Mechanical Vent Test 2
The ventilator mode that allows the patient to breathe spontaneously between operator-selected time-triggered volume and pressure-targeted breaths is which of the following?
IMV
Full ventilatory support is provided by which of the following modes?
PC-IMV, rate 12 with pressure support
The mode of ventilation that provides pressure-limited, time-cycled breaths that use a set tidal volume as a feedback control is which of the following?
PRVC (Pressure Regulated volume control)
The ventilator mode that delivers pressure breaths that are patient or time triggered, volume targeted, time cycled, and where the pressure is automatically adjusted to maintain delivery of the targeted volume is which of the following?
PRVC (Pressure Regulated volume control)
A 57-year-old, 5'3", 165 lb female patient arrives in the open heart unit following coronary artery bypass surgery. The patient has a history of diabetes and no history of pulmonary disease. The most appropriate initial VC-CMV settings are which of the following?
VT = 360 mL rate = 15 breaths/min PEEP = 5 cm H2O
A 5'2" female patient with normal lungs has been intubated and requires mechanical ventilation with volume-controlled continuous mandatory ventilation (VC-CMV). The tidal volume and ventilator rate settings that should be recommended for this patient are which of the following?
VT = 364 mL rate = 14 breaths/min
CaO2 formula
[(Hb * 1.34)(Sao2/100)] + (Pao2 * 0.0031)
A patient triggered, pressure limited, flow cycled breath describes which of the following breaths?
pressure support
When a patient is to be switched from continuous mandatory ventilation (CMV) to intermittent mandatory ventilation (IMV) to facilitate weaning from mechanical ventilation, which of the following could be used in addition to IMV to assist this process?
pressure support
The disorders that cause respiratory failure due to increased work of breathing include which of the following? 1. Myasthenia gravis 2. Cardiogenic pulmonary edema 3. Interstitial pulmonary fibrosis 4. Amyotrophic lateral sclerosis
2. Cardiogenic pulmonary edema 3. Interstitial pulmonary fibrosis
Calculate the inspiratory to expiratory (I:E) ratio for a ventilator that is set to deliver 850 mL at a frequency of 15 breaths/min with a flow rate of 45 L/min.
( (60/RR) = TCT = Ti + Te, when you use this and the formula to calculate inspiratory time, you get I:E ratio) 1:2.5
Calculate the expiratory time (TE) when the ventilator frequency is set to 25 breaths/min and the inspiratory time (TI) is 0.75 second.
((60/RR) = TCT = Ti + Te) 1.65 second
Total Cycle Time (TCT) formula
(60/RR) = TCT = Ti + Te
P/F Ratio Formula
(PaO2/FiO2) x 100
Calculate the inspiratory time (Ti) when a ventilator is set at a tidal volume (VT) of 500 mL and a constant flow rate of 30 L/min.
(Ti = Vt (in liters) / Flow (in liters per second) ) 1 second
Calculate the inspiratory time (Ti) when a ventilator is set at a tidal volume (VT) of 800 mL and a constant flow rate of 40 L/min.
(Ti = Vt (in liters) / Flow (in liters per second) ) 1.2 seconds
Calculate the average tidal volume for a patient who has a minute ventilation of 10 L/min with a respiratory rate (RR) of 12 breaths/min.
(Vt = Mve / RR (Mve has to be in mL) ) 833 mL
Calculate the inspiratory to expiratory (I:E) ratio when the inspiratory time is 0.5 second and the respiratory rate is 30 breaths/min.
(i have no idea to explain this one, sorry lol) 1:3
A patient with inadequate oxygenation of the brain may display which of the following conditions? 1. Confusion 2. Excitement 3. Somnolence 4. Compliance
1. Confusion 3. Somnolence
A 6-foot 3-inch male patient was involved in a MVC (motor vehicle crash) arrives in the ED with chest and facial injuries. Because of the nature of the facial injuries, he is intubated with a size 8.0 mm endotracheal tube. Following resuscitative measures, he is transferred to the ICU. 1. What type of ventilator support would this patient require initially? 2. What ventilator mode would you use when this patient wakes, has the desire to breathe spontaneously, and has a PaO2 of 58 mm Hg with the FIO2set at 0.50?
