Positive Pressure Ventilation Flashcard 2
Rationale
A. Rationale: The oxygen hose must be connected in the open reservoir or tail of the self-inflating valve.
Question
To provide free-flowing oxygen via a self-inflating valve to a non vigorous patient in respiratory distress, where should the oxygen hose be connected?
a. Through the open reservoir or “tail”
b. At the pop-off valve
c. Into the one-way valve
d. Into the mask cushion
Answer
a. Through the open reservoir or “tail”
Rationale
D. Rationale: The peak inspiratory pressure (PIP) must be enough to overcome any airway resistance. It is the highest pressure supplied to the lungs during each positive pressure ventilation. The required PIP increases when there are secretions or bronchospasm.
Question
When analyzing the normal-pressure time curve of assisted ventilation, which one of the following corresponds to the highest pressure administered to the neonate after each breath?
a. Positive-end expiratory pressure
b. Plateau pressure
c. Inspiratory time
d. Peak inspiratory pressure
Answer
d. Peak inspiratory pressure
Rationale
B. Rationale: The first course of action when providing positive pressure ventilation with any device is to clear the infant’s oral and nasal secretions using a bulb syringe to open the patient’s airway.
Question
When preparing a newborn for positive pressure ventilation using a free-flow inflation bag and mask, what is the first thing you should do?
a. Adjust the head and neck to open the airway.
b. Use a bulb syringe to remove secretions in the nose and mouth.
c. Apply the mask firmly over the nose and mouth using the E-C clamp technique.
d. Intubate the patient.
Answer
b. Use a bulb syringe to remove secretions in the nose and mouth.
Rationale
C. Rationale: The T-piece cap has a dial that can be adjusted to regulate the gas that can escape after each PPV. This enables the adjustment of PEEP and CPAP administered to the patient.
Question
Which device used in giving positive pressure ventilation has a dial that can be adjusted to regulate the gas that can escape after each delivered breath, which in turn enables the adjustment of the positive end-expiratory pressure and continuous positive airway pressure?
a. A self-inflating bag
b. A flow-inflating bag
c. A T-piece resuscitator
d. An endotracheal tube
Answer
c. A T-piece resuscitator
Rationale
A. Rationale: When giving assisted ventilation, it is necessary to measure the pressures in the lungs to ensure adequate ventilation and avoid barotrauma. A manometer is connected to the mechanical ventilation device to record the pressures in the lungs during mechanical ventilation.
Question
Which medical device can measure the pressure delivered during each breath when positive pressure ventilation is being administered during neonatal resuscitation?
a. Manometer
b. Central line
c. Capnography
d. Pulse oximeter
Answer
a. Manometer
Rationale
D. Rationale: Chest X-ray gives a definitive diagnosis of pneumothorax when hypolucent areas where air leakage is suspected are seen as the diagnostic feature. Auscultation of the patient