MV2 Ch 21 Flashcards

1
Q

A VAI patient has expressed the desire to be able to speak. The most appropriate speaking device to use in line with this ventilator patient is which of the following?

A. Voice TT
B. Passy-Muir
C. Portex Speaking TT
D. Pittsburg Talking TT

A

B. Passy-Muir

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2
Q

A VAI patient with a TT is having a trial of cuff deflation to allow for speech. The patient’s voice is weak and he can speak only 2 or 3 words with each exhalation. The RT could adjust which vent setting to improve the patient’s speech?

  1. Expiratory time
  2. Inspiratory time
  3. Volume
  4. PEEP
A

2 and 4

  1. Inspiratory time
  2. PEEP
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3
Q

A VAI with amyotrophic lateral sclerosis and a TT is unable to clear secretions from his airway. Which of the following should be considered to manage this patient’s airway clearance problem.

  1. Manual chest percussion and TT suctioning
  2. Autogenic drainage and postural drainage
  3. Positive expiratory pressure
  4. Mechanical insufflation-exsufflation (MI-E)
A

1 and 4

  1. Manual chest percussion and TT suctioning
  2. Mechanical insufflation-exsufflation (MI-E)
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4
Q

A minimum of _____ days should be allowed to obtain insurance verification and authorization and to procure equipment before a ventilated patient is transferred home from the acute care hospital.

A. 3-5
B. 7-14
C. 10-16
D. 21-30

A

B. 7-14

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5
Q

A patient with a TT is being discharged home with a ventilator, which he uses only during the night, without supplemental oxygen. During the day he uses a speaking valve. Which of the following equipment must he have in his home?

  1. Suctioning equipment
  2. Oxygen concentrator
  3. Second mechanical ventilator
  4. Manual resuscitator bag
A

1 and 4

  1. Suctioning equipment
  2. Manual resuscitator bag
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6
Q

A patient with muscular dystrophy currently receiving ventilatory support with vc imv is being prepared for discharge home. The case manager asks the RT to recommend a ventilator that will meet the patient’s needs with the least complexity and at the lowest cost. The RT should recommend which of the following ventilators?

A. PLV 102
B. LP 6 PLUS
C. LTV 1000
D. Life are PLV 100

A

C. LTV 1000

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7
Q

A patient with which condition is a suitable candidate for home care ventilation?

A. Flail chest due to trauma
B. Amyotrophic lateral sclerosis
C. Severe exacerbation of asthma
D. ARDS

A

B. Amyotrophic lateral sclerosis

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8
Q

A quadriplegic partner is getting ready for discharge home from an acute care hospital. He has a TT and requires MV around the clock, but not supplemental O2. What equipment must he have in his home?

  1. Transport vent
  2. Manual resuscitator bag
  3. E cylinder of O2
  4. Vent circuits
A

1, 2 and 4

  1. Transport vent
  2. Manual resuscitator bag
  3. Vent circuits
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9
Q

During an education session with the family of a ventilator assisted individual who is being prepared for discharge home, the RT explains ventilator circuit/suction equipment disinfection. Which of the following is an important instruction that should be part of this teaching?

A. A white vinegar/distilled water mix can be reused as a disinfectant solution.
B. Water for humidifiers can be taken directly from the tap
C. Suction catheters and plastic containers must be changed after 8 hour
D. Medicare will reimburse for all the disposable supplies needed for the vent

A

C. Suction catheters and plastic containers must be changed after 8 hours

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10
Q

List the potential locations for patients requiring long term ventilatory care in order of cost from most expensive to least expensive.

  1. Patients home
  2. Long term acute care
  3. Intensive care or acute care unit
  4. Extended care facility
A

3, 2,4, 1

  1. Intensive care or acute care unit
  2. Long term acute care
  3. Extended care facility
  4. Patients home
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11
Q

One of the goals of long term MV in the home or alternative care site is which of the following?

A. Premit lung healing
B. Reduce hospitalizations
C. Relieve respiratory distress
D. Improve pulmonary gad exchange

A

B. Reduce hospitalizations

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12
Q

The American college of chest physicians considers long ventilator assisted patients to be those who require mechanical ventilation for at least ____ hours per day for ____ days or more.

A. 4; 7
B. 6; 14
C. 6; 21
D. 8; 21

A

C. 6 ;21

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13
Q

The appropriate power source for a wheelchair mounted ventilator is which of the following?

A. AC current
B. Pneumatic
C. Internal DC battery
D. External DC battery

A

D. External DC battery

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14
Q

The most important factors to consider when choosing a ventilator for home use include which of the following?

  1. Sophistication
  2. Reliability
  3. Versatility
  4. Cost
A

2, 3, and 4

  1. Reliability
  2. Versatility
  3. Cost
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15
Q

The preferred location for ventilator dependent patients is ___________.

A. A skilled nursing facility
B. A subacute care unit
C. Their own homes
D. A long term acute care hospital

A

C. Their own homes

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16
Q

What pressure range may be necessary to achieve a sufficient VT using a chest cutlass?

A. -10 to -20 cmh20
B. -25 to -50 cmh20
C. -35 to -60 cmh20
D. -50 to -75 cmh20

A

C. -35 to -60 cmH2O

17
Q

Which of the following is an essential step the RT must perform when setting up a speaking valve for a ventilator assisted individual?

A. Turn up the required flow to 6-8 L/min
B. Make sure the cuff is inflated before applying the valve
C. Make sure the cuff is deflated before applying the valve
D. Place the speaking valve in a 22 mm corrugated tube

A

C. Make sure the cuff is deflated

18
Q

Which of the following modes do the first generation portable home care ventilators use?

  1. VC CMV
  2. PSV
  3. VC IMV
  4. PC IMV
A

1 and 3

  1. VC CMV
  2. VC IMV
19
Q

Which of the following ventilator requirements for a ventilator assisted individual demonstrates clinical stability and indicated that the patient most likely is ready for discharge home from an acute care hospital?

A. PC CMV f=14 PIP= 30 PEEP= 10 FiO2= 0.5
B. VC SIMV f=8 Vt=400 PS=5 PEEP= 5 FiO2= 0.3
C. VC CMV f=12 Vt= 600 PEEP= 8 FiO2= 0.6
D. PC IMV f= 10 PIP= 25 PS= 10 PEEP= 10 FiO2= 0.8

A

B. VC SIMV f=8 Vt=400 PS=5 PEEP= 5 FiO2= 0.3

20
Q

Which site for MV of patients provides the least patient independence and quality of life?

A. ICU
B. Skilled nursing facility
C. Long term care hospital
D. Chronic assisted ventilator unit

A

A. ICU

21
Q

A patient recently been diagnosed with OSA. The most appropriate treatment includes which of the following?

A. PSV
B. NPPV
C. CPAP
D. PC CMV

A

C. CPAP

22
Q

A patient who requires prolonged ventilatory support should not be considered permanently ventilator dependent until ____ months has/have passed and all weaning attempts during that time have failed.

A. 1
B. 3
C. 6
D. 9

A

B. 3