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Mechanical Ventilation: Key Questions and Answers for Respiratory Care, Exams of Nursing

Aims Community CollegeNursing

A set of questions and answers on mechanical ventilation, covering pip ranges, ventilator modes (volume, pressure controlled), minute ventilation, and alarm management. It addresses interventions to decrease delirium, weaning, and complications. This resource enhances understanding of mechanical ventilation in clinical practice, valuable for healthcare professionals and students in respiratory therapy and critical care. It includes practical scenarios and calculations, such as determining minute ventilation and adjusting ventilator settings. It also covers patient care, such as oral care, sedation vacations, and family education. The questions promote critical thinking and problem-solving skills for managing patients on mechanical ventilation. The content is relevant for theoretical understanding and practical application.

Typology: Exams

2024/2025

Available from 06/08/2025

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NUR 2016: MECHANICAL VENTILATION TEST 2 QUESTIONS
WITH CORRECT ANSWERS
1) What is a normal PIP range? -- Answer โœ”โœ” 20-30 cm H20 (the higher the number
the less compliant the lungs, the harder the vent has to push the tidal volume in)
2) What PIP range has been shown to increase lung injury? -- Answer โœ”โœ” Upper 30s-
40s
3) What are the modes on a ventilator? -- Answer โœ”โœ” Volume controlled, pressure
controlled, time-cycled, pressure support/synchronized intermittent mechanical
ventilation
4) What is the volume controlled mode on a ventilator? -- Answer โœ”โœ” A set rate and
volume. (Works well for most pts but not ideal for super sick pts)
5) How do you know you need to switch the ventilator mode from volume controlled
to pressure controlled? -- Answer โœ”โœ” If you keep getting high PIPs.
6) What is the pressure controlled mode on a ventilator? -- Answer โœ”โœ” Removes the
set volume but you still have a set rate and set PIP. Will only allow however much
volume the lungs can tolerate.
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Download Mechanical Ventilation: Key Questions and Answers for Respiratory Care and more Exams Nursing in PDF only on Docsity!