1. Full Ventilatory support to ensure adequate ventilation 2. PCSIMV with pressure support and PEEP
A 45-year-old woman arrives in the emergency department after ingesting an unknown quantity of pain medication and alcohol. Her friend found her unconscious in her apartment. She is currently unresponsive to verbal stimuli. Vital signs reveal: pulse 56 beats/min; respiratory rate 10 breaths/min and shallow; and BP 90/50 mm Hg. Her ABG on room air reveals: pH 7.21; PaCO2 64 mm Hg; PaO2 52 mm Hg, HCO3- 24 mEq/L. The appropriate treatment for this patient includes which of the following? 1. Naloxone hydrochloride (Narcan) 2. Nasal cannula 4 L/min 3. Nonrebreather mask 4. Intubation and ventilatory support
1. Naloxone hydrochloride (Narcan) 4. Intubation and ventilatory support
Which of the following are goals of mechanical ventilation? 1. To provide support to the pulmonary system to maintain an adequate level of alveolar ventilation 2. To reduce the WOB until the cause of respiratory failure can be eliminated 3. To restore ABG levels to normal for the patient and current condition 4. To prevent or treat atelectasis with adequate end-inspiratory lung inflation
1. To provide support to the pulmonary system to maintain an adequate level of alveolar ventilation 2. To reduce the WOB until the cause of respiratory failure can be eliminated 3. To restore ABG levels to normal for the patient and current condition 4. To prevent or treat atelectasis with adequate end-inspiratory lung inflation
A mechanically ventilated patient is going to be placed on pressure support ventilation following an acceptable spontaneous weaning trial. The patient is a 5'9" male who weighs 185 lb. During volume-controlled continuous mandatory ventilation (VC-CMV) his average peak inspiratory pressure (PIP) was about 26 cm H2O and the plateau pressure (PPlateau) was 16 cm H2O. What initial pressure support level should be set?
10 cm H2O
Partial ventilatory support can be provided by which of the following ventilator modes? 1. Pressure-controlled continuous mandatory ventilation (PC-CMV) set rate 8 breaths/min 2. Volume-controlled intermittent mandatory ventilation (VC-IMV) set rate 4 breaths/min 3. Pressure-controlled intermittent mandatory ventilation (PC-IMV) set rate 10 breaths/min 4. VC-MMV set Ve8 L/min
2. VC-IMV (Volume-controlled intermittent mandatory ventilation) set rate 4 breaths/min 4. VC-MMV set Ve8 L/min
Which of the following values are indicative of acute respiratory failure and the need for ventilatory support? 1. Maximum inspiratory pressure (MIP) = -38 cm H2O. 2. Vital capacity (VC) = 650 mL for a 70 kg male. 3. Alveolar-to-arterial partial pressure of oxygen [P(A-a)O2] = 150 on 100% oxygen. 4. Maximum expiratory pressure (MEP) = 25 cm H2O.
2. Vital capacity (VC) = 650 mL for a 70 kg male 4. Maximum expiratory pressure (MEP) = 25 cm H2O
Which of the following values are indicative of acute respiratory failure and the need for ventilatory support? 1. Maximum inspiratory pressure (MIP) = -25 cm H2O 2. Dead space to tidal volume ratio (VD/VT) = 0.4 3. Vital capacity (VC) = 8 mL/kg IBW 4. pH = 7.20
3. Vital capacity (VC) = 8 mL/kg IBW 4. pH = 7.20
What is the flow rate necessary to deliver a tidal volume (VT) of 600 mL, with a constant waveform, at a respiratory rate of 15 breaths/min with an I:E of 1:4?
45 L/min
A 47-year-old, 5'6", 112 lb female patient, is still under the effects of anesthesia following a hysterectomy. Her body temperature is 37° C. She has no history of lung disease. The appropriate initial minute ventilation for this patient is which of the following?
