Mechanical Ventilation and Respiratory Support Flashcards
6 cards from real Acute Care Nurse Practitioner practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Mechanical Ventilation and Respiratory Support flashcards as text
Which complication of mechanical ventilation is characterized by new infiltrates on CXR, fever, purulent secretions, and leukocytosis after 48 hours of ventilation?
Answer: Ventilator-associated pneumonia (VAP)
VAP is defined as pneumonia developing ≥48 hours after intubation, presenting with new infiltrates, fever, leukocytosis, and purulent secretions.
Which intervention is MOST effective for preventing VAP?
Answer: Head of bed elevation to 30–45°
HOB elevation to 30–45° is the most evidence-based intervention for VAP prevention by reducing aspiration of oropharyngeal secretions.
Non-invasive positive pressure ventilation (NIPPV) is MOST beneficial in which acute respiratory scenario?
Answer: Acute hypercapnic COPD exacerbation
NIPPV (BiPAP) most clearly reduces intubation and mortality in acute hypercapnic COPD exacerbations by offloading respiratory muscles.
A ventilated patient develops a sudden decrease in compliance and hypoxia. CXR shows absent breath sounds on the left. What is the IMMEDIATE priority?
Answer: Needle decompression of the left chest
Sudden unilateral absent breath sounds with hemodynamic compromise in a ventilated patient indicates tension pneumothorax requiring immediate needle decompression.
Which acid-base disturbance is an expected finding in a patient with permissive hypercapnia during ARDS management?
Answer: Respiratory acidosis with partial metabolic compensation
Permissive hypercapnia intentionally allows PaCO₂ to rise; the kidneys partially compensate with bicarbonate retention, producing respiratory acidosis.
Which neuromuscular blocking agent is recommended in early severe ARDS (PaO₂/FiO₂ <150) to improve outcomes?
Answer: Cisatracurium
Cisatracurium was used in the ACURASYS trial for early severe ARDS, showing improved mortality and reduced ventilator days (though ROSE trial showed mixed results).