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RES 260 Neonatal 5
RES 260 Management of Ventilation and Oxygenation
Question | Answer |
---|---|
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'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 |