Med Surg III Exam 2: Mechanical Ventilation Questions
With Complete Solutions
What are common causes of a low tidal volume / minute
ventilation alarm (4)?
♡ Disconnection
♡ Leak in circuit
♡ Change in patient condition
♡ Loss of airway
What are common causes when the ventilator is inoperable
(3)?
♡ Unplugged
♡ Malfunction
♡ Battery low/out
What are common causes of a low-pressure ventilator alarm
(3)?
♡ Disconnection
♡ Loss of airway
♡ Cuff leak
,What is high-frequency oscillatory ventilation (HFOV) and
when is it used?
A specialized ventilator mode that delivers very small tidal
volumes at extremely rapid rates
Recruits lung volume and decreases shunting
Commonly used in pediatrics
What are key components of airway hygiene for ventilated
patients?
Oral care
Chlorhexidine swabs every 4 hours
Brush teeth and tongue every 12 hours
What is inhaled nitric oxide and what is it used for?
A selective pulmonary vasodilator gas
Causes pulmonary vasodilation when inhaled
Indication: pulmonary hypertension
Use in ARDS (also diagnostic screening tool for pulmonary
hypertension during cardiac catheterization, and during or after
cardiac surgery)
What is epoprostenol (Flolan) and what is it used for?
,A prostacyclin analog (potent vasodilator and platelet inhibitor)
Provides pulmonary vasodilation
Usually inhaled, can also be given IV
Indication: pulmonary hypertension
What is prone positioning and what are its benefits?
A therapy where patient is placed on their stomach face-down to
improve lung function.
Improves lung recruitment
Decreases weight of mediastinum on lungs
Gravity moves fluid out of dependent (distal) areas
What is Extracorporeal Membrane Oxygenation (ECMO)
and what are the two types?
A life support technique where blood is oxygenated outside the
body and returned. Involves partially removing blood from
patient with large-bore catheters, infusing O2, removingCO2,
and returning blood back to the patient.
Requires systemic anticoagulation
VA (veno-arterial): supports both heart and lungs
VV (veno-venous): supports lungs only
What are common complications of mechanical ventilation?
, VAP (Ventilator-Associated Pneumonia)
Cardiac: High PEEP → ↓ CO & venous return
Pulmonary: Barotrauma (pressure), Volutrauma (volume)
Ventilation issues: Hypo/hyperventilation (vent settings)
Renal: Na & H₂O imbalance from ↓ renal perfusion
Neuro: ↑ intrathoracic pressure → ↓ venous drainage → ↑ ICP
GI: Stress ulcers, constipation, reliance on tube feeds
MSK: Deconditioning from immobility
Psychosocial: Communication barriers, condition-related stress
Equipment: Disconnection/malfunction → bag patient if in
doubt
What are key ventilator safety considerations with alarms?
High pressure alarm: Common, often from patient coughing
→ Nurse: assess and suction if needed
Low pressure alarm: May mean patient disconnected from
ventilator → Nurse: reconnect immediately
If unsure and patient in resp distress: Ventilate with Ambu
bag and call for help
What are indicators a patient is ready for weaning?
Cause of failure reversed
Adequate oxygenation
With Complete Solutions
What are common causes of a low tidal volume / minute
ventilation alarm (4)?
♡ Disconnection
♡ Leak in circuit
♡ Change in patient condition
♡ Loss of airway
What are common causes when the ventilator is inoperable
(3)?
♡ Unplugged
♡ Malfunction
♡ Battery low/out
What are common causes of a low-pressure ventilator alarm
(3)?
♡ Disconnection
♡ Loss of airway
♡ Cuff leak
,What is high-frequency oscillatory ventilation (HFOV) and
when is it used?
A specialized ventilator mode that delivers very small tidal
volumes at extremely rapid rates
Recruits lung volume and decreases shunting
Commonly used in pediatrics
What are key components of airway hygiene for ventilated
patients?
Oral care
Chlorhexidine swabs every 4 hours
Brush teeth and tongue every 12 hours
What is inhaled nitric oxide and what is it used for?
A selective pulmonary vasodilator gas
Causes pulmonary vasodilation when inhaled
Indication: pulmonary hypertension
Use in ARDS (also diagnostic screening tool for pulmonary
hypertension during cardiac catheterization, and during or after
cardiac surgery)
What is epoprostenol (Flolan) and what is it used for?
,A prostacyclin analog (potent vasodilator and platelet inhibitor)
Provides pulmonary vasodilation
Usually inhaled, can also be given IV
Indication: pulmonary hypertension
What is prone positioning and what are its benefits?
A therapy where patient is placed on their stomach face-down to
improve lung function.
Improves lung recruitment
Decreases weight of mediastinum on lungs
Gravity moves fluid out of dependent (distal) areas
What is Extracorporeal Membrane Oxygenation (ECMO)
and what are the two types?
A life support technique where blood is oxygenated outside the
body and returned. Involves partially removing blood from
patient with large-bore catheters, infusing O2, removingCO2,
and returning blood back to the patient.
Requires systemic anticoagulation
VA (veno-arterial): supports both heart and lungs
VV (veno-venous): supports lungs only
What are common complications of mechanical ventilation?
, VAP (Ventilator-Associated Pneumonia)
Cardiac: High PEEP → ↓ CO & venous return
Pulmonary: Barotrauma (pressure), Volutrauma (volume)
Ventilation issues: Hypo/hyperventilation (vent settings)
Renal: Na & H₂O imbalance from ↓ renal perfusion
Neuro: ↑ intrathoracic pressure → ↓ venous drainage → ↑ ICP
GI: Stress ulcers, constipation, reliance on tube feeds
MSK: Deconditioning from immobility
Psychosocial: Communication barriers, condition-related stress
Equipment: Disconnection/malfunction → bag patient if in
doubt
What are key ventilator safety considerations with alarms?
High pressure alarm: Common, often from patient coughing
→ Nurse: assess and suction if needed
Low pressure alarm: May mean patient disconnected from
ventilator → Nurse: reconnect immediately
If unsure and patient in resp distress: Ventilate with Ambu
bag and call for help
What are indicators a patient is ready for weaning?
Cause of failure reversed
Adequate oxygenation
