Complex Care Pre course Study Guide Exam
Questions and Verified for Accuracy Answers
2024/2025
Tidal Volume - correct answer The normal volume (ml) of air displaced b/t normal inhalation &
exhalation
Based on pt's sex & ideal body wt
Normal: ~10ml/kg
Too much volume can cause volutrama-titrate for lung compliance/respiratory issue (COPD
8ml/kg which ARDS use 6)
PEEP - correct answer Positive End Expiratory Pressure: pressure in the lungs (above
atmospheric pressure) that exists at the end of expiration (cmh2o)
Helps in alveolar recruitment & prevents atelectasis
Why is PEEP important? - correct answer If PEEP is at zero lugs will collapse, keeping open
helps with alveolar recruitment.
Too high causes barotrauma and can put pressure on heart that decr venous blood return
Normal ~5, maximum of 15
Fio2 - correct answer Fraction of inspired oxygen, titrated to spo2 & pao2 on ABG
Normal=40%.0.4
Too much can lead to oxygen toxicity
Flow Rate - correct answer Speed with which tidal volume is delivered
Inspiratory:Expiratory Ratio - correct answer I:E
Normal is 1:2, expiration is longer
Noncompliant lungs may need longer inspiration
,Sensitivity - correct answer The amount of effort a pt must generate to trigger the ventilator to
deliver a breath (r/t pressure changes)
Plateau Pressure - correct answer Measurement of pressure applied to alveoli during positive
pressure ventilation (measured during inspiratory pause)
Peak Inspiratory Pressure - correct answer PIP
Highest airway pressure reached during inspiration
*Not a setting, just measurement
Minute Ventilation - correct answer RR x Tidal volume
AC Ventilation - correct answer Assist Control
Ventilator is set to deliver a breath according to parameters from operator
4 settings: rate, tidal volume, PEEP & fio2
Pt can initiate additional breaths
PSV Ventilation - correct answer Pressure Support Ventilation
Spontaneous mode-pt initiates every breath while ventilator provides support
3 Settings: pip, PEEP & fio2
Good to prevent barotrauma & ween pts from vent
Ventilator Low Pressure Alarms - correct answer Circuit may be disconnected-air being blown
into room
ETT could have moved or been dislodged
Ventilator High Pressure Alarms - correct answer Circuit is blocked d/t secretions/mucus
pulling or pt biting down on tube
Pt is "asynchronous" w/ the vent
Ventilator Invasive Complications - correct answer Bronchospasm, laryngeal bleeding, trauma
to vocal cords or tongue, loss of teeth, infection (VAP)
, Preventing Ventilator Associated Pneumonia (VAP) - correct answer HOB >30 degrees
Daily sedation vacation & spontaneous breathing trial
GI & DVT prophylaxis
Frequent oral care w/ chlorhexidine-q2 + oral suctioning
+ Handwashing
+Used subglottic suction as needed
ARDS - correct answer Acute Respiratory Distress Syndrome
Lung injury of acute onset w/i 1 wk of insult
Bilat opacities on CXR not explained by other pathology
Non-cardiogenic resp failure (no heart failure or hypervolemia)
Decr pao2/fio2 ratio (no matter how much O2 given, pao@ remains the same
ARDS Classic Signs - correct answer Refractory hypoxemia-sao2 unresponsive to O2 support
"White-out" on chest scans
"Stiff-lung"-non compliant
Pulmonary hypertension
ARDS Pathophys - correct answer Interaction & amplification of mediated
(immune/inflammatory) response systems
Caused by direct or indirect injury
Issues: permeability defect, changes to caliber of small airways, injury to pulmonary circulation,
problems w/ transport & utilization of O2 at cellular level
V & Q issue
Direct causes ARDS - correct answer Trauma, near drowning, aspiration, burns (smoke
inhalation)
Indirect causes ARDS - correct answer Secondary to other DZ process-urosepsis, pancreatitis,
drug OD
Questions and Verified for Accuracy Answers
2024/2025
Tidal Volume - correct answer The normal volume (ml) of air displaced b/t normal inhalation &
exhalation
Based on pt's sex & ideal body wt
Normal: ~10ml/kg
Too much volume can cause volutrama-titrate for lung compliance/respiratory issue (COPD
8ml/kg which ARDS use 6)
PEEP - correct answer Positive End Expiratory Pressure: pressure in the lungs (above
atmospheric pressure) that exists at the end of expiration (cmh2o)
Helps in alveolar recruitment & prevents atelectasis
Why is PEEP important? - correct answer If PEEP is at zero lugs will collapse, keeping open
helps with alveolar recruitment.
Too high causes barotrauma and can put pressure on heart that decr venous blood return
Normal ~5, maximum of 15
Fio2 - correct answer Fraction of inspired oxygen, titrated to spo2 & pao2 on ABG
Normal=40%.0.4
Too much can lead to oxygen toxicity
Flow Rate - correct answer Speed with which tidal volume is delivered
Inspiratory:Expiratory Ratio - correct answer I:E
Normal is 1:2, expiration is longer
Noncompliant lungs may need longer inspiration
,Sensitivity - correct answer The amount of effort a pt must generate to trigger the ventilator to
deliver a breath (r/t pressure changes)
Plateau Pressure - correct answer Measurement of pressure applied to alveoli during positive
pressure ventilation (measured during inspiratory pause)
Peak Inspiratory Pressure - correct answer PIP
Highest airway pressure reached during inspiration
*Not a setting, just measurement
Minute Ventilation - correct answer RR x Tidal volume
AC Ventilation - correct answer Assist Control
Ventilator is set to deliver a breath according to parameters from operator
4 settings: rate, tidal volume, PEEP & fio2
Pt can initiate additional breaths
PSV Ventilation - correct answer Pressure Support Ventilation
Spontaneous mode-pt initiates every breath while ventilator provides support
3 Settings: pip, PEEP & fio2
Good to prevent barotrauma & ween pts from vent
Ventilator Low Pressure Alarms - correct answer Circuit may be disconnected-air being blown
into room
ETT could have moved or been dislodged
Ventilator High Pressure Alarms - correct answer Circuit is blocked d/t secretions/mucus
pulling or pt biting down on tube
Pt is "asynchronous" w/ the vent
Ventilator Invasive Complications - correct answer Bronchospasm, laryngeal bleeding, trauma
to vocal cords or tongue, loss of teeth, infection (VAP)
, Preventing Ventilator Associated Pneumonia (VAP) - correct answer HOB >30 degrees
Daily sedation vacation & spontaneous breathing trial
GI & DVT prophylaxis
Frequent oral care w/ chlorhexidine-q2 + oral suctioning
+ Handwashing
+Used subglottic suction as needed
ARDS - correct answer Acute Respiratory Distress Syndrome
Lung injury of acute onset w/i 1 wk of insult
Bilat opacities on CXR not explained by other pathology
Non-cardiogenic resp failure (no heart failure or hypervolemia)
Decr pao2/fio2 ratio (no matter how much O2 given, pao@ remains the same
ARDS Classic Signs - correct answer Refractory hypoxemia-sao2 unresponsive to O2 support
"White-out" on chest scans
"Stiff-lung"-non compliant
Pulmonary hypertension
ARDS Pathophys - correct answer Interaction & amplification of mediated
(immune/inflammatory) response systems
Caused by direct or indirect injury
Issues: permeability defect, changes to caliber of small airways, injury to pulmonary circulation,
problems w/ transport & utilization of O2 at cellular level
V & Q issue
Direct causes ARDS - correct answer Trauma, near drowning, aspiration, burns (smoke
inhalation)
Indirect causes ARDS - correct answer Secondary to other DZ process-urosepsis, pancreatitis,
drug OD
