Ventilator Modes Practice Questions

Ventilator Modes Practice Questions:

Leave the first rating Students also studied Terms in this set (100) Science MedicinePulmonology Save TMC Mechanical Ventilation Practic...35 terms macie_dugasPreview ICU Nursing Ventilator Modes and S...25 terms ShhURsmartPreview Ventilator Waveforms & Graphics 32 terms kim_do88Preview Ventila 43 terms Sar What are 5 examples of positive pressure ventilators? CMV, A/C, IMV, SIMV, CPAP What type of pressure ventilation involves normal respirations, chest cuirass, and an iron lung?Negative pressure Positive pressure ventilators can be ____ vs ____ controlled. pressure, volume What are 2 types of nonconventional ventilation? HFOV and APRV How does PPV create transairway pressure?By increasing airway opening pressure above the alveolar pressure List the modes of positive pressure ventilation from the most support to the least support

CMV, A/C, IMV, SIMV, CPAP

What is an advantage of volume controlled mode? It ensures minimal minute ventilation.What are some disadvantages of volume controlled modes?The pressure is variable, possible barotrauma/volutrauma, volume is limited by the high pressure alarm What is an advantage of pressure limited modes? There is less risk of barotrauma What are some disadvantages of pressure controlled modes?It doesn't ensure minute ventilation; The tidal volume is variable What two things are variable on pressure controlled ventilation Volume (dependent on a set pressure) and Flow.

What are the four types of triggers?Time, patient, pressure, flow What is the control used to adjust the ventilator sensory of the patient's inspiratory effort called?Sensitivity What are the two types of sensitivity controls?Pressure and Flow How does a pressure trigger work?The ventilator senses a drop in pressure below the baseline and senses the patient's negative inspiratory effort.hich trigger type is more sensitive, pressure or flow Flow How does a flow trigger work?When a patient initiates a breath, base flow returning to the ventilator is reduced, thus triggering an inspiration.What is Controlled Mandatory Ventilation?A mode that is time-triggered, machine breath, and volume or pressure cycled.What are the indications for CMV?The need to control minute ventilation completely. Also, the need to control chest expansion completely, for example, with a patient with flail chest.What are some complications of CMV?The patient is totally ventilator dependent, alarms are essential, you may be unable to assess weaning, and seizures may interrupt the delivery of a breath What are some indications for A/C mode?The patient needs full ventilatory support, the need to support a high minute ventilation with low oxygen consumption, the need for sedation after intubation.What are some advantages of A/C mode?Decreased work of breathing. The patient controls the respiratory rate, therefore the minute ventilation.What are some complications of A/C modeHyperventilation (i.e., respiratory alkalosis), pain/anxiety/CNS disease, Biots or Cheyne-stokes respirations.Describe IMV mode?It was the first widely used mode that allowed partial ventilatory support, facilitates weaning, increase muscle strength. It is not widely used today.What are some complications of IMV?Breath stacking, which is a spontaneous effort immediately followed by a mechanical breath, which leads to an increased PIP; barotrauma; and cardiac compromise.What is barotrauma/volutrauma?A lung injury that occurs from hyperinflation of the alveoli past the rupture point.It usually occurs at a PIP > 50 and a Pplat > 35.What is the synchronization window?It is the time interval just prior to time triggering in which the ventilator is responsive to the patient's spontaneous breath.What are some indications for SIMV?If the patient needs partial ventilatory support, and if the patient can actively contribute to their minute ventilation.If the set rate is high (8-12) in SIMV mode?This can provide total support (SIMV with no spontaneous rate is essentially the same as A/C)

Setting the rate low (<8>

CPAP In this mode, the ventilator delivers a time-triggered breath and allows the patient to breathe at their own tidal volume between mechanical breaths?

IMV / SIMV

In this mode, the ventilator delivers a set tidal volume or pressure at a time-triggered rate but the patient can trigger a mechanical breath above the pre-set rate?Assist/Control In this mode of ventilation, the patient cannot trigger a mechanical or spontaneous breath so there is no negative deflection on graphics. The patient must be sedated or paralyzed. It is not as commonly used.Controlled Mandatory Ventilation (CMV) In order for this mode to be used, the patient must be spontaneously breathing, have adequate lung function to maintain normal PaCO2, and not be at risk for hypoventilation?

CPAP What does pressure support do?It augments spontaneous tidal volume, decreases spontaneous respiratory rate, and reduces the patient's work of breathing.How does pressure support decrease the patient's spontaneous respiratory rate?An increased volume decreases the need for a high respiratory rate in order to achieve the required minute ventilation. Also, it decreases deadspace ventilation.What is the desired respiratory rate?Less than 25.What is tidal volume dependent upon with a pressure support mode?It's dependent on the set inspiratory pressure, lung compliance, and airway resistance.What makes flow variable in pressure support? It's dependent upon the flow needed to maintain the plateau pressure.What would be considered CPAP with pressure support cBiPAP CPAP with no pressure support would be considered? CPAP How do you manage pressure support?Begin with 5 - 10 and increase in increments of 3 - 5.You should titrate pressure support according to what 3 things?(1) Spontaneous tidal volume of 5 - 7 ml/kg of IBW. (2) Respiratory rate of less than 25. (3) A decrease in work of breathing.

Is PEEP considered a standalone mode on ventilation? No What are some effects of PEEP?They recruit alveoli, increase FRC (oxygenation), increase alveolar surface area (gas diffusion), increase compliance.What are some complications of PEEP?Cardiac compromise, increased intrathoracic pressure, decreased venous return, decreased cardiac output and blood pressure.What is an indication for PEEP?Refractory hypoxemia How do you manage PEEP?5 is the physiologic normal setting. Then you can increase in increments of 3 - 5 while also watching the patient's blood pressure. You should decrease to the previous level or zero for to lower blood pressure. You can treat low blood pressure with volume expansion or vasopressors, then increase PEEP again while continuing to monitor.What is compliance?It is the volume change per unit of pressure.Inverse ratio ventilation is?Pressure controlled During breathing, a long inspiration and a short expiration causes what?Air trapping, auto PEEP, and prevents alveolar collapse.What is Auto-PEEP?Increased oxygenation, peep effects, increased FRC, PaO2, and surface area How does IRV prevent alveolar collapseThe critical opening pressure is reduced, the pressure needed for ventilation is less, and it improves ventilation.What are some complications of IRV?Barotrauma, requires paralysis sedation, and cardiovascular compromise When is mandatory minute ventilation activated? When the patient's spontaneous breathing is less than minimum set minute ventilation. When this occurs, the ventilator increases ventilation.The method of increased ventilation with MMV varies upon what?The ventilator model (some increase respiratory rate, some tidal volume, and some pressure support).What should the minute ventilation be set to achieve? A satisfactory PaCO2 What are some advantages of MMV?It promotes spontaneous breathing, it requires minimal support but protects against hypoventilation and respiratory acidosis, and it permits weaning but compensates for apnea.What are some disadvantages and complications of MMV?It doesn't protect against deadspace breathing. A high respiratory rate with a low tidal volume means the patient is breathing above minute ventilation (MMV remains inactive but PaCO2 increases, respiratory acidosis).What does pressure control generate?A flow in order to increase the airway pressure to a preset pressure limit.When is inspiration terminated in Pressure Control? When the preset I-Time is reached..