Chapter 12; Methods to Improve Ventilation in Patient-Ventilator Management

Chapter 12; Methods to Improve Ventilation in Patient-Ventilator Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

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

a.	4.3 L/min
b.	4.8 L/min
c.	6.6 L/min
d.	7.1 L/min

 

 

ANS:   D

Desired V_T =

 

DIF:    2                      REF:    pg. 224

 

2. A patient with CHF is being mechanically ventilated. The patient’s current PaCO₂ = 28 mm Hg, and the ventilator set rate is 16/minute. The desired PaCO₂ for this patient is 40 mm Hg. To what should the set rate be changed?

a.	7/min
b.	11/min
c.	14/min
d.	18/min

 

 

ANS:   B

Desired f =

 

DIF:    2                      REF:    pg. 225

 

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

a.	400 mL
b.	800 mL
c.	1000 mL
d.	1200 mL

 

 

ANS:   B

Desired V_T =

 

DIF:    2                      REF:    pg. 223

 

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

a.	4 to 5 mL/kg IBW
b.	5 to 8 mL/kg IBW
c.	8 to 10 mL/kg IBW
d.	12 to 15 mL/kg IBW

 

 

ANS:   B

Recommended guidelines are to target the V_T to 5 to 8 mL/kg ideal body weight (IBW) while ensuring that the plateau pressure (P_plateau) is maintained at less than 30 cm H₂O.

 

DIF:    1                      REF:    pg. 223

 

5. 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, V_T = 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?

a.	Increase VT to 595 mL
b.	Increase VT to 760 mL
c.	Increase frequency to 16/min
d.	Decrease frequency to 10/min

 

 

ANS:   A

Desired V_T =

The desired target for V_T for this patient is 5 to 8 mL/kg IBW. Because the set V_T of 450 mL is at 5.9 mL/kg, there is room to increase the V_T. After calculating the desired V_T using the formula, the new volume is at 7.8 mL/kg. A V_T of 760 mL would be at 10 mL/kg IBW.

 

DIF:    3                      REF:    pg. 225