An absolute contraindication to a trial of NIV in a child with respiratory distress is Quizlet
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Terms in this set (50)Which of the following features are often components of CPAP systems incorporated within infant ventilators? d. I, II, and IV Which form of CPAP has been associated with a "thoracic wiggle"? a. IF-CPAP (infant flow CPAP c. B-CPAP (bubble CPAP) When nasal cannulas are used in infants at high flows, which factors determine
the amount of pressure to the airways? a. I and II only d. I, II, and III only After initiating IF-CPAP in an infant at 8 cm H2O, the therapist notices a low-pressure alarm. What should be done to correct this situation? a. Correct the leak by placing a chin trap. a. Correct the leak by placing a chin trap. How should a therapist determine the size of the nasal prongs to effectively administer CPAP to infants? d. The prongs should occlude 100% of the external nares diameter without blanching. Weaning strategies from CPAP include which of the following? a. I and III only d. I, II, and IV only A child with a chronic disorder complicated by alveolar hypoventilation is placed on intermittent NIV at night. What is the primary goal of this therapy? a. To decrease the work of breathing c. To improve the quality of sleep and reduce daytime symptoms What is considered the most successful therapeutic condition where NIV can be used in children? a. Treatment of hypoxemic exacerbation of children with chronic neuromuscular disorders b. Treatment of hypercapnic exacerbation of children with chronic neuromuscular disorders In what particular setting has long-term use of NIV on children with cystic fibrosis been successful? a. As a bridge to transplantation a. As a bridge to transplantation When a bilevel ventilator is used in the spontaneous/timed mode, at what point does the ventilator employ the timed feature? a. During exhalation d. Only in the event of prolonged apnea Which of the following NIV interfaces should the therapist consider when a child complains of discomfort with a nasal mask? a. I and II only c. II and IV only What is the only
absolute contraindication to a trial of NIV in pediatric patients with acute respiratory distress? a. Cardiovascular instability Which of the following are indications for HFV? b. Existing pulmonary air leak syndrome During volume-controlled ventilation, which of the following factors influences the peak inspiratory pressure?
c. Pulmonary compliance Which of the following modes of ventilation attempts to maintain a minimum target tidal volume with a constant pressure by manipulating the inspiratory flow? d. Pressure-regulated volume control (PRVC) Enhanced diffusion in HFV is a function of which of the following factors? a. Inspiratory flow d. Respiratory frequency How is the high-volume strategy achieved when the goal is to deliver a high lung volume to a neonate receiving HFV? a. By increasing the
continuous distending pressure a. By increasing the continuous distending pressure On the basis of the following flow/time scalar, which of the following conditions has developed? a. Trigger dyssynchrony c. Air trapping During high-frequency ventilation, as the diameter of the ETT increases, what happens to the delivered tidal volume under the same pressure settings? a. It does not change. b. It increases. Which of the following adjustments should the therapist consider to improve ventilation on a patient undergoing HFV? a. Increase frequency d. Decrease frequency During HFOV, which of the following factors has a direct influence on a neonate's delivered tidal volume? a. Frequency c. Peak inspiratory pressure The therapist is conducting a ventilator check for a neonate and makes the following notations on the ventilator flow sheet: PEEP: 5 cm H2O Peak inspiratory pressure (PIP): 25 cm H2O Mandatory rate: 15 breaths per minute FiO2: 0.35 On the basis of these observations, what should the therapist recommend for this neonate? a. Shunt study b. Weaning from mechanical ventilation How is the radiographic assessment of neonatal lung volume performed? a. Counting the number of anterior ribs above the diaphragm b.Counting the number of posterior ribs above the diaphragm c.Counting the number of posterior ribs below the clavicle b.Counting the number of posterior ribs above the diaphragm Which of the following substances prevents the release of Ca2+ from the sarcoplasmic reticulum? a. Intracellular cGMP c. cGMP-dependent kinase What is the
primary physiologic activity of inhaled nitric oxide? b. Pulmonary vasodilation Which of the following medications contributes to an increased right-to-left intrapulmonary shunting? a. Dobutamine c. Prostacyclin The respiratory therapist has initiated iNO at 20 ppm for an infant with pulmonary hypertension. After 2 hours a blood gas test reveals a 10% improvement in SaO2. What should the therapist do? a. Keep iNO at 20 ppm and wait at least 2 hours before considering any change. a. Keep iNO at 20 ppm and wait at least 2 hours before considering any change. The respiratory therapist has initiated nitric oxide for an infant with severe refractory hypoxemia. The initial dose was 20 ppm and titrated up to 30 ppm for the last 1 hour due to lack of response. However, there still is no response. What should the therapist do? a. Increase iNO to 40 ppm d. Discontinue iNO and consider a different therapeutic intervention Inhaled NO has been administered to an infant for nearly 2 hours. The respiratory therapist notices suboptimal response and suggests HFOV. What is the principle behind the potential benefit of adding this ventilatory modality to this infant? b.Lung volumes are optimized with HFOV and further enhance the effects of iNO. An infant has been receiving iNO for the last 3 days. Which important level should be monitored when ordering a co-oximetry? a. Methemoglobin a. Methemoglobin The therapist is using an oxygen flowmeter to deliver an 80:20 heliox mixture to a patient. The reading on the flowmeter is 10 L/minute. What is the actual flow received by the patient? a. 5.5 L/minute d. 18 L/minute The therapist is treating a very irritable young child with upper airway obstruction. Which oxygen device will be the most appropriate to administer the greatest concentration of helium? a.Close-fitting nonrebreathing mask The therapist is evaluating a small tachypneic infant receiving heliox mixture 70:30 through an infant hood. Although the SpO2 has improved, the child shows signs of worsening work of breathing. What is the most probable mechanism to explain this situation? d. The infant is breathing too fast; thus heliox is not reaching the airways. The therapist is performing a routine assessment and ventilator check on a patient who is receiving heliox near the wye adapter of the ventilator circuit.
