“Top Twenty” Session Review for Mechanical Ventilation Concepts What you should remember from the Fall… RET 2264C-12

Question # 1 What happens to Alveolar PCO2, PO2 and, Arterial pH, PCO2, PO2 as spontaneous Alveolar Ventilation drops from 4.2L/min to 3L/min? What happens to Alveolar PCO2, PO2 and, Arterial pH, PCO2, PO2 as spontaneous Alveolar Ventilation drops from 4.2L/min to 3L/min?

Please make your selection PaCO 2 ↑s, pH ↓s, PaO 2 ↓s 2. PaO 2 ↑s ; pH does not Δ 3. pH ↑s, PaCO 2 ↓s 4. SvO2 ↑s

Remember the Basics

Question # 2 All of the following are controls for PCV mode used in Pediatric Ventilation except? All of the following are controls for PCV mode used in Pediatric Ventilation except?

Please make your selection Tidal Volume 2. Inspiratory Time 3. Peak Airway Pressure 4. Expiratory Time or f

Question # 3 What is the best indicator of appropriate alveolar Ventilation for a Mechanically Ventilated Pt.? What is the best indicator of appropriate alveolar Ventilation for a Mechanically Ventilated Pt.?

Please make your selection PaCO 2 2. PaO 2 3. pH 4. SaO2

Question # 4 Define Lung Compliance using appropriate units: Define Lung Compliance using appropriate units:

Please make your selection mm Hg/ liter/sec. 2. cm H 2 O / liter/ sec. 3. ml /cm H 2 O 4. cm H2O/ liter

Question # 5 Airways resistance is defined as _____? Airways resistance is defined as _____?

Please make your selection PIP - PEEP 2. PIP + Ppl Flow / PIP PIP- Ppl / Flow

Question # 6 How is the delivered tidal volume determined for a premature neonate requiring mech. vent. ?

Please make your selection Compliance & Raw 2. Tidal Volume Control ml/kg 4. CXR

Question # 7 What controls are used to decrease the PaCO2 on a pediatric pt using Mechanical Ventilation with PCV? All of the following are appropriate except? What controls are used to decrease the PaCO2 on a pediatric pt using Mechanical Ventilation with PCV? All of the following are appropriate except?

Please make your selection Increase FIO 2 2. Increase T I 3. Increase PIP 4. Increase f 15

Question # 8 Managing Oxygenation is a more complex issue than managing Alveolar Ventilation. Primary Ventilator Controls for oxygenation include all of the following except?

Please make your selection FIO 2 2. PEEP 3. MAP 4. Sensitivity

Question # 9 What is significant about distribution of tidal volume and with a positive pressure breath?

Please make your selection As FRC increases distribution of ventilation increases 2. The Supine position enhances bi- basilar compliance 3. As Peak flow increases Raw decreases 4. Compliance increases in the dependent lung segments

Question # 10 TITI + TETE = ?

Please make your selection I:E ratio 2. TCT 3. f 4. PIP

Question # 11 Identify the appropriate Press/Time waveform for pt. trigger of the mechanical breath: Identify the appropriate Press/Time waveform for pt. trigger of the mechanical breath:

Please make your selection A 2. B 3. C 4. D

Question # 12 Identify the appropriate Press/Time waveform for Ppl of the mechanical breath: Identify the appropriate Press/Time waveform for Ppl of the mechanical breath:

Please make your selection A 2. B 3. C 4. D

Question # 13 Identify the appropriate Press/Time waveform for the cycling transition of the mechanical breath: Identify the appropriate Press/Time waveform for the cycling transition of the mechanical breath:

Please make your selection A 2. B 3. C 4. D

Question # 14 Identify the appropriate adjustment to increase if “Auto peep” is detected when analyzing the Flow scalar: Identify the appropriate adjustment to increase if “Auto peep” is detected when analyzing the Flow scalar:

Please make your selection Tidal Volume 2. T I 3. Expiratory Time 4. PIP

Question # 15 Identify what is meant by the term control panel (or user interface). How does this feature vary from older to more modern ventilators? Identify what is meant by the term control panel (or user interface). How does this feature vary from older to more modern ventilators?

Please make your selection Newer Ventilators include a CRT screen with active controls and wave form displays 2. Newer vents may have closed circuit logic enabling adjustments of control variables 3. Newer ventilators are capable of multiple waveform 4. All of the above are correct

Question # 16 Consider the three control variables for M.V. Which control is used predominantly for adult mechanical ventilation? Consider the three control variables for M.V. Which control is used predominantly for adult mechanical ventilation?

Please make your selection Flow Control 2. Pressure Support 3. Volume Control 4. Pressure Control

Question # 17 Consider the three control variables for M.V. Which control is used predominantly for neonatal mechanical ventilation? Consider the three control variables for M.V. Which control is used predominantly for neonatal mechanical ventilation?

Please make your selection Flow Control 2. Pressure Support 3. Volume Control 4. Pressure Control

Question # 18 Which of the following assessments, made at the bedside, is not appropriate to determine if Mechanical Ventilation is indicated? Which of the following assessments, made at the bedside, is not appropriate to determine if Mechanical Ventilation is indicated?

Please make your selection Maximum Inspiratory Pressure or NIF 2. ABG’s 3. Cyanotic Index 4. Vital Capacity

Question # 19 The Rapid Shallow Breathing Index (RSBI) is used in Clinic to evaluate a pt’s ability to maintain spontaneous ventilation. What is measured by this index? The Rapid Shallow Breathing Index (RSBI) is used in Clinic to evaluate a pt’s ability to maintain spontaneous ventilation. What is measured by this index?

Please make your selection Maximum Inspiratory Pressure or NIF 2. SaO 2 / PaO 2 3. f/V T ratio 4. A-a DO 2

Question # 20 All of the following are primary objectives of Mechanical Ventilation except: All of the following are primary objectives of Mechanical Ventilation except:

Please make your selection Reduce the WOB in Hypoxemic R.F. 2. Improve Alveolar Ventilation in Hypercapnic R.F. 3. Reverse Metabolic Acidosis 4. Improve Oxygenation

Next let’s begin to understand the basis for the Basic Modes of Ventilation