Student Clinical Knowledge Evaluation 2

Question 1

IPPB: Indications (3)

Answer 1

1. To improve lung expansion (VC < 10 ml/kg, neuromuscular, atelectasis)
2. Short term noninvasive vent support
3. Deliver medications

Question 2

IPPB: Hazards/Complications/Precautions (7)

Answer 2

1. Hyperventilation and respiratory alkalosis
2. Bronchospasms
3. Barotrauma
4. Discomfort (inadequate pain control)
5. Fatigue
6. Gastric Distention
7. Hemodynamic compromise (CO, VR)

Question 3

IPPB: Preliminary Settings/Instructions

Answer 3

15-15-15 Verbalize instructions for passive treatment - Relax, place mouthpiece between your teeth, inhale just to trigger on the machine, relax and let the machine fill your lungs. Once your lungs are full hold your breath for 5 seconds. When the machine shuts off exhale normally.

Question 4

IPPB: Troubleshooting an IPPB Treatment (2)

Answer 4

1. Sluggish needle (increase flow).
2. Inspiratory does not terminate (Check for leaks).

Question 5

EzPAP: Indications (4)

Answer 5

1. Prevent or treat atelectasis
2. Dec air trapping
3. Mobilize secretions
4. Optimize med delivery

Question 6

EzPAP: Hazards/Complications/Precautions (7)

Answer 6

1. Hyperventilation and respiratory alkalosis
2. Bronchospasm
3. Barotrauma
4. Discomfort (Inadequate pain control)
5. Fatigue
6. Gastric Distention
7. Hemodynamic Compromise (CO,VR)

Question 7

CPT: Indications (4)

Answer 7

1. Mobilize secretions (>25 ml/day)
2. Remove soft foreign bodies
3. Atelectasis from mucus plugging
4. Improve V/Q by turning

Question 8

CPT: Hazards/Complications/Precautions (4)

Answer 8

1. Hypoxemia
2. Vomiting and aspiration
3. Pain/injury to ribs
4. Increased ICP

Question 9

BiPAP: Indications (4)

Answer 9

1. Avoid intubation
2. relieve symptoms
3. Improve gas exchange
4. Improve QOL

Question 10

BiPAP: Hazards/Complications/Precautions (4)

Answer 10

1. Barotrauma from pressures
2. Facial soreness
3. Decreased VR, CO
4. Hypo/Hyperventilation

Question 11

ABG: Indications (4)

Answer 11

1. Evaluate PaCO2 and A/B balance
2. Assess response to tx
3. Monitor severity of disease
4. Recent SOB

Question 12

ABG: Hazards/Complications/Precautions (4)

Answer 12

1. Arteriospasm
2. Hemorrhage
3. Trauma
4. Pain, infection

Question 13

ABG: List Normal Values (pH, CO2, O2, HCO3)

Answer 13

1. pH = 7.35 - 7.45
2. CO2 = 35 - 45
3. O2 = 80 - 100
4. HCO3 = 22-26

Question 14

Mechanical Ventilation: Indications (4)

Answer 14

1. IVF (VC < 10mL/kg, MIP > 20cmH2O, RSBI > 105,
   VT < 5mL/kg, RR > 35, VE > 10L)
2. AVF (pH < 7.20, PACO2 > 55, Apnea
3. Prophylactic (CHI, Smoke Abd/Thoracic surg)
4. Severe Oxygenation Issues (P/F < 200, P(A-a)O2 on 100% O2 > 350, PaO2 < 60 on > 50%)

Question 15

Mechanical Ventilation: Hazards/Complications/Precautions (3)

Answer 15

1. Decreased CO, VR, and urine output, decreased gastrointestinal and liver perfusion and function
2. Increased ICP
3. Barotrauma from pressures

Question 16

Tidal Volume Settings: Normal and ARDS

Answer 16

Normal: Vt 6 -8 ml/kg
ARDS: Vt 4 -8 ml/kg

Question 17

Types of Ventilation/Presets and Varied

Answer 17

1. Volume: Preset Volume & Rate, Pressures vary
2. Pressure: Preset Pressure & Rate, Volumes vary

Question 18

Ventilation Terms
1. Trigger
2. Cycle
3. Limit

Answer 18

1. Trigger: Initiates the breath
2. Cycle: Ends the inspiratory breath - can be pressure, volume, flow, time
3. Limit: Stops the inspiration early - can be pressure, volume, flow, time