NRNP 6566 Week 7 knowledge check
• Question 1
A patient with respiratory failure has hemodynamic monitoring and is receiving
mechanical ventilation with peak end-expiratory pressure (PEEP) of 10 cm H2O. Which
information indicates that a change in the ventilator settings may be required?
a. The arterial line shows a blood pressure of 90/46.
b. The pulmonary artery pressure (PAP) is decreased.
c. The cardiac monitor shows a heart rate of 58 beats/min.
d. The pulmonary artery wedge pressure (PAWP) is increased.
Correct
Answer: The hypotension indicates that the high intrathoracic pressure caused by the
PEEP may be de-creasing venous return and cardiac output (CO).
Decreasing
the PEEP should decrease the intrathoracic pressure and improving venous
return and cardiac output.
• Question 2
The APRN is monitoring a newly intubated patient. He appears to be very anxious and
“fighting” the ventilator. What would be the most appropriate action?
Correct
Answer: Remove the patient from the ventilator and bag him with 100% FIO2. If the
patient improves, then the problem is with the ventilator. Respiratory
professional should check the ventilator function.
If the patient does not improve, the problem is with the patient. If death
appears imminent, airway obstruction pneumothorax, and dislodged
endotracheal tube must be considered as the cause. If death is not imminent,
close examination of the patient and chest X-ray should be completed. The
need for additional sedation should be considered as well.
• Question 3
A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated
earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and
peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen
to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88
to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has
decreased breath sounds on the left side.
Where do you think the problem lies with this particular patient?
Correct
Answer: This patient has had increases in both the peak and static pressures
suggestion this patient has a new “compliance” problem. A patient with COPD
This study source was downloaded by 100000851646087 from CourseHero.com on 12-13-2022 08:38:48 GMT -06:00
https://www.coursehero.com/file/60383123/Week-7-knowledge-checkdocx/
, who develops unilateral decreased breath sounds, tachycardia, and
hypotension while on mechanical ventilation should be suspected that he has
developed a tension pneumothorax.
This study source was downloaded by 100000851646087 from CourseHero.com on 12-13-2022 08:38:48 GMT -06:00
https://www.coursehero.com/file/60383123/Week-7-knowledge-checkdocx/
NRNP 6566 Week 7 knowledge check
• Question 1
A patient with respiratory failure has hemodynamic monitoring and is receiving
mechanical ventilation with peak end-expiratory pressure (PEEP) of 10 cm H2O. Which
information indicates that a change in the ventilator settings may be required?
a. The arterial line shows a blood pressure of 90/46.
b. The pulmonary artery pressure (PAP) is decreased.
c. The cardiac monitor shows a heart rate of 58 beats/min.
d. The pulmonary artery wedge pressure (PAWP) is increased.
Correct
Answer: The hypotension indicates that the high intrathoracic pressure caused by the
PEEP may be de-creasing venous return and cardiac output (CO).
Decreasing
the PEEP should decrease the intrathoracic pressure and improving venous
return and cardiac output.
• Question 2
The APRN is monitoring a newly intubated patient. He appears to be very anxious and
“fighting” the ventilator. What would be the most appropriate action?
Correct
Answer: Remove the patient from the ventilator and bag him with 100% FIO2. If the
patient improves, then the problem is with the ventilator. Respiratory
professional should check the ventilator function.
If the patient does not improve, the problem is with the patient. If death
appears imminent, airway obstruction pneumothorax, and dislodged
endotracheal tube must be considered as the cause. If death is not imminent,
close examination of the patient and chest X-ray should be completed. The
need for additional sedation should be considered as well.
• Question 3
A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated
earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and
peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen
to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88
to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has
decreased breath sounds on the left side.
Where do you think the problem lies with this particular patient?
Correct
Answer: This patient has had increases in both the peak and static pressures
suggestion this patient has a new “compliance” problem. A patient with COPD
This study source was downloaded by 100000851646087 from CourseHero.com on 12-13-2022 08:38:48 GMT -06:00
https://www.coursehero.com/file/60383123/Week-7-knowledge-checkdocx/
, who develops unilateral decreased breath sounds, tachycardia, and
hypotension while on mechanical ventilation should be suspected that he has
developed a tension pneumothorax.
This study source was downloaded by 100000851646087 from CourseHero.com on 12-13-2022 08:38:48 GMT -06:00
https://www.coursehero.com/file/60383123/Week-7-knowledge-checkdocx/
