Test Bank For Neonatal and
Pediatric Respiratory Care 5th
Edition
Recommend an appropriate initial ventilator mode or mode modification for the
perinatal/pediatric patient - ANSWERSa. Continuous Positive Airway Pressure (CPAP) 4-
6cmH2O increases FRC and decreases WOB
b. Noninvasive Positive Pressure Ventilation (NPPV or NIV) better choice when needing to
restore adequate CO2 elimination.
c. Pressure Support Ventilation (PSV): Main mode used for neonates and pediatrics.
d. Intermittent Mandatory Ventilation (IMV): TCPL is used with this mode,
e. Synchronized Intermittent Mandatory Ventilation (SIMV): Most commonly used mode in
neonates w PS,
f. Assist Control (A/C)
g. Pressure Control Ventilation (PCV)/ Time-cycled, Pressure-limited Ventilation (TCPL)
h. Pressure Regulated Volume Control (PRVC): with SIMV and A/C is frequently used in
larger infants and children.
Recommend appropriate perinatal/pediatric settings for the following set ventilator
parameters when given specific patient information. - ANSWERSA. Peak inspiratory pressure
(PIP)/Tidal volume (VT) pressure to be reached and maintained through the inspiratory
cycle. In PCV, this setting allows changes to the delivered tidal volume. Most readily affects
oxygenation as it results in an increased MAP.
B. Positive end-expiratory pressure (PEEP) 3-7cmh20. >7-8cmh2o are associated w
barotrauma/pneumo. Discontinuing PEEP for infants is not recommended. PEEP increased
MAP and decreases pulmonary shunt. Has a positive effect on oxygenation.
C. Set rate or frequency RDS-30-50/min MAS 25-40/min AoP or surgical-10-30/min adjust to
support needs.
D. Flow rate (Inspiratory flow and bias flow)
E. Inspiratory time (IT or I-time), Expiratory time (ET or E-time), I:E Ratio adequate
inspiratory time will help oxygenating infants w RDS. Inter-dependent variables where the
adjustment of any one or two affects the thirds. These parameters w RR determine the
length of inspiration, duration of positive pressure, and contribute to MAP. RDS 0.25-
0.5secs. MAS-0.4-0.7sec. AoP or surgical-at least 0.3sec
, F. FIO2 pao2 50-80 for preemies. Pao2 near 80-100 for term/postterm w PPHN. Pao2 <50
may be used for cyanotic heart defects or extremely low birth weight babies.
G. Rise time the time it takes for PIP to be reached after inspiration begins. It is set in
seconds or percentage. It is a function for modes of PCV, PRVC, PSV, volume support. Part of
your inspiratory time.
H. Sensitivity (flow, pressure, motion, neurally adjusted ventilator assist-NAVA) flow trigger
is most common and better than the pressure in infants. It is best to use an infant flow
sensor at the patient's ETT adapter to best monitor and sense breathing. NAVA is available
on SERVO vents. Uses an NG tube w special sensors, the diaphragm's electrical activity is
obtained by sensors, is not affected by leaks, works well w compl
Determine acceptable perinatal/pediatric ranges for the following monitored parameters
and describe how they may change utilizing the set parameters in Objectives 1 and 2. -
ANSWERSa. Mean airway pressure (MAP or Paw) has a direct effect on oxygenation. Paw
may be altered by changes in set VT/PIP, flow, PEEP/CPAP, i-time, RR, and rise time. Can
adversely affect ventilation and cardiac output. 8-12cmh2o appropriate for RDS.
b. Inspiratory /expiratory tidal volume (VT)
c. Respiratory rate/total rate
d. Deadspace/alveolar ventilation
e. Compliance
f. SpO2
g. Blood gas results
1. Explain how changes in each set and monitored parameter list above will affect other set
and monitored parameters. - ANSWERS
Identify indications for mechanical ventilation in the perinatal/pediatric patient. -
ANSWERSImprove gas exchange, reduce respiratory distress, prevent or reverse atelectasis,
reduce respiratory muscle fatigue, manage ICP, stabilize chest wall.
State the advantages and disadvantages of utilizing volume-cycled ventilation and pressure-
limited ventilation - ANSWERSAdvantages: control over ventilation pressure to limit
barotrauma, manipulation of I:E ratio and PAW to oxygenate, manipulation of I-time and
flow wave pattern to oxygenate and ventilate.