NUR 2016: MECHANICAL VENTILATION TEST 2 QUESTIONS

WITH CORRECT ANSWERS

  1. What is a normal PIP range? -- Answer โœ”โœ” 20 - 30 cm H20 (the higher the number the less compliant the lungs, the harder the vent has to push the tidal volume in)
  2. What PIP range has been shown to increase lung injury? -- Answer โœ”โœ” Upper 30s- 40s
  3. What are the modes on a ventilator? -- Answer โœ”โœ” Volume controlled, pressure controlled, time-cycled, pressure support/synchronized intermittent mechanical ventilation
  4. What is the volume controlled mode on a ventilator? -- Answer โœ”โœ” A set rate and volume. (Works well for most pts but not ideal for super sick pts)
  5. How do you know you need to switch the ventilator mode from volume controlled to pressure controlled? -- Answer โœ”โœ” If you keep getting high PIPs.
  6. What is the pressure controlled mode on a ventilator? -- Answer โœ”โœ” Removes the set volume but you still have a set rate and set PIP. Will only allow however much volume the lungs can tolerate.
  1. What is minute ventilation? -- Answer โœ”โœ” The volume of gas inhaled and exhaled in a minute. Respiratory rate x tidal volume
  2. What is the normal range for minute ventilation? -- Answer โœ”โœ” 4 - 8 L/min
  3. What does it mean if the patient has a minute ventilation of over 8 L/min? -- Answer โœ”โœ” You are hyperventilating the patient
  4. What does it mean if the patient has a minute ventilation of less than 4 L/min? -- Answer โœ”โœ” You are hypoventilating the patient
  5. If your patient has a respiratory rate of 18 and a tidal volume of 450, what is their minute ventilation? What is your assessment of their minute ventilation? -- Answer โœ”โœ” 8,100 = 8.1 L/min. This means we are hyperventilating the patient.
  6. If your patient has a respiratory rate of 18 and a tidal volume of 240, what is their minute ventilation? What is your assessment of their minute ventilation? -- Answer โœ”โœ” 4,320 = 4.32 L/min. This is a good minute ventilation.
  7. If your patient has a rate of 18 and a tidal volume of 180, what is their minute ventilation? What is your assessment of their minute ventilation? -- Answer โœ”โœ” 3,240 = 3.24 L/min. We are hypoventilating the patient.
  8. If your patient is on a pressure control mode on the ventilator and their minute ventilation is too low, what setting needs to be changed on the vent? -- Answer โœ”โœ” The rate
  9. You have a patient on the volume controlled ventilator mode. You checked on him in the morning and his PIP was 27 cm H2O. You come back and check on him in the afternoon and his PIP shows 38 cm H2O.
  1. What can cause a high pressure alarm on a ventilator? -- Answer โœ”โœ” May be caused by mucus plug, obstruction, pt biting on tube, coughing, the patient getting sicker and their lungs are getting less compliant.
  2. What are low volume alarms on a ventilator? -- Answer โœ”โœ” Alarming because not enough volume is coming back through the ventilator from the patient.
  3. What can cause a low volume alarm on a ventilator? -- Answer โœ”โœ” Air leak, disconnection, ET tube not in place, balloon is deflated (air is coming out of mouth instead of vent)
  4. Why can mechanical ventilation decrease cardiac output? -- Answer โœ”โœ” Large volumes of air being pushed into the lungs decreases the room within the chest for the heart to relax and fill thus decreasing the stroke volume and cardiac output.
  5. What are the symptoms of decreased cardiac output related to mechanical ventilation? -- Answer โœ”โœ” Elevated CVP, fluid backing up in the lungs, (pre-renal kidney injury) high potassium, high creatinine and BUN, low GFR, low urine, (GI) decreased peristalsis, ileus, necrosis leading to sepsis
  6. What is included in the vent bundle? -- Answer โœ”โœ” Hob > 30 degrees, Q4hr oral care (minimum), DVT prophylaxis, PUP (peptic ulcer prevention), daily sedation vacation
  7. What medications are typically used for peptic ulcer prevention? -- Answer โœ”โœ” Famotidine (Pepcid) or pantoprazole (protonix)
  8. What is a sedation vacation and how often should it be done? -- Answer โœ”โœ” Lightening sedation to let the patient wake up. Q 12 hours
  1. You have a patient on a ventilator who is due for their Q 4 hour oral care. What all does their oral care include? -- Answer โœ”โœ” Tooth brush, chlorhexidine impregnated swabs, oral rinses, suctioning (do not just use a swab and call it a day!)
  2. You have a patient on a ventilator. What interventions can you do to help decrease their delirium and recover faster? -- Answer โœ”โœ” Mimic day/night cycles โ€” turn of lights at night time, turn them on and open curtains during the day. Sedation vacation once a shift. Get them moving!! Passive range of motion or sit them up. Don't overstimulate pt when they are relaxed.
  3. A "sedation vacation" is also known as...? -- Answer โœ”โœ” Spontaneous awakening trial (SAT) or spontaneous breathing trail (SBT)
  4. Spontaneous Awakening Trial (SAT) and spontaneous breathing trail (SBT) is done on what ventilator setting? -- Answer โœ”โœ” Pressure support
  5. How do you know if a patient is able to come off the ventilator? -- Answer โœ”โœ” They have stable vitals and they are able to maintain their minute ventilation
  6. What is the rapid shallow breathing index? -- Answer โœ”โœ” The RR to tidal volume ratio. A calculation the RT will do to see if the patient may be successfully extubated.
  7. What is a good rapid shallow breathing index? -- Answer โœ”โœ” Less than 105
  8. You have a patient on a ventilator. Their family has been coming to visit a lot and is very noisy. They are constantly touching and shaking the patient. What should you educate the family on? -- Answer โœ”โœ” Do not shake, constantly touch, or be loud to the patient. Constant pressure like holding their hand is okay. The patient needs their rest/lower stimulation in order to heal.
  1. True or false: A patient cannot breath under the set rate on a ventilator. -- Answer โœ”โœ” True (but they can breathe over)
  2. What is the A or C stand for in the upper right hand corner of the ventilator screen? -- Answer โœ”โœ” A stands for assisting, the patient initiated their own breath and the vent is just helping. C stands for controlled, the vent is doing all of the work.
  3. On the ventilator screen, the bottom shows the ____. -- Answer โœ”โœ” Settings.
  4. On the ventilator screen, the top shows the....? -- Answer โœ”โœ” Real time patient data
  5. What is tidal volume on a ventilator? -- Answer โœ”โœ” A setting of how much air will go into the patient with each breath. (Ex. 400 mL of air with every breath.)
  6. What is FiO2 on a ventilator? -- Answer โœ”โœ” A setting of how much oxygen concentration the patient is receiving.
  7. True or false: The FiO2 shows you active feedback on the ventilator monitor. -- Answer โœ”โœ” False
  8. What is FiO2 typically set to on a ventilator? -- Answer โœ”โœ” No less than 35% but up to 100%
  9. What does PEEP stand for? -- Answer โœ”โœ” positive end expiratory pressure
  10. What is positive end expiratory pressure (PEEP)? -- Answer โœ”โœ” The amount of positive pressure that stays in the lungs after expiration.
  11. True or false: The positive end expiratory pressure (PEEP) shows you active feedback on the monitor. -- Answer โœ”โœ” False
  1. Why is positive end expiratory pressure (PEEP) important? -- Answer โœ”โœ” It recruits more alveoli to open up and to stay open.
  2. Positive end expiratory pressure (PEEP) is a setting on the ventilator that should never be set lower than ___ cm h2o. -- Answer โœ”โœ” 5.
  3. How do you know that the positive end expiratory pressure (PEEP) setting needs to be adjusted? -- Answer โœ”โœ” If the PaO2 is low, we're turning up the oxygen and nothing is happening, we probably need to turn up the peep to open up more alveoli.
  4. What occurs with higher positive end expiratory pressure (PEEP)? -- Answer โœ”โœ” The higher the peep, the more damage you are causing to the lungs. (The higher the peep, the sicker the pt)
  5. What is peak inspiratory pressure (PIP) on a ventilator? -- Answer โœ”โœ” How hard the ventilator had to push to get the set volume (tidal volume) of air in. It tells us how compliant the lungs are.
  6. True or false: The peak inspiratory pressure (PIP) shows you active feedback on the monitor. -- Answer โœ”โœ” True
  7. What makes lung less compliant? -- Answer โœ”โœ” Injuries and age
  8. The less compliant the lungs, the ___ the peak inspiratory pressure (PIP) -- Answer โœ”โœ” Higher
  9. What are the complications of higher peak inspiratory pressure (PIP)? -- Answer โœ”โœ” Barotrauma and volutrauma