Exam 19: Basic Concepts of Noninvasive Positive-Pressure Ventilation

A patient has acute pulmonary edema from left-sided heart failure and acute hypoxemic respiratory failure that has not responded to conventional pharmacologic and oxygen therapy.As the next line of therapy,the respiratory therapist should recommend which of the following?

The leading cause of patient discomfort and noncompliance with NIV is which of the following?

Which of the following is the most efficient means of delivering a medicated aerosol during NIV?

A 75-year-old,5-foot,7-inch female patient with an exacerbation of COPD is placed on the following NIV settings: IPAP = 8 cm H₂O,EPAP = 4 cm H₂O,rate = 12 breaths/min,FɪO₂ = 0.3.The resulting Vᴛ is 255 mL.An arterial blood gas sample is drawn 1 hour later,and the results are: pH = 7.33,PₐCO₂ = 70 mm Hg,PₐO₂ = 58 mm Hg,HCO₃⁻ = 35 mEq/L.What action should the respiratory therapist take at this time?

A home care patient using NIV complains that when she puts on the NIV mask at night and turns on the machine,"at first the gas feels like it is punching her in the face." The patient is noncompliant with the NIV because of this.What action should the respiratory therapist take?

The variable that ends pressure support breaths from a pressure-supported breath is ______________.

A 62-year-old male patient with COPD is being seen in the pulmonary clinic for dyspnea at rest and daytime hypersomnolence.The patient has been hospitalized three times in the past year for COPD exacerbations and once for pneumonia.He currently uses 2 L/min oxygen from a concentrator all the time.The patient reports that he is able to sleep only about 2 hours each night and that he has a headache every morning.Which of the following should be recommended to the physician?

A patient in the subacute care unit is receiving NIV with a PTV system,with an IPAP of 10 cm H₂O and an EPAP of 3 cm H₂O.The patient's latest arterial blood gas values reveal an increase in the PₐCO₂.The most appropriate action to take is which of the following?

A patient with acute respiratory failure requires NIV.The patient is very dyspneic.Which of the following patient interfaces is most appropriate?

To use CPAP successfully,a patient must have which of the following?

If oxygen is bled into each of the following portable PTVs at the same rate,which of the following combinations will provide the highest oxygen concentration?

Overtightening of the headgear straps for a nasal mask may lead to which of the following?

A patient with acute cardiogenic pulmonary edema is to be placed on CPAP.What should the initial setting be?

What determines the patient's delivered tidal volume in all modes of bilevel positive-pressure ventilation?

Negative-pressure ventilators cause air to enter the lungs by increasing ______________ pressure.

NIV has just been initiated on a patient in respiratory distress with an inspiratory positive airway pressure (IPAP)of 12 cm H₂O and an end-expiratory positive airway pressure (EPAP)of 5 cm H₂O.Which of the following would indicate clinical improvement of the patient's condition? 1)Decreased respiratory rate 2)Synchronization with the ventilator 3)Decreased inspiratory muscle activity 4)Decreased arterial oxygen saturation (SₐO₂)

Patients with chronic hypoventilation disorders typically need a minimum of _________ hours of NIV to experience improved quality of life.

A patient with acute cardiogenic pulmonary edema (ACPE),as evidenced by pink,frothy secretions,arrives in the emergency department (ED)by ambulance with a nonrebreather mask (NRM)at 15 L/min.An arterial blood gas sample is drawn in the ED while the patient is on the NRM; the values are: pH = 7.50,PₐCO₂ = 28 mm Hg; PₐO₂ = 43 mm Hg; SₐO₂ = 84%; HCO₃⁻ = 24 mEq/L.After evaluating the situation,the respiratory therapist should suggest which of the following therapies?

Which of the following NIV settings produces the greatest tidal volume,with all other variables being equal (i.e.,airway resistance and lung compliance)?

NIV is considered the standard of care for the treatment of which of the following?