Pediatric Respiratory Care 5th
Edition
Recommend an appropriate initial ventilator mode or mode modification for the
perinatal/pediatric patient - ANSWERSa. Continuous Positive Airway Pressure (CPAP) 4-
6cmH2O increases FRC and decreases WOB
b. Noninvasive Positive Pressure Ventilation (NPPV or NIV) better choice when needing to
restore adequate CO2 elimination.
c. Pressure Support Ventilation (PSV): Main mode used for neonates and pediatrics.
d. Intermittent Mandatory Ventilation (IMV): TCPL is used with this mode,
e. Synchronized Intermittent Mandatory Ventilation (SIMV): Most commonly used mode in
neonates w PS,
f. Assist Control (A/C)
g. Pressure Control Ventilation (PCV)/ Time-cycled, Pressure-limited Ventilation (TCPL)
h. Pressure Regulated Volume Control (PRVC): with SIMV and A/C is frequently used in
larger infants and children.
Recommend appropriate perinatal/pediatric settings for the following set ventilator
parameters when given specific patient information. - ANSWERSA. Peak inspiratory pressure
(PIP)/Tidal volume (VT) pressure to be reached and maintained through the inspiratory
cycle. In PCV, this setting allows changes to the delivered tidal volume. Most readily affects
oxygenation as it results in an increased MAP.
B. Positive end-expiratory pressure (PEEP) 3-7cmh20. >7-8cmh2o are associated w
barotrauma/pneumo. Discontinuing PEEP for infants is not recommended. PEEP increased
MAP and decreases pulmonary shunt. Has a positive effect on oxygenation.
C. Set rate or frequency RDS-30-50/min MAS 25-40/min AoP or surgical-10-30/min adjust to
support needs.
D. Flow rate (Inspiratory flow and bias flow)
E. Inspiratory time (IT or I-time), Expiratory time (ET or E-time), I:E Ratio adequate
inspiratory time will help oxygenating infants w RDS. Inter-dependent variables where the
adjustment of any one or two affects the thirds. These parameters w RR determine the
length of inspiration, duration of positive pressure, and contribute to MAP. RDS 0.25-
0.5secs. MAS-0.4-0.7sec. AoP or surgical-at least 0.3sec
, F. FIO2 pao2 50-80 for preemies. Pao2 near 80-100 for term/postterm w PPHN. Pao2 <50
may be used for cyanotic heart defects or extremely low birth weight babies.
G. Rise time the time it takes for PIP to be reached after inspiration begins. It is set in
seconds or percentage. It is a function for modes of PCV, PRVC, PSV, volume support. Part of
your inspiratory time.
H. Sensitivity (flow, pressure, motion, neurally adjusted ventilator assist-NAVA) flow trigger
is most common and better than the pressure in infants. It is best to use an infant flow
sensor at the patient's ETT adapter to best monitor and sense breathing. NAVA is available
on SERVO vents. Uses an NG tube w special sensors, the diaphragm's electrical activity is
obtained by sensors, is not affected by leaks, works well w compl
Determine acceptable perinatal/pediatric ranges for the following monitored parameters
and describe how they may change utilizing the set parameters in Objectives 1 and 2. -
ANSWERSa. Mean airway pressure (MAP or Paw) has a direct effect on oxygenation. Paw
may be altered by changes in set VT/PIP, flow, PEEP/CPAP, i-time, RR, and rise time. Can
adversely affect ventilation and cardiac output. 8-12cmh2o appropriate for RDS.
b. Inspiratory /expiratory tidal volume (VT)
c. Respiratory rate/total rate
d. Deadspace/alveolar ventilation
e. Compliance
f. SpO2
g. Blood gas results
1. Explain how changes in each set and monitored parameter list above will affect other set
and monitored parameters. - ANSWERS
Identify indications for mechanical ventilation in the perinatal/pediatric patient. -
ANSWERSImprove gas exchange, reduce respiratory distress, prevent or reverse atelectasis,
reduce respiratory muscle fatigue, manage ICP, stabilize chest wall.
State the advantages and disadvantages of utilizing volume-cycled ventilation and pressure-
limited ventilation - ANSWERSAdvantages: control over ventilation pressure to limit
barotrauma, manipulation of I:E ratio and PAW to oxygenate, manipulation of I-time and
flow wave pattern to oxygenate and ventilate.