He notices a serious discrepancy between the set tidal and the exhaled volume. What should the therapist do to correct this situation? a. Administer heliox through the heliox-approved inlet of the mechanical ventilator. A patient who has been admitted with status asthmaticus is receiving beta adrenergics every 2 hours and heliox with very limited response. What should the therapist suggest at this time? c. Administer inhaled anesthetics. Which of the following inhaled anesthetics should the therapist recommend to administer via a face mask to a conscious, spontaneously breathing pediatric patient who has status asthmaticus? d. Halothane A neonate on mechanical ventilation with respiratory distress has a PaO2 of 50 mm Hg, a of 20 cm H2O and FiO2 of 0.8. Why should the therapist suggest therapies other than ECMO? c. The OI does not meet ECMO criteria. Which
of the following strategies is greatly responsible for decreasing the need for ECMO in neonates? d. HFOV Which of the following conditions is considered contraindications for neonatal ECMO? b. Less than 2 kg of weight Which of the following conditions are cardiac applications of ECMO? I. High cardiac output syndrome a. I and II only d. I, II, III, and IV Which of the following statements describes venoarterial ECMO? d. A cannula is inserted into the right common carotid artery for arterial return. During administration of venovenous ECMO, the therapist notices that the SvO2 is greater than SaO2. What is the best explanation to this phenomenon? c. Native cardiac output has increased. What are the major advantages of venovenous ECMO? b. Cardiovascular support is uninvolved. The therapist should evaluate raceway occlusion because too much roller tension could be associated with which of the
following events? c. Hemolysis What is the advantage of having the centrifugal pump automatically respond to resistances against which it is pumping? a. It avoids placing increased pressures on the heart. c. It maintains regulated flow through the system. Because the minimum flow rate required to remove condensation in the gas compartment usually results in excessive elimination of carbon dioxide, what should the therapist do? a. Reduce pump flow. b. Blend sweep gas with a carbogen mixture. What are the most common causes of a decrease in venous return in ECMO? a. I and III only c. I, II, III, and IV only The therapist in charge of a patient on ECMO has noticed an increase in premembrane pressures. What is the most probable explanation? b. Clotting in the circuit How can membrane malfunction be suspected? a. Narrowing of the premembrane and postmembrane PaCO2 b.Widening of the premembrane and postmembrane PaO2 a. Narrowing of the premembrane and postmembrane PaCO2 What is considered the most concerning complication of ECMO in the newborn? c. Intracranial hemorrhage Sets with similar termsCardiopulmonary A&P Exam 1111 terms kit_lovell Quiz 7 (Compliance/ Raw, PEEP, Autopeep, Modes inc…101 terms Will_Stewart8PLUS Sets found in the same folderChapter 16 Noninvasive Mechanical Ventilation of t…43 terms aminatene Ch. 10: Oxygen Administration Neo/Peds55 terms Melissa_Duncan18 Neo/Peds ch 816 terms brittany_pickard1 Neo/Peds ch 2226 terms brittany_pickard1 Other sets by this creatorA & P Exam 418 terms Kaitlyn_Wingate4 TMH 15 terms Kaitlyn_Wingate4 Pathophysiology Unit 2: Interstitial Lung Diseases27 terms Kaitlyn_Wingate4 Hemo Quiz12 terms Kaitlyn_Wingate4 Other Quizlet setsMacro 4 - Financial Sector53 terms morgan_scheible5 AP EXAM 3, A & P Exam 2, A & P Exam 1500 terms olive_1_2 Anatomy Exam III62 terms samweinhouse Related questionsQUESTION How are concentrations of LDL and HDL associated with the risk for heart disease? 15 answers QUESTION Who is the universal recipient of RBCs? 15 answers QUESTION A momentary conduction delay at the AV junction 11 answers QUESTION what is a third degree block 15 answers What is the most common complication associated with NIV among pediatric patients?Interface-related complications are common in the use of long term NIV. Skin trauma caused by prolonged use of masks is the most common complication. Skin lesions were reported in half of the patients after 6-month use of NIV via nasal masks (108).
What are the primary objectives of noninvasive ventilation NIV )? Quizlet?The primary goal of NIV is to improve gas exchange without endotracheal intubation. List three potential benefits of NIV in the acute care setting.
What is the primary role of NPPV in the treatment of children with acute respiratory failure?Non-invasive positive-pressure ventilation (NPPV) has assumed an important role in the management of respiratory failure because it provides ventilatory support without the need for an invasive airway.
How should a volume regulated ventilator for NIV be adjusted to deliver the appropriate tidal volume Vt to a pediatric patient?How should a volume-regulated ventilator for NPPV be adjusted to deliver the appropriate tidal volume (VT) to a pediatric patient? The delivered VT should be set at twice the child's physiologic VT. The VT should be set by dividing the patient's PaCO2 by two.
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