6.1 L/min
A 39-year-old, 5'4", 138 lb female patient requires intubation and mechanical ventilation. Her body temperature is 39° C. She has no history of lung disease. The appropriate initial minute ventilation for this patient is which of the following?
6.8 L/min
The most appropriate tidal volume setting for a 6'3" male ventilator patient with normal lungs is which of the following?
700 mL
Which of the following is the minimum ventilator rate that is considered full ventilatory support?
8 breaths/min
A 26-year-old, 6'6", 250 lb male patient, is still under the effects of anesthesia following knee surgery. His body temperature is 37° C. He has no history of lung disease. The appropriate initial minute ventilation for this patient is which of the following?
9.7 L/min
What is the ventilator mode where the optimal breathing frequency that the ventilator delivers is determined by delivering a test breath to the patient?
ASV (Adaptive support ventilation)
A patient with an opiate drug overdose is unconscious and has the following ABG results on room air: pH 7.20; PaCO2 88 mm Hg; PaO2 42 mm Hg; HCO3- 25 mEq/L. Which of the following best describes this patient's condition?
Acute hypercapnic respiratory failure
A 46-year-old male presents to the emergency department with a chief complaint of shortness of breath. Physical assessment reveals: pulse 102 beats/min, blood pressure 138/80 mm Hg, respiratory rate 25 breaths/min with accessory muscle use, and breath sounds are decreased with bilateral inspiratory and expiratory wheezing with a prolonged expiratory phase. The peak expiratory flow rate is 100 L/min. The immediate action by the respiratory therapist should include which of the following?
Administer continuous bronchodilator therapy
A 55-year-old male with acute dyspnea is admitted to the hospital. He is alert and oriented. His physical examination reveals: heart rate 120 beats/min and regular; blood pressure 146/88 mm Hg; temperature 38° C; respiratory rate 28 breaths/min shallow and labored. Breath sounds are decreased throughout with fine late crackles on inspiration, chest expansion is decreased in both bases. The patient is not coughing. The ABG on room air is: pH 7.52; PaCO2 30 mm Hg; PaO2 42 mm Hg; Hb-O2 80%; HCO3- 24 mEq/L. This patient is retired after working in a steel factory for 38 years and he has a 50-pack-year history of smoking. The most appropriate action for the respiratory therapist to take is which of the following?
Administer oxygen via a high flow nasal cannula
The underlying physiological process leading to pure hypercapnic respiratory failure is which of the following?
Alveolar hypoventilation
Hypercapnic respiratory failure due to increased work of breathing will be caused by which of the following?
Asthma exacerbation
The physician requests that the respiratory therapist make a recommendation for a patient with post polio complaints of increasing daytime weakness. Her VC is 12 mL/kg and maximal inspiratory pressure is -32 cm H2O. Her ABG on room air reveals pH 7.38, PaCO2 46 mmHg, PaO2 74 mmHg, and HCO3 24 mEq/L. The respiratory therapist should suggest which of the following?
BiPAP via nasal mask at night
A patient has recently been diagnosed with obstructive sleep apnea. The most appropriate treatment includes which of the following?
CPAP
pH 7.50, partial pressure of carbon dioxide (PaCO2) 30 mm Hg, partial pressure of oxygen (PaO2) 98 mm Hg, arterial oxygen saturation (SaO2) 100%, bicarbonate (HCO3-) 24 mEq/L. The respiratory therapist should perform which of the following?
Change the mode to VC-IMV (volume-controlled intermittent mandatory ventilation)
An 80-year-old female with a diagnosis of pneumonia was admitted to the hospital 2 days ago from a nursing home. The patient is responsive only to painful stimuli. She has a peripheral IV and a feeding tube in place. Physical examination reveals: pulse 98 beats/min; respiratory rate 24 breaths/min and shallow; blood pressure 100/48 mm Hg; and temperature 39.2° C. Auscultation reveals decreased breath sounds with crackles in the bases. The patient has an occasional weak, nonproductive cough. Arterial blood gas on NC 4 L/min is pH 7.42, PaCO2 38 mm Hg, PaO2 40 mm Hg, SaO2 76%, HCO3- 24 mEq/L. A portable chest X-ray shows patchy basilar infiltrates in both lungs. The most appropriate action to take at this time is which of the following?
