Exam 12: Methods to Improve Ventilation in Patient-Ventilator Management

During mechanical ventilation of a patient with COPD,the PₐCO₂ = 58 mm Hg and the minute ventilation = 5.5 L/min.The desired PₐCO₂ for this patient is 45 mm Hg.To what should the minute ventilation be changed?

Which of the following is the normal ratio of dead space to tidal volume (VD/Vᴛ)?

During a closed suctioning procedure,the patient's heart rate changes from 95 to 58 beats/min.The respiratory therapist should take what immediate action?

Which of the following ventilator graphics could be used to assess the response to bronchodilator therapy for a patient receiving mechanical ventilation with VC-CMV? 1)Pressure-time scalar 2)Flow-time scalar 3)Pressure-volume loop 4)Volume-time scalar

A male patient (83-kg IBW)is intubated and ventilated with PC-CMV,f = 12/min,set PIP = 28 cm H₂O,resulting in a Vᴛ of 430 mL.The ABG results on this setting are: pH 7.35,PₐCO₂ 45 mm Hg,and HCO₃⁻ 23 mEq/L.Forty-eight hours later on the same settings,the ABG results are: pH 7.54,PₐCO₂ 27 mm Hg,and HCO₃⁻ 21 mEq/L with an exhaled Vᴛ of 800 mL.The most appropriate action at this time is which of the following?

If respiratory acidosis persists after alveolar ventilation of a patient has been increased,which of the following could be the cause?

When using an SVN or pMDI with NPPV,where in the NPPV circuit should the device be placed to obtain the greatest aerosol deposition?

Common causes of respiratory alkalosis include which of the following? 1)Mechanical ventilation 2)Anxiety 3)Hyperventilation 4)Parenchymal lung disease

A suction catheter long enough to reach a mainstem bronchus should be what length?

Advantages of closed suctioning include which of the following? 1)No need to prehyperoxygenate or posthyperoxygenate. 2)No need to prehyperventilate or posthyperventilate. 3)Decreased risk of infection for caregiver. 4)No loss of PEEP during the procedure.

What effect does positive-pressure ventilation have on fluid balance?

In which of the following situations should iatrogenic hyperventilation be considered?

A patient diagnosed with sepsis who is being mechanically ventilated has a combined minute ventilation of 25 L/min with a PₐCO₂ of 38 mm Hg.The reason for these findings is most likely which of the following? 1)Increased $\dot V$ CO₂ 2)Decreased $\dot V$ CO₂ 3)Increased VD/Vᴛ 4)Decreased VD/Vᴛ

Which of the following can cause metabolic acidosis?

A male patient (76-kg IBW)with no history of pulmonary disease is brought to the emergency department for treatment of a drug overdose.He is intubated and placed on mechanical ventilation with VC-CMV,f = 12/min,Vᴛ = 450 mL.The resulting arterial blood gas values are: pH 7.32,PₐCO₂ 53 mm Hg,and HCO₃⁻ 25 mEq/L.The most appropriate action to correct the acid-base disturbance is which of the following?

Permissive hypercapnia could benefit patients with which of the following?

What size suction catheter is appropriate for use in a patient with a 7-mm ET tube?

The average tidal volume range in an individual with no pulmonary problems is which of the following?

Which of the following is recommended when administering aerosols to mechanically ventilated patients with a small-volume nebulizer?

A patient with pneumonia and underlying COPD is being mechanically ventilated in the VC-CMV mode with Vᴛ 650 mL.The resulting PₐCO₂ is 62 mm Hg.What change should be made to the Vᴛ to obtain a desired PₐCO₂ of 50 mm Hg for this patient?