Question 1

What physiologic effect will raising the expiratory positive airway pressure have in the patient receiving noninvasive ventilation?

Accepted Answer

Raising the expiratory positive airway pressure (EPAP) will increase the functional residual capacity (FRC) by preventing airway collapse during expiration, leading to improved gas exchange and better oxygenation. Increasing EPAP does not directly increase tidal volume or lower mean airway pressure, and there is no such thing as PCO_2..

Question 2

What is the best option for the patient in respiratory failure who continues to deteriorate 30 min after the initiation of noninvasive ventilation?

Accepted Answer

If the patient's vital signs and blood gas values are worsening after 30 min on optimal settings, intubation should be considered.

Question 3

What is the recommended initial setting for ventilating pressure when delivering noninvasive ventilation in the pressure triggered timed mode?

Accepted Answer

The majority of patients only require ventilating pressure of 8 to 12 cm H₂O.

Question 4

What patient population is the only group currently accepted for the use of noninvasive ventilation (NIV) in the hospital ward?

Accepted Answer

Currently, the only patient population for whom initiation and management of NIV on hospital wards are recommended is hypercapnic COPD patients with a pH of 7.30 or greater.

Question 5

Initiating noninvasive ventilation (NIV) can be done in which of the following settings?
1) Emergency department
2) Intensive care unit
3) Hospital ward
4) Nursing home

Accepted Answer

Noninvasive ventilation can be initiated in emergency departments, intensive care units, and hospital wards. However, it may not be readily available in nursing homes, and the decision to initiate NIV in this setting should be made on an individual basis.

Question 6

Which of the following define successful application of noninvasive ventilation (NIV)? 1) Overall improvement of patient's blood gas 2) Normal blood gas 3) PaO₂ increased 4) PaCO₂ decreased

Accepted Answer

Successful application of noninvasive ventilation (NIV) is indicated by overall improvement in the patient's blood gas values, an increase in PaO2 (partial pressure of oxygen in arterial blood), and a decrease in PaCO2 (partial pressure of carbon dioxide in arterial blood). Normal blood gas values are not a necessary outcome for NIV to be considered successful, as the goal is improvement relative to baseline values.

Question 7

What complication associated with noninvasive ventilation (NIV) is most common?

Accepted Answer

Air leaks are the most common complication associated with noninvasive ventilation (NIV), occurring in up to 50% of patients. Aspiration is a potential complication but it is less common, and hypotension and nasal congestion are rare.

Question 8

Which of the following are possible solutions to correct a large air leak during noninvasive ventilation?
1) Selecting an appropriately sized mask
2) Applying chin straps
3) Using a full-face mask
4) Decreasing the inspiratory time

Accepted Answer

Selecting an appropriately sized mask and applying chin straps can help to improve the fit of the mask and minimize air leakage. Using a full-face mask may also be a solution for a significant air leak. However, decreasing the inspiratory time is not necessarily a solution for correcting an air leak and may instead affect patient ventilation.

Question 9

Which of the following techniques are useful to avoid claustrophobia in the patient being ventilated by face mask?
1) Allow patient to hold the mask.
2) Increase the inspiratory flow.
3) Use sedation.
4) Use a larger mask.

Accepted Answer

The answer of Which of the following techniques are useful...

Question 10

What is the recommended initial setting for positive end-expiratory pressure (PEEP) when delivering noninvasive ventilation in the pressure triggered timed mode?

Accepted Answer

The vast majority of patients only require PEEP levels of 5 to 8 cm H₂O.

Question 11

Which of the following is likely to occur when decreasing the expiratory positive airway pressure in the patient being ventilated using noninvasive ventilation?

Accepted Answer

Decreasing the expiratory positive airway pressure (EPAP) in noninvasive ventilation can lead to an increase in tidal volume. This is because lowering EPAP reduces the pressure support during expiration, which can decrease the resistance against which the patient exhales, potentially allowing for a greater volume of air to be inhaled during the next breath, thereby increasing tidal volume.

Quiz 49: Noninvasive Ventilation

What physiologic effect will raising the expiratory positive airway pressure have in the patient receiving noninvasive ventilation?

What is the best option for the patient in respiratory failure who continues to deteriorate 30 min after the initiation of noninvasive ventilation?

What is the recommended initial setting for ventilating pressure when delivering noninvasive ventilation in the pressure triggered timed mode?

What patient population is the only group currently accepted for the use of noninvasive ventilation (NIV) in the hospital ward?

Initiating noninvasive ventilation (NIV) can be done in which of the following settings? 1) Emergency department 2) Intensive care unit 3) Hospital ward 4) Nursing home

Which of the following define successful application of noninvasive ventilation (NIV) ? 1) Overall improvement of patient's blood gas 2) Normal blood gas 3) PaO₂ increased 4) PaCO₂ decreased

What complication associated with noninvasive ventilation (NIV) is most common?

Which of the following are possible solutions to correct a large air leak during noninvasive ventilation? 1) Selecting an appropriately sized mask 2) Applying chin straps 3) Using a full-face mask 4) Decreasing the inspiratory time

Which of the following techniques are useful to avoid claustrophobia in the patient being ventilated by face mask? 1) Allow patient to hold the mask. 2) Increase the inspiratory flow. 3) Use sedation. 4) Use a larger mask.

What is the recommended initial setting for positive end-expiratory pressure (PEEP) when delivering noninvasive ventilation in the pressure triggered timed mode?

Which of the following is likely to occur when decreasing the expiratory positive airway pressure in the patient being ventilated using noninvasive ventilation?

Quiz 49: Noninvasive Ventilation

What physiologic effect will raising the expiratory positive airway pressure have in the patient receiving noninvasive ventilation?

What is the best option for the patient in respiratory failure who continues to deteriorate 30 min after the initiation of noninvasive ventilation?

What is the recommended initial setting for ventilating pressure when delivering noninvasive ventilation in the pressure triggered timed mode?

What patient population is the only group currently accepted for the use of noninvasive ventilation (NIV) in the hospital ward?

Initiating noninvasive ventilation (NIV) can be done in which of the following settings? 1) Emergency department 2) Intensive care unit 3) Hospital ward 4) Nursing home

Which of the following define successful application of noninvasive ventilation (NIV) ? 1) Overall improvement of patient's blood gas 2) Normal blood gas 3) PaO2 increased 4) PaCO2 decreased

What complication associated with noninvasive ventilation (NIV) is most common?

Which of the following are possible solutions to correct a large air leak during noninvasive ventilation? 1) Selecting an appropriately sized mask 2) Applying chin straps 3) Using a full-face mask 4) Decreasing the inspiratory time

Which of the following techniques are useful to avoid claustrophobia in the patient being ventilated by face mask? 1) Allow patient to hold the mask. 2) Increase the inspiratory flow. 3) Use sedation. 4) Use a larger mask.

What is the recommended initial setting for positive end-expiratory pressure (PEEP) when delivering noninvasive ventilation in the pressure triggered timed mode?

Which of the following is likely to occur when decreasing the expiratory positive airway pressure in the patient being ventilated using noninvasive ventilation?

Which of the following define successful application of noninvasive ventilation (NIV) ? 1) Overall improvement of patient's blood gas 2) Normal blood gas 3) PaO₂ increased 4) PaCO₂ decreased