Change the nasal cannula to a nonrebreather mask
The flow waveform pattern that provides the shortest inspiratory time (TI) of all the available flow patterns with an equivalent peak flow rate setting is which of the following?
Constant
A patient having an acute, severe asthma exacerbation is intubated and set up on volume-controlled continuous mandatory ventilation (VC-CMV). To ensure volume delivery at the lowest peak pressure while providing for better air distribution, which flow waveform should be used?
Descending ramp
The flow waveform pattern that is created during pressure targeted ventilation is which of the following?
Descending ramp
The flow waveform pattern that will decrease peak pressure but at the same time may increase mean airway pressure is which of the following?
Descending ramp
The pattern that has been shown to improve the distribution of gas in the lungs for an intubated patient on volume-controlled continuous mandatory ventilation (VC-CMV) is which of the following?
Descending ramp
With which flow waveform pattern will the mean airway pressure be the highest?
Descending ramp
After oxygen is administered, a patient's heart rate changes from 110 to 85 beats/min. The initial tachycardia was most likely caused by which of the following?
Hypoxemia
Tidal volume formula
Flow (L/sec!) x Ti = Vt
Respiratory failure due to inadequate ventilation is known as which of the following?
Hypercapnic
A 28-year-old man is admitted to the emergency department with suspected drug overdose. The patient is obtunded and slightly cyanotic. The ABG results obtained while the patient was breathing room air were: pH 7.24; PaCO2 58 mm Hg; PaO2 52 mm Hg; HCO3- 24 mEq/L. The most appropriate interpretation of these results is which of the following?
Hypercapnic respiratory failure
A patient, who is nasally intubated, due to facial surgery, has been successful on her spontaneous breathing trial. She currently has moderate hypoxemia, despite a fractional inspired oxygen (FIO2) of 40% and positive end-expiratory pressure (PEEP) of 5 cm H2O while on volume-controlled continuous mandatory ventilation (VC-CMV). The most appropriate ventilator mode for this patient is which of the following?
IMV with PSV and PEEP
A patient has a body temperature of 40° C. How should the initial minute ventilation setting be adjusted?
Increase it by 30%.
Setting flow rates high will cause which of the following to occur?
Increase peak airway pressures
A 64-year-old female patient having an acute exacerbation of chronic obstructive pulmonary disease (COPD) was admitted to the hospital yesterday. During rounds today the respiratory therapist finds the patient to be difficult to arouse and has the following physical findings: heart rate 102 beats/min, respiratory rate 23 breaths/min shallow and slightly labored, breath sounds are bilaterally decreased with rhonchi in both bases. The patient has a frequent but weak cough. The respiratory therapist draws an ABG with the following results on a 2 L/min nasal cannula: pH 7.52, PaCO2 30 mm Hg, PaO2 45 mm Hg, SaO2 86%, HCO3- 24 mEq/L. The most appropriate action is which of the following?
Increase the nasal cannula to 4 L/min
A 14-year-old boy who had previously been diagnosed with mild persistent asthma has a PEFR of 100 L/min. This indicates which of the following?
Increased airway resistance
A postoperative patient complaining of dyspnea is found to have tachypnea and tachycardia, and is somewhat confused. Breath sounds reveal end inspiratory crackles in both lung bases. An arterial blood gas (ABG) is drawn and reveals the following: pH 7.49; PaCO2 33 mm Hg; PaO2 51 mm Hg; SaO2 87%; HCO3- 25 mEq/L while on a 30% air entrainment mask. The most appropriate respiratory therapy intervention includes which of the following?
Initiate CPAP by mask.
A 28-year-old man with botulism poisoning is beginning to develop progressive paralysis. The respiratory therapist has been monitoring the patient's MIP and VC every 2 hours. The most recent results show that the patient continues to deteriorate: MIP = -27 cm H2O, VC = 32 mL/kg. Which of the following could be appropriately recommended?
