clinical exam2

  1. what type of trigger does the 840 have?
    • pressure
    • flow
  2. ideally, where do u want to keep the cuff pressure
    < 25 cmh20 water pressure
  3. best measure of muscle strength
    < -20 NIF
  4. what vent changes will you make to increase co2
    • in volume ventilation:
    • dec RR
    • dec VT

    • in pressure vent:
    • dec pressure

    • non-setting:
    • add deadspace (every 6in = 50cc's)
  5. if someone has a ABG of

    inc fio2 or peep
  6. if pt is off ventilator for an hour weaning and hr increases from 86 to 106 and develops PVC's, what would u do?
    • increase fio2 for PVC's
    • put the pt back on vent
  7. when is PS activated in what kinda modes?
    any mode w/ a spontaneous breath
  8. what is CMV
    basically AC
  9. what does CMV stand for
    continuous/controlled mechanical ventilation
  10. if pt has a 1:1.2 ratio and the pt appears uncomfy, what could u do to correct?
    increase flow (short the itime, longer etime)
  11. by increasing flow you will also increase
  12. if u change vent circuit and the pt exhaled vt is 300 cc's less than set, what would u do
    • take pt off vent and bag pt
    • and then check for leaks
  13. what would cause a high pressure alarm
    • tension pneumothorax
    • secreations
    • water in the tube/circuit
    • biting
    • kink in circuit
    • mucus plugs
  14. formula for MV
    rr x vt
  15. formula for VT
  16. formula for RR
  17. formula for RSBI
    f/vt in liters
  18. ABG's of


    what would u do?
    dec rr or vt so CO2 will rise
  19. if u have a severe lung term COPD pt with these ABGS what would u do

  20. if somebody is in SIMV, and they appear alil uncomfy but vital signs are stable and pt keeps getting a low exhaled vt on spont breath, what can u do to correct that?
    increase PS
  21. if the flow sensitivity is set too sensitive, what will happen?
    auto cycle (keep triggering) w/o the pt
  22. medical patients vt
    5-8 cc/kl
  23. surgical patients vt
    8-12 cc/kl
  24. if u increase someones peep from 3 to 9, what will you watch?
    • peak pressure
    • bp (increasing peep will decrease bp)
  25. if u did a spontaneous weaning parameter on a pt and results are

    -14, vt of 500, vc of 1600, nif of -30
    • wean if u haven't started weaning
    • or extubate
  26. what is the formula of static compliance
    ppl-peep/corrected vt

    know how to calculate
  27. if u have a 80 kg pt on these settings

    simv of 12, 400, .50, 15 ps
    and indicating that theyre not getting enough air, what would you do?
    increase vt
  28. pt in the ICU with

    simv of 12, 750, .50, 10 of ps
    w/ ABG's of


    what would you recommend to do to the pt?
    • increase RR
    • give bicarb
  29. how would u classify this ABG

    resp acidosis w/ moderate hypoxemia
  30. 7.31/57/42/22

    how would you fix the problem?
    • increase RR
    • increase FIO2 or peep
  31. does the avea have a internal nebulizer?
  32. does the avea have a PRVC
  33. how do you get ppl pressure and a compliance on the 840?
    inspiratory hold
  34. if u put a pasemear valve (speaking valve) on a pt's tube, what do u have to do to the patient's cuff?
    DEFLATE the cuff!!!!!!
  35. if u put a pasemear valve (speaking valve) on a pt's tube, and you don't deflate it, what will happen to the patient and their lungs?
    pt WONT be able to EXHALE

    pt's lungs will OVER INFLATES until they pop (barotrauma)
  36. is VC+ a mode available on the 840?
  37. VC+ acts like (which mode)?
  38. if you are looking for a leak on a ventilator, where are some places will you look
    • circuit
    • cuff
    • filters
    • water traps
  39. when u turn on the 840, what do u do? what screen will pop up?
    • open atmosphere (cap off)
    • new pt or same pt screen
  40. if patient is intubated with ett and u want to decrease their work or breathing (on vent and NOT on the vent)
    • give PS
    • CUT THE TUBE (will decrease resistance)
  41. where do you auscultate after intubation? and what should u do to verify?
    • stomach
    • then lungs
    • check c02
    • cxr (3cm above carina)
  42. what would u wanna take a long on a road trip?
    • ambu bag
    • mask
    • o2
  43. if youre doing a circuit change, what do you remove first?
    patient first
  44. if youre giving a MDI through the 840 you can give an ins pause, manuel inspiration OR?
    pause time (ppl time)
  45. does the 840 have a sigh
  46. if youre doing trach care for a disposable shilley trach, what are the things you need
    • inner cannula
    • gauze
    • saline/peroxide
    • qtips

    NO NEED FOR A CLEANING BRUSH (only w/ a non-disposable trach)
  47. when is pressure sensitivity active on the avea?
    when the nebulizer is on
  48. if you have someone set on

    simv of 6, 600, .40, 5 of peep

    you want their APNEA settings on what?
    • 20 seconds
    • 100% fio2
    • rate of 10 (no less than 10)
  49. what are some hazards on a in-line suction catheters
    • suction button may not be locked
    • pt may self extubate
    • suck vt away

    (peak pressure may rise; low vt)
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clinical exam2
clinical exam2