Anesthesia machine 5

Question 1

The piston ventilator (select 2):
a. relies on fresh gas flow coupling
b. preserves tank oxygen in the event of oxygen pipeline failure
c. allows for more precise delivery of tidal volumes
d. removes the risk of barotrauma

Answer 1

b. preserves tank oxygen in the event of oxygen pipeline failure
c. allows for more precise delivery of tidal volumes

Question 2

Piston ventilators utilize

Answer 2

an electric motor to compress a piston that generates positive pressure in the breathing circuit

Question 3

Since the piston ventilator doesn’t use a drive gas, it won’t

Answer 3

consume tank oxygen in the event of an oxygen pipeline failure

Question 4

The piston ventilator decouples

Answer 4

fresh gas flow from the ventilator

Question 5

The piston ventilator delivers a consistent tidal volume regardless of changes made in

Answer 5

the fresh gas flow, respiratory rate or the I:E ratio

Question 6

With the piston ventilator, a collapsed bag signals

Answer 6

a circuit disconnect

Question 7

What happens to the breathing bag with inspiration and expiration with a piston ventilator?

Answer 7

it inflates during inspiration and deflates during expiration

Question 8

The piston ventilator has _____ pressure relief valves

Answer 8

two

Question 9

What are the two pressure relief valves of the piston ventilator?

Answer 9

the negative pressure valve guards against negative end-expiratory pressure
the positive pressure valve guards against excessive pressure in the breathing circuit

Question 10

When does the positive pressure relief valve open in the piston ventilator?

Answer 10

when circuit pressure exceeds 75 +/- 5 cm H2O

Question 11

When does the negative pressure relief valve open in the piston ventilator?

Answer 11

when circuit pressure is less than -8 cmH2O

Question 12

The negative pressure relief valve protects the patient against

Answer 12

negative end-expiratory pressure

Question 13

If the negative pressure relief valve is activated in the piston ventilator, the mixing of

Answer 13

room air with fresh gas will cause a dilution of oxygen and anesthetic agents

Question 14

Describe what will happen to the bag with spontaneous breaths on the piston ventilator.

Answer 14

the bag will not move when a patient initiates spontaneous breaths while on the ventilator

Question 15

Which statement regarding pressure control ventilation is true? (choose 2)
a. the risk of ventilator-associated lung injury is decreased
b. increased lung compliance will decrease tidal volume
c. gas flow decelerates during inspiration
d. the ventilator switches to expiration after a preset pressure is achieved

Answer 15

a. the risk of ventilator-associated lung injury is decreased
c. gas flow decelerates during inspiration

Question 16

Pressure controlled ventilation reduces the risk of

Answer 16

ventilator-associated lung injury in select patients

Question 17

Pressure controlled ventilation delivers

Answer 17

a preset inspiratory pressure (with a decelerating flow pattern) over a predetermined time

Question 18

The tidal volume in pressure controlled ventilation

Answer 18

varies as a function of the patient’s compliance

Question 19

If a patient’s compliance changes when in pressure control ventilation, you must adjust

Answer 19

the ventilator settings to prevent unintended changes in minute ventilation and PaCO2

Question 20

Volume controlled ventilation delivers

Answer 20

a preset tidal volume over a predetermined time

Question 21

With volume controlled ventilation, the peak inspiratory pressure

Answer 21

will vary as a function of the patient’s compliance

Question 22

With VCV, if airway resistance rises or lung compliance decreases, then

Answer 22

the PIP will increase

Question 23

The _____________ is held constant during inspiration with VCV

Answer 23

inspiratory flow

Question 24

With PCV, if airway resistance rises or lung compliance decreases, then

Answer 24

the Vt will decrease

Question 25

What is fixed with VCV?

Answer 25

tidal volume inspiratory flow rate inspiratory time

Question 26

What is variable with VCV?

Answer 26

peak inspiratory pressure

Question 27

What is fixed with PCV?

Answer 27

peak inspiratory pressure inspiratory time

Question 28

What is variable with PCV?

Answer 28

tidal volume inspiratory flow

Question 29

PCV is useful if the patient has

Answer 29

low compliance where high PIP is dangerous or to compensate for leaks

Question 30

When you're using PCV, intraoperative events

Answer 30

can change the Vt you're delivery to the patient

Question 31

With PCV, Vt is decreased by

Answer 31

decreased compliance- pneumoperitoneum, trendelenburg position increased resistance- bronchospasm, kinked ETT

Question 32

With PCV, Vt is increased by

Answer 32

increased compliance- release of pneumoperitoneum, going from Trendelenburg to supine decreased resistance- bronchodilator therapy removing airway secretions

Question 33

Situations in which PCV is better than VCV can be broken down to these three categories:

Answer 33

patient has low compliance high PIP would be dangerous need to compensate for a leak

Question 34

When might PCV be advantageous for patients with low compliance?

Answer 34

pregnancy obesity laparoscopy ARDs

Question 35

When might PCV be advantageous for patients where PIP would be dangerous?

Answer 35

LMA neonate emphysema

Question 36

When might PCV be advantageous to compensate for a leak?

Answer 36

LMA uncuffed ETT in children

Question 37

Which modes of mechanical ventilation are BEST suited for a laryngeal mask airway? (select 2) a. synchronized intermittent mandatory ventilation b. inverse ratio ventilation c. pressure support ventilation d. controlled mandatory ventilation

Answer 37

a. synchronized intermittent mandatory ventilation c. pressure support ventilation

Question 38

No matter what mode of ventilation is used, __________________ indicates a patient triggered a breath

Answer 38

a negative deflection just before the breath

Question 39

What is controlled mandatory ventilation?

Answer 39

machine initiated breath delivers a preset Vt & RR on a fixed schedule

Question 40

Controlled mandatory ventilation does not

Answer 40

compensate for patient initiated breaths (risk of patient-ventilator asynchrony)

Question 41

Controlled mandatory ventilation is best for

Answer 41

apneic patients

Question 42

What is assist control ventilation?

Answer 42

machine initiated breath delivers a preset Vt and RR -spontaneous breaths receives the full preset tidal volume

Question 43

For patients on assist control ventilation, a patient that over breathes the ventilator is

Answer 43

at risk for hyperventilation and respiratory alkalosis

Question 44

SIMV is useful for

Answer 44

weaning or with an LMA

Question 45

Synchronized intermittent mandatory ventilation is a

Answer 45

machine initiated breath delivers a preset Vt and RR but this mode allows the patient to breath spontaneously between machine initiated breaths

Question 46

What is PCV-VG?

Answer 46

gives the benefits of pressure control ventilation but it also guarantees a predetermined tidal volume while applying the minimum pressure required to achieve it

Question 47

What does the pro in PSV pro stand for?

Answer 47

"protect"

Question 48

When is PSV pro useful?

Answer 48

weaning or with an LMA

Question 49

PSV Pro allows

Answer 49

a spontaneously breathing patient to receive pressure-support ventilation and will convert to pressure-control ventilation if the patient becomes apneic