Intubation and mechanical ventilation
A 52-year-old male with a medical history of congestive heart failure and hypertension arrives in the emergency department because of an acute onset of dyspnea. The patient has pink frothy secretions at the mouth. A rapid physical assessment reveals a pulse of 128 beats/min, respiratory rate 28 breaths/min and labored, and blood pressure 82/56 mm Hg. Bilateral coarse crackles are heard in the lung bases. Arterial blood gas results on a 12 L/min nonrebreather mask are: pH 7.32, PaCO2 49 mm Hg, PaO2 50 mm Hg, arterial SaO2 74%. The most appropriate immediate action for this patient is which of the following?
Intubation and mechanical ventilation
A patient seen in the emergency department exhibits paralysis of the lower extremities that is getting progressively worse. Vital capacity is 6 mL/kg, maximum inspiratory pressure (MIP) is -17 cm H2O, and oxygen saturation measured by pulse oximeter (SpO2) is 89%. Arterial blood gases are pending. The physician suspects Guillain-Barré syndrome. The most appropriate action at this time is which of the following?
Intubation and mechanical ventilation
The first arterial blood gas for an asthma patient in the emergency department reveals: pH 7.49; PaCO2 30; PaO2 82; SaO2 95%; HCO3- 24 on a nasal cannula 3 L/min. The patient's peak expiratory flow rate was 165 L/min, respiratory rate was 16 breaths/min, and pulse 106 beats/min. After continuous aerosolized albuterol over the past hour, the patient's current ABG results are as follows: pH 7.34; PaCO2 45; PaO2 49; SaO2 79%; HCO3- 25 on a high flow nasal cannula 15 L/min. The patient's peak expiratory flow rate is 95 L/min, respiratory rate 35 breaths/min, pulse 128 beats/min, and the patient is diaphoretic. The respiratory therapist should suggest which of the following at this time?
Intubation and mechanical ventilation
The respiratory assessment of a 44-year-old female patient diagnosed with myasthenia gravis shows: vital capacity 475 mL, maximum inspiratory pressure (MIP) -18 cm H2O. The patient is 5 feet 6 inches tall and weighs 188 lb. The most recent ABG on a 2 L/min nasal cannula is pH 7.32, PaCO2 49 mm Hg, PaO2 77 mm Hg, SaO2 95%, HCO3- 24 mEq/L. The most appropriate recommendation for this patient is which of the following?
Intubation and mechanical ventilation
What type of breath occurs when the ventilator controls the timing, tidal volume, or inspiratory pressure?
Mandatory
A 59-year-old patient is in severe respiratory distress in the emergency department. The patient is being treated for congestive heart failure and pulmonary edema. Vital signs are pulse 98 beats/min, respiratory rate 23 breaths/min, and BP 138/98 mm Hg. The patient's ABG results on a nonrebreather mask are as follows: pH 7.35; partial PaCO2 45 mm Hg; PaO2 49 mm Hg; SaO2 79%; and HCO3- 24 mEq/L. The respiratory therapy that is most appropriate at this time is which of the following?
Mask, CPAP with 100% oxygen
A 38-year-old female suffered a deceleration injury in an MVC. She is alert and oriented but in respiratory distress. A portion of the patient's right anterior chest wall is moving in a paradoxical motion. Breath sounds are decreased on the right and the trachea is midline and no pneumothorax was detected. ABG data reveal pH 7.48, PaCO2 31 mmHg, PaO2 63 mmHg, and HCO3 24 mEq/L. The respiratory therapist should recommend which of the following therapies for this patient at this time?
Mask, CPAP with supplemental oxygen
Arterial blood gas on nonrebreather mask is: pH 7.53, partial pressure of carbon dioxide (PaCO2) is 25 mm Hg, partial pressure of oxygen (PaO2) is 59 mm Hg, arterial oxygen saturation (SaO2) 93%, bicarbonate (HCO3-) 23 mEq/L. The respiratory therapist should recommend which of the following for this patient?
