exam 1

Question 1

what is the significance of the lower inflection point?

Answer 1

useful in determining optimal PEEP

Question 2

what ventilator changes could be made to over-distention?

Answer 2

Increase I-time

Question 3

If a patient has a PaO2 level of 62 the patient is exhibiting what level of hypoemxia?

Answer 3

mild

Question 4

the normal range for alveolar partial pressure of oxygen (PAO2) is what?

Answer 4

100-673 torr

Question 5

what are the indications for PEEP?

Answer 5

bilateral infiltrates on the CXR, recurrent atelectasis with low FRC, PaO2 <60 torr on FiO2 >0.6, refectory hypoxemia

Question 6

how do you know if optimum PEEP is being used?

Answer 6

highest level of ESC, highest cardiac output, lowest VD/VT level

Question 7

what is a contraindication for PEEP?

Answer 7

High ICP

Question 8

what is the equation when wanting to obtain a certain PaCO2? (finding what VT would be used)

Answer 8

Known PaCO2 x Known VT/Desired PaCO2

Question 9

what are the causes of Resp Alkalosis?

Answer 9

pain and anxiety, CNS disorders, Medications that stimulate ventilation, Hyperventilation

Question 10

What is the equation to figure out deadspace to VT ratio?

Answer 10

PaCO- PeCO/PaCO

Question 11

what should you monitor while suctioning the patient?

Answer 11

HR and Rhythm, SpO2 and color, General Appearance, RR

Question 12

What is the purpose of a HiLo Evac tube?

Answer 12

provides continuous suction above the cuff to clear secretions

Question 13

what is an indication bronchodilator therapy was effective?

Answer 13

there is an increase in peak expiratory flow rate, there is a reduction in PIP, auto-PEEP (if present) and transairway pressure

Question 14

what statements regarding permissive hypercapnia are accurate?

Answer 14

pH levels are allowed to fall to 7.2-7.25, PaCO2 levels are allowed to raise to 50-100, Supplemental O2 likely to be required

Question 15

what statements regarding closed suction caths are true?

Answer 15

they decrease the risk of hypoxemia, alveolar collapse
they decrease the risk of developing VAP

Question 16

what is the purpose of flexible fiberoptic bronchoscopy?

Answer 16

to visualize upper and lower resp tract

Question 17

what is an contraindications of prone positioning?

Answer 17

spinal cord injury

Question 18

what is the purpose of prone positioning a patient?

Answer 18

increase oxygenation

Question 19

if a patient has a unilateral lung disease what is the best position to place them in to optimize oxygenation?

Answer 19

positioning the healthy lung side down

Question 20

green, foul smelling sputum is an indicative of what?

Answer 20

pseudomonas

Question 21

your patient is putting 10 ml/hr of urine out, what type of output is this?

Answer 21

oliguria

Question 22

VAP is associated with what?

Answer 22

increased length of stay, increased healthcare cost, increased mortality rates

Question 23

an injury that occurs at the alveolar level in the lung when a patient is being ventilated is called?

Answer 23

ventilator induced lung injury

Question 24

what interventions are useful in prevention of VAP?

Answer 24

elevate the head of the bed, proper placement if feeding tube, peptic ulcer prophylaxis, sedation vacation, deep vein thrombosis prophylaxis

Question 25

which of the following actions would result in an increased mean airway pressure?

Answer 25

long I-time, PIP of 40, increase in VT, use of 20 of PEEP

Question 26

how do you calculate the cerebral perfusion pressure?

Answer 26

systolic BP + (2 X Diastolic BP)/3 this answer - ICP????

Question 27

what mode can prolong the weening process?

Answer 27

SIMV

Question 28

which of the following lab results are useful in evaluation of renal function?

Answer 28

BUN, Serum electrolytes

Question 29

what conditions increase barotrauma?

Answer 29

High PEEP, aspiration of gastric fluid, ALI/ARDS, high peak airway pressure, bullous lung disease

Question 30

if pressure support ventilation is used to wean patient from mechanical ventilation, at what PSV level should patient be extubated?

Answer 30

5

Question 31

what methods are used to correct PEEP?

Answer 31

decrease I-time decrease RR

Question 32

how is WOB evaluated?

Answer 32

esophageal pressure, airway pressure, flow

Question 33

what are the advantages of automatic tube compensation?

Answer 33

support or overcome imposed WOB caused by the end tube, to improve patient-ventilator synchrony, reduce air trapping since the resistance to expiratory flow is decreased, improve patient comfort

Question 34

which of the following criteria must be met prior to putting patient on spontaneous breathing trial?

Answer 34

a partial or complete reversal of underlying lung condition, patient is hemodynamically stable

Question 35

which of the following measurements evaluates the patients ventilatory rate?

Answer 35

P0.01