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RES 260 Neonatal 5

RES 260 Management of Ventilation and Oxygenation

QuestionAnswer
According to the FDA, high-frequency ventilation is any form of mechanical ventilation delivering rates higher than _____ breaths per minute. 150
With a compliance of 3.6 ml/cm H20 and an airway resistance of 42 cm H20/L/sec what would be an appropriate expiratory time? 0.46 sec
Which of the following statements are true regarding extracorporeal life support (ECLS)? infants with a mortality risk of 80%. Venoarterial bypass oxygenates the blood and supports cardiac function, whereas venovenous bypass only oxygenates blood. alveolar-arterial oxygen difference, P(A-a)O2, the oxygen index may be used to determine selecti
Which of the following is the main factor that determines airway resistance? Airway radius
Which of the following aspects is an advantage to using negative-pressure ventilation over positive-pressure ventilation? Decreased risk of cardiopulmonary complications
Which of the following would indicate a failure of CPAP? PaO2 less than 50mm Hg with an FiO2 of 0.80 to 1.0 and CPAP of 10 to 12cm H2O,Marked retractions,Frequent apnea spells
6-year-old female/40 pound/being ventilated /tidal volume of 280 ml /rate 20 breaths/mm.PIP 38 cm H2O/ PEEP of 4 cm H2O.compliance of the circuit tubing is measured at 2.5 ml/cm H2O.the following accurately describes this patient's corrected tidal volume? 10.8 ml/kg
Of the following, which best describes wasted ventilation? (Points : 1) The ratio of physiologic deadspace to tidal volume.
What arterial blood gas change is most likely to be observed when the mean airway pressure is increased? Increased PaO2
The first parameter weaned from a mechanically ventilated infant should be FiO2.
Assuming an alveolar opening pressure of 23 cm H20, which of the following com¬binations of PIP and PEEP would achieve the desired compression pressure? PIP-26, PEEP-3
The respiratory care practitioner receives blood gas results on a ventilated infant. The PaCO2 is 48 mm Hg and previously it was 43 mm Hg. A proper ventilator change would be increase the rate by 5 BPM or the PIP by 2 cm H2O.
Which of the following parameters has the greatest influence on mean airway pressure? PEEP
Which of the following are clinical signs of a failure to wean? Bradycardia,Retractions,Tachycardia,Pallor
Which of the following are predictive of a low risk of the need for reintubation in the pediatric patient? Mean airway pressure of 4.0 cm H2O,PIP of 20 cm H20, VT/Ti of 16 ml/kg/sec
Which of the following statements are true regarding inhaled nitric oxide (NO)? NO can induce selective pulmonary vasodilation, max dose NO is 20(ppm),NO can combine with hemoglobin in the presence of oxygen to form methemoglobin(NO2). NO should not until FIO2 < 0.40 with a PEEP of 5 cm H2O
What mode of ventilation should be instituted if the physician requests an increase in the spontaneous tidal volume during SIMV? PSV
RDS lowers lung compliance by increasing alveolar surface forces
An ABG obtained two hours ago showed a PaCO2 = 43 mm Hg. A recent ABG indicates the PaCO2 to be 49 cm Hg. Which of the following changes in ventilator settings would be reasonable for ventilation of an infant with these ABG changes? Increase the rate by 5 BPM
Infant ventilator settings are FIO2 = 0.8, rate = 60 BPM, PIP = 30 cm H2O, and PEEP = 5 cm H2O in the SIMV mode. Assuming adequate ABGs, which parameter should be weaned first? FIO2
Which of the following is the goal of mechanical ventilation? Provide adequate alveolar ventilation with minimal lung damage.
The main advantage in using volume-cycled ventilation with neonates is delivery of a consistent tidal volume.
Which of the following is not considered a hazard of mechanical ventilation? Diaphragmatic paralysis
What is the usual range of Positive End-Expiratory Pressure (PEEP) settings used for mechanically ventilating newborn infants? 4 to 6 cm H2O
Which of the following findings are an indication for prophylactic administration of surfactant? 30 weeks gestational age infant,Infant weighs 960 grams,L/S ratio = 1:1,No phosphatidylglycerol (PG) present in amniotic fluid
Of the following which would not be an indication for obtaining a blood gas sample? Significant blood loss
Which of the following available surfactants lacks surface-active proteins? Exosurf
Which of the following newborn conditions would warrant chest compressions following a period of positive-pressure ventilation with 100% oxygen? Heart rate of 58 beats per minute,Heart rate of 70 beats per minute and not increasing.
You are intending to use an "E" cylinder of oxygen containing 1800 psi for transporting an infant on mechanical ventilation across town. You estimate the oxygen consumption to be 8 liters per minute during transport. How long will this cylinder last? 63 minutes
Balloon septostomy is employed to improve blood mixing in which of the following congenital heart defects? Complete transposition of the great vessels
While managing a patient receiving HFOV the respiratory care practitioner notices that the PaO2 is decreased. This can be corrected by all of the following except increasing the PIP
Which of the following tests may aid in the diagnosis of persistent pulmonary hypertension of the newborn? Hyperoxia test,Measuring preductal and postductal PaO2 levels,Hyperoxia-hyperventilation test ,Echocardiogram
What range of PEEP setting should be achieved when weaning a neonate from mechanical ventilation before extubation is considered? 3 to 5 cm H2O
On examination of a chest radiograph, you note an air pocket on the right lateral heart border. This indicates a possible pneumomediastinum.
A problem with an umbilical artery catheter is that it must be removed after several weeks use.
A safe range of PaO2 for neonates is ____________mm Hg. 50 - 70
Dense cystic patches arranged in generalized patterns that gradually increase in size and number describe which stage of BPD? Stage 3
Flattened diaphragms seen on a chest x-ray indicate air trapping.
When using an infant ventilator, which two parameters most directly affect tidal volume? Peak inspiratory pressure,PEEP
a post-surgical pediatric patient weighing 45 pounds. a tidal volume of 8 ml/kg. The ventilator circuit compliance is 2 ml/cm H2O. a PEEP of 5 cm H2O and you are anticipating a PIP of 30 cm H2O. What should your initial tidal volume setting be? 211 ml
How is tidal volume increased during pressure-controlled ventilation? Increase the Delta P
The major advantage to HFV is reduced barotraumas
All of the following are hazards of HFV except hypertension
Which of the following are common sites used to obtain arterial blood in neonates? Umbilical artery,Radial artery,Capillary
Clamping of the umbilical cord results in raising the neonate&apos;s arterial pressure
As you examine a patient's chest x-ray, you note the tip of the endotracheal tube to be near the carina, what should you do? pull the tube back slightly
Drug transfer across the placenta is affected by which of the following? Concentration difference, Lipid solubility of the drug,Degree of ionization,Molecular drug weight
Which of the following statements is false regarding fluid balance in newborns? There is a proportionately greater increase in extracellular fluid (ECF) as gestation increases compared to intracellular fluid (ICF).
The initial response of a neonate to cold stress is peripheral vasoconstriction
Which of the following are indicative of TTN? tachypnea,cyanosis,normal PaO2 and PaCO2
Created by: Cam1228
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