Mask, CPAP with supplemental oxygen
A 28-year-old male has arrived in the emergency department following a motor vehicle accident. He has a Glasgow Coma Score of 14. Chest x-ray reveals 5 ribs broken anteriorly in 2 areas each. Physical assessment reveals paradoxical movement of the chest. Breath sounds are diminished and the trachea is midline. Arterial blood gas on nonrebreathing mask is: pH 7.53, partial pressure of carbon dioxide (PaCO2) is 25 mm Hg, partial pressure of oxygen (PaO2) is 59 mm Hg, arterial oxygen saturation (SaO2) 93%, bicarbonate (HCO3-) 23 mEq/L. The respiratory therapist should recommend which of the following for this patient?
Mask, CPAP with supplemental oxygen.
The arterial blood gas on the nonrebreather mask is: pH 7.34; PCO2 46 mm Hg; partial pressure of oxygen in the arteries (PaO2) is 52 mm Hg; oxygen saturation is 86%; bicarbonate (HCO3-) is 24 mEq/L. The patient is diaphoretic. The most appropriate ventilator mode to manage this patient initially is which of the following?
NIV
Which of the following patients is showing the signs of acute respiratory distress?
One who is in the high Fowler position, diaphoretic, anxious, and unable to complete a sentence
Every breath from the ventilator is time or patient triggered, pressure limited, and time cycled. This describes which of the following ventilator modes?
PC-CMV (Pressure controlled continuos mandatory ventilation)
The ventilator mode that would be most appropriate to iatrogenically induce hyperventilation to manage a closed head injury patient with severely elevated intracranial pressure (ICP) is which of the following?
PC-CMV (Pressure controlled continuous mandatory ventilation)
A post-thoracic surgery patient currently receiving mechanical ventilation on VC-CMV with 60% oxygen has the following arterial blood gas: pH 7.45, PaCO2: 36 mmHg, PaO2: 68 mmHg. The patient's peak inspiratory pressures are averaging 55 cm H20. The ventilator mode that is most appropriate at this time is which of the following?
PC-CMV with PEEP
The pressure-time scalar shown in the figure represents which of the following? (big and small squares)
PC-IMV with PEEP
Of the following breath descriptions, which one is considered spontaneous?
Patient triggered, patient cycled, baseline pressure +5 cm H2O
An assisted breath in the pressure controlled continuous mandatory ventilation (PC-CMV) mode can be described by which of the following?
Patient triggered, pressure limited, time cycled
In which of the following situations would NIV be tried?
Patient with COPD and right lower-lobe pneumonia with respiratory acidosis and increased WOB
When changing the control variable from volume control (VC) to pressure control (PC), the initial inspiratory pressure should be set based on which of the following methods?
Plateau pressure measurement taken during VC ventilation
A dual control mode provides pressure-limited ventilation with volume delivery targeted for every breath. If the desired volume is not met the ventilator will volume cycle. This describes which of the following ventilator modes?
Pressure augmentation (Paug)
Acute hypercapnic respiratory failure may be caused by which of the following?
Respiratory muscle fatigue
Slow flow rates will cause which of the following to occur?
Shorten expiratory time
An intubated patient with chronic obstructive pulmonary disease (COPD) is breathing on pressure support ventilation (PSV) 13 cm H2O with positive end-expiratory pressure (PEEP) 5 cm H2O and a flow cycle setting of 25%. The pressure-time scalar shown in the figure is evaluated by the respiratory therapist. What action should the respiratory therapist take at this time?
The flow cycle setting should be increased to allow more time for exhalation.
A 63-year-old, 5'11", 185 lb male patient with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted to the hospital due to liver failure. Over the course of the 48 hours he has developed respiratory distress. The respiratory therapist performs a physical assessment and finds the following: heart rate 135 bpm, respiratory rate 28 with accessory muscle use. Breath sounds are decreased bilaterally with coarse crackles in the right base. A chest x-ray from 24 hours ago shows bilateral lower lobe infiltrates. The patient has a nonproductive cough. The respiratory therapist draws an arterial blood gas which reveals: pH 7.31; partial pressure of carbon dioxide (PaCO2) 57 mm Hg; partial pressure of oxygen (PaO2) 58 mm Hg; arterial oxygen saturation (SaO2) 87%; bicarbonate (HCO3-) 27 mEq/L while receiving oxygen via nasal cannula 3 L/min. The respiratory therapist should recommend which of the following for this patient?
Use BiPAP with IPAP 10 cm H2O, EPAP 5cm H2O, bleed in 4 L/min oxygen
Which mode of ventilation is shown in the pressure-time scalar in the figure?
VC-CMV
Which mode of ventilation is shown in the pressure-time scalar in the figure? (pyramids, with small squares in between)
VC-CMV with pressure support
The ventilator mode where every breath is patient triggered, pressure targeted, and flow cycled with a volume target is which of the following?
VSV (Volume support ventilation)
A patient receiving mechanical ventilation via pressure-regulated volume control (PRVC) has a set target volume of 500 mL with an upper pressure limit setting of 35 cm H2O. During the respiratory therapist's first patient ventilator system check, 25 cm H2O was needed to deliver the set volume. Several hours later the pressure to deliver the set volume is 15 cm H2O. The respiratory therapist should do which of the following?
The upper pressure limit should be reduced
A 47-year-old, 6'1" male patient is admitted to the hospital due to trauma from a motor vehicle accident. Forty-eight hours post admission, the patient is suffering from respiratory distress with severe hypoxemia and is intubated. A chest X-ray, done prior to intubation, reveals a ground glass appearance bilaterally. The physician requests the volume-controlled continuous mandatory ventilation (VC-CMV) mode for this patient. The initial settings for the ventilator should be which of the following?
VT = 450 mL rate = 18 breaths/min PEEP = 8 cm H2O
A 5'10" male patient with normal lungs has been intubated and requires mechanical ventilation with volume-controlled continuous mandatory ventilation (VC-CMV). The tidal volume and ventilator rate settings that should be recommended for this patient are which of the following?
VT = 525 mL rate = 14 breaths/min
A 65-year-old, 73-inch-tall, 195 lb male patient was admitted 2 days ago for renal failure. The patient has a history of chronic obstructive pulmonary disease (COPD) and has a pulse of 122 breaths/min, BP 153/88, and temperature 37° C. The patient is intubated for acute-on-chronic respiratory failure with hypoxemia. The physician requests volume-controlled continuous mandatory ventilation (VC-CMV). The initial settings for the ventilator should be which of the following?
VT = 700 mL rate = 12 breaths/min PEEP = 3 cm H2O
If flow or sensitivity is set incorrectly, which of the following is most likely to occur during the continuous mandatory ventilation (CMV) mode?
Ventilator dyssynchrony
A 28-year-old female was admitted last night for weakness and what appears to be ascending muscle paralysis. The patient is alert and oriented. Physical findings reveal: pulse 96 beats/min, regular; blood pressure 134/83 mm Hg; temperature 37° C; respiratory rate 24 breaths/min shallow with bilateral decrease in air entry; and no adventitious breath sounds. The patient's ABG results on room air are: pH 7.46; PaCO2 39 mm Hg; PaO2 80 mm Hg; Sat 97%; and HCO3- 26 mEq/L on room air. The most appropriate suggestion that the respiratory therapist should make for this patient includes which of the following?
Vital capacity every 2 hours
Minute ventilation equation
Vt x RR = Mve
A breath that is patient triggered, pressure targeted, and time cycled is which of the following?
assisted breath
The mode of pressure ventilation that is patient- or time-triggered and flow-cycled is which of the following?
bilevel PAP
During volume control ventilation a patient's airway resistance increases. This change will cause which of the following to occur?
increase peak airway pressures
A breath that is triggered, limited, and cycled by the mechanical ventilator is which of the following?
mandatory breath
If lung compliance decreases while a patient is receiving mechanical ventilation with pressure-controlled continuous mandatory ventilation (PC-CMV), which of the following would occur?
tidal volume decreases
A leak around a patient's ET tube cuff during pressure support ventilation (PSV) will cause which of the following to occur?
time cycle
