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FCCN LEVEL II-mechanical ventilation, ARDS, NMB, Exams of Medicine

A.T. Still University of Health Sciences (ATSU)Medicine

FCCN LEVEL II-mechanical ventilation, ARDS, NMB

Typology: Exams

2024/2025

Available from 08/25/2025

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FCCN LEVEL II-mechanical ventilation, ARDS,
NMB
1.Normal PaO2?: 80-100, assess oxygenation
2.Normal HCO3?: 22-26, measures acid/base balance
3.Normal PaCO2?: 35-45, assess ventilation
4.Normal pH?: 7.35-7.45, measures acidity of blood
5.PaCO2 >45, decreased pH?: respiratory acidosis
6.PaCO2 <35, increased pH?: respiratory alkaolsis
7.Assessment: headache, tachycardia, confusion, restlessness Causes: over sedation,
head/chest trauma, COPD: respiratory acidosis
8.Assessment: rapid/deep respirations, anxiety, fear Causes: fever,
sepsis, PE: respiratory alkalosis
9.HCO3 <22, decreased pH?: metabolic acidosis
10.HCO3 >26, increased pH?: metabolic acidosis
11.Assessment: mkussmual breathing, lethargy/coma, N/V, abdominal pain Causes: DKA, aerobic
metabolism, shock, renal failure: metabolic acidosis
12.Assessment: slow, shallow breathing, confusion, convulsions Causes: loss of acids,
increased Bicarb administration: metabolic alkalosis
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FCCN LEVEL II-mechanical ventilation, ARDS,

NMB

1. Normal PaO2?: 80-100, assess oxygenation

2. Normal HCO3?: 22-26, measures acid/base balance

3. Normal PaCO2?: 35-45, assess ventilation

4. Normal pH?: 7.35-7.45, measures acidity of blood

5. PaCO2 >45, decreased pH?: respiratory acidosis

6. PaCO2 <35, increased pH?: respiratory alkaolsis

7. Assessment: headache, tachycardia, confusion, restlessness Causes: over sedation,

head/chest trauma, COPD: respiratory acidosis

8. Assessment: rapid/deep respirations, anxiety, fear Causes: fever,

sepsis, PE: respiratory alkalosis

9. HCO3 <22, decreased pH?: metabolic acidosis

10. HCO3 >26, increased pH?: metabolic acidosis

11. Assessment: mkussmual breathing, lethargy/coma, N/V, abdominal pain Causes: DKA, aerobic

metabolism, shock, renal failure: metabolic acidosis

12. Assessment: slow, shallow breathing, confusion, convulsions Causes: loss of acids,

increased Bicarb administration: metabolic alkalosis

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13. CPAP?: continuous positive airway pressure

14. BiPAP?: bilevel positive airway pressure, has IPAP and EPAP

15. Does CPAP or BiPAP improve oxygenation?: CPAP

16. Does CPAP or BiPAP improve ventilation?: BiPAP

17. Patient who are hypercapnia are placed on?: BiPAP

18. Tachycardia, dysrhythmia, acute hypertension w/a increased heart rate, hypotension d/t

tachycardia if hypovolemic, cyanosis/pallor: cardiovascular in- dicators of respiratory failure

19. Extreme work of breathing, use of accessory muscles, nasal breathing, dyspnea,

wheezing/grunting, sputum, coughing, body position: respiratory in- dicators of respiratory failure

20. Bradypnea indicates?: excessive sedation, tissue damage, diabetic coma

21. Tachypnea?: fever, anxiety, respiratory distress

22. Kussmaul breathing?: rapid/deep breathing, DKA, respiratory system tries to blow off CO

23. Cheyenne-stokes breathing?: alternating rapid/shallow breathing, heart fail- ure, kidney

failure

24. Anxiety, restlessness, confusion, delirium, as hypoxia worsens so does LOC: CNS indictors

of respiratory failure

25. Indications for mechanical ventilation?: inadequate oxygenation, ventilation or inability to

protect airway

26. What is the nurses role in the intubation process?: notify RT, obtain intuba- tion kit, monitor

vital signs, administer meds

27. What is in the intubation kit?: pre-med (versed and fentanyl), induction (eto- midate,

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42. SIMV vent setting?: set tidal volume, patient can take own breaths and tidal volumes vary

with each breath

43. CMV?: continuous mandatory ventilation

44. CMV vent setting?: set tidal volume, patient can take own breaths but consis- tency get set

tidal volume

45. Spontaneous CPAP?: continuous positive airway pressure, usually used to determine

extubation readiness

46. ASV?: Adaptive support ventilation

47. ASV vent setting?: adjust ventilation based on patients own lung mechanics, based on

percent minute ventilation 100 mL/kg

48. What are the causes of high pressure ventilator alarms?: excessive secre- tions, mucous plug,

biting ETT, decreased compliance

49. What should you do if high pressure alarm goes on?: suction, sedation, check lung sounds,

ABGs

50. What causes low pressure/minute ventilation?: leak in ventilator/circuit, ETT displacement

51. What does DOPE mean?: displacement, obstruction, pneumothorax, equip- ment and

stack breaths

52. Suctioning mmHg?: <120 (open), <150 (closed)

53. Suctioning indications?: preformed PRN and every 8 hours, pre oxygenate and apply for

no more than 10 seconds

54. When is closed in line suctioning indicated?: PEEP of 10, positive for COVID, MRSA and TB

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55. What is the progression of ARDS?: pulmonary insults, worsening hypoxemia, respiratory

failure, decreased O2 to tissues, metabolic acidosis, organ dysfunction and death

56. Sepsis, aspiration, infectious penomnia, severe trauma, pancreatitis, drug overdose, near

drowning, smoke inhalation, surgery, blood transfusions: pul- monary insults that can lead to ARDS

57. What is the progression of ARDS in terms of alveolar damage and tissue damage?: injury

causes alveolar damage releasing pro-inflammatory cytokines attracting neutrophils to the lungs, neutrophils release toxic mediators damaging capillary endothelium, endothelium causes proteins to Leake out causing fluid to move around causing edema

58. Which type of alveolar epithelial cells provide structure, 90% alveolar surface, easily

damaged and allow "debris to enter alveoli?: type 1

59. Which type of alveolar epithelial cells secrete surfactant, 10% alveolar surface and damage

causes decreased compliance and can't release surfac- tant?: type 2

60. How do we assess ventilation?: PaCO

61. How can you improve ventilation?: blow off CO2 (BiPAP) or increase rate, TV and pressure

support

62. How can you improve oxygenation?: add oxygen through nasal cannula, or increase FiO2 or

PEEP

63. What is lung protective ventilation?: tidal volume of <6 mL/kg to not over distend alveoli

64. What is the pressure exerted on small airway and alveoli during mechani- cal ventilation? ideally

no more than 30 cm H20: plateau pressure

65. What is used for selective vasodilation of pulmonary vessels improving ventilation/perfusion,

decreases pulmonary artery pressure?: inhaled nitric ox- ide