mech vent | ch 8

initiation of mechanical ventilation

What is are indications for mechanical ventilation:

acute ventilatory failure

impending ventilatory failure

severe hypoxemia

prophylactic ventilatory support

A patient has an admitting diagnosis of acute ventilatory failure. This condition is characterized by a PaCO2 of ___________ mmHg or greater with an accompanying respiratory __________.

50; acidosis

Impending ventilatory failure may be evaluated by trending a patient's…

respiratory parameters and mechanics

Among other criteria of assessment, impending ventilatory failure may be present when the patient's minute ventilation is __________ 10 L/min and maximum inspiratory pressure is less than_________.

more than; -20 cmH2O

the primary purposes of prophylactic mechanical ventilation include…

to minimize the risk of pulmonary complications

to reduce prolonged hypoxia of major body organs

to reduce the work of the cardiopulmonary system

A physician asks the therapist to set up a ventilator using volume-controlled mode for a 35-year-old postoperative patient who weighs 132 lbs(60kg). The therapist should use an initial tidal volume of ________ and a frequency of _______

600 mL; 12/min

A therapist is using the standard procedure to measure the compressible volume of a new ventilator circuit. the observed expired volume(mL) and peak inspiratoey pressure (cmH2O) are 150 mL and 50 cmH20, respectively. The circuit compressible evaluated is therefore…

3mL/ cmH2O

With a circuit compressible volume of 3mL/cmH2O, what would be the delivered tidal volume with an expired tidal volume of 550 mL and a peak inspiratory pressure of 30 cmH2O

460 mL

positive end-expiratory pressure(PEEP) may be indicated in pts with decreased _________ and presence of ________

functional residual capacity; refractory hypoxemia

At constant tidal volume and frequency, increasing the inspiratory flow rate will lead to a ____________ inspiratory time (I time) and __________ expiratory time (E time)

shorter; longer

What should be the minimum flow rate for a minute volume of 12 L/min and an I:E ratio of 1:4?

60 L/min

if the desired I:E ratio is 1:3, what should the I time % be

25%

the_______ and ________ are two alarms that are to detect circuit disconnection

low pressure; low volume

What are the common potential complications of positive pressure ventilation

decrease in cardiac output

Accidental patient disconnection

barotrauma

What is an example of hazards and complications of mechanical ventilation related to pressure and volume

barotrauma

What is an example of hazards and complications of mechanical ventilation related to patient condition

physical and psychologic trauma

What are examples of hazards and complications of mechanical ventilation related to equipment

circuit disconnection

What are examples of hazards and complications of mechanical ventilation related to medical professionals

Inappropriate ventilator settings

what are the goals of mechanicl ventilation

improve gas exchange

relieve respiratory distress

improve pulmonary mechanics

permit lung and airway healing

avoid complications

Acute ventilatory failure

PaCO2 greater than 50 mmHg and a decrease of pH less than 7.30

imending ventilatory failure

PaCO2 greater than 50 mmHg caused by deteriorating lung functions

prophylactic ventilatory support

Early intervention of potential ventilatory failure by means of mechanical ventilation

what does p/f ratio stand for

PaO2 / FiO2

Clinical assessment of oxygenation and degree of hypoxemia:

p/f ratio

p/f ratio of < 300mmHg indicates

ALI

p/f ratio of < 200mmHg indicates

ARDS

what does MIP stand for

maximum inspiratorwhay pressure

Does NIF stand for

negative inspiratory force

MIP(NIF)

reflects a patient’s respiratory muscle strength

Dual control mode

a combined mode between 2 control variables that are regulated by independent feedback loops so that the delivered breath switches between pressure-controlled and volume-controlled