 breathes per min.
Peak Inspiratory Pressure (PIP) - ANSWER-Maximum pressure measured during one
respiratory cycle, usually at end-inspiration.
20-25 cm H2O
A PIP > 25 cm H2O can contribute to barotruama
