Which of the following is an indicator of weaning failure?
- decreasing VD/VT
- increasing MIP
- increasing f/VT
- decreasing f
Based on the weaning protocol described in the textbook, all of the following conditions must be met for consideration of a weaning attempt except:
- hemodynamic stability.
- little or no sedation required.
- presence of inspiratory effort.
Terminal weaning is defined as _______________ of mechanical ventilation that results in the ______________ of a patient.
- withdrawal; death
- withholding; death
- withdrawal; vegetative state
- withholding; vegetative state
Other causes of increased airflow resistance during mechanical ventilation include all of the following conditions except:
- kinking of the ET tube.
- secretions in ET tube.
- use of a humidifier.
- use of an HME.
All of the following pulmonary measurements suggest readiness for weaning attempt except:
- maximal inspiratory pressure = -12 cm H2O
- VD/VT = 40%
- static compliance = 32 mL/cm H2O
- f/VT = 80 breaths/min/L
If pulse oximetry is used to monitor a patient’s oxygenation status, the pulse oximetry O2 saturation (SpO2) should be kept in the mid-80s for allowance of machine inaccuracies.
The ____ is measured by dividing the patient’s tidal volume (measured at the airway opening) by the difference in the plateau pressure and the PEEP.
- airway resistance
- static lung compliance
- deadspace to tidal volume ratio
- dynamic lung compliance
Patients who fail the SBT often do so within the first 10 minutes of the trial.
____ is an indicator of weaning failure.
- Increasing PaO2
- Increasing PaCO2
- Increasing SpO2
- Increasing PaO2/FIO2
Patients who fail the spontaneous breathing trial (SBT) may exhibit which of the following clinical signs and symptoms:
____ remains an effective tool in altering the degree of partial ventilatory support during continuous mechanical ventilation.
Generally accepted ventilatory weaning criteria includes a ____.
- vital capacity of greater than 5 mL/kg
- minute ventilation of less than 15 L with satisfactory blood gases
- spontaneous VT of greater than 5 mL/kg
- PaCO2 of less than 65 mm Hg with normal pH
For a successful weaning outcome, ____.
- the PaO2 should be > 75 mm Hg
- the P(A-a)O2 should be < 450 mm Hg while on 100% O2.
- the PaO2/FIO2 should be 150 mm Hg
- the QS/QT should be < 45%
Weaning criteria are used to evaluate the:
- Likelihood of weaning success.
- Readiness for extubation.
- Readiness of a patient to begin the weaning trial.
The ____ is used to estimate how much pulmonary perfusion is wasted.
- P/F index
- QS/QT ratio
- P(A-a)O2 gradient
- CaO2 content
Which of the following patient conditions is the least importantconsideration prior to weaning a patient from mechanical ventilation?
- frequent arrhythmias
- severe acidosis
- ventilatory failure
- use of PEEP
The blood gases and related parameters of a patient are as follows: pH = 7.43, PaCO2 = 40 mm Hg, PaO2 = 80 mm Hg, PECO2 = 30 mm Hg. What portion of the tidal volume is considered wasted (deadspace) ventilation?
A patient has the following oxygen content measurements: CcO2 = 20 vol%, CaO2 = 18 vol%, CvO2 = 13 vol%. The claculated QS/QT is about _________ and it reflects ___________ shunting.
- 19%; mild
- 29%; significant
- 39%; severe
- 55%; severe
____ is defined as an absence of ventilatory support 48 hours following an extubation.
- Weaning success
- Weaning in progress
- Weaning failure
- Spontaneous breathing trial
Which of the following are included in a weaning protocol:
- the detailed process of weaning.
- the evaluation of weaning outcomes.
- the patient condition in which weaning may be attempted.
Automatic tube compensation (ATC) allows the patient to have a breathing pattern as if breathing spontaneously without an artifcial airway.
When the RSBI or f/VT ratio becomes greater than 100 breaths/min/L, it correlates with weaning failure.
____ is a clinical condition that decreases static compliance.
- Kinking of ET tube
- Airway obstruction
- Tension pneumothorax
____ is a clinical condition that decreases dynamic compliance.
- Retained secretions in the airways
- Retained secretions in the lungs
____ = PAO2 – PaO2
A patient has the following measurements while receiving mechanical ventilation: exhaled VT = 480 mL, PIP = 45 cm H2O, plateau pressure = 30 cm H2O, PEEP = 8 cm H2O. What is the calculated static compliance? Is it normal based on the pulmonary measurement criteria for weaning?
- 11 mL/cm H2O; normal
- 11 mL/cm H2O; abnormal
- 22 mL/cm H2O; normal
- 22 mL/cm H2O; abnormal
Respiratory muscle dysfunction may be due to all of the following conditions except:
- electrolyte imbalance.
- excessive nutritional intake.
- low oxygen delivery.
- respiratory muscle atrophy due to muscle disuse.
Patients who fail an SBT often exhibit the following objective clinical signs: tachypnea, ____, hypertension, hypotension, hypoxemia or acidosis, arrhythmias.
- atrial fibrillation
- ventricular fibrillatio
Termination criteria for weaning from mechanical ventilation includes a ____.
- SpO2 < 80%
- heart rate >120/min
- systolic pressure >180 mm Hg
- systolic pressure < 75 mm Hg
Sometimes SIMV and ____ are used together in patients who have failed the spontaneous breathing trial.
In ____, the pressure support level is adjusted automatically to achieve the target tidal volume.
For a successful weaning outcome, the patient should have a ____.
- static lung compliance
- VD/VT ratio should be >60%
- MIP of at least –30 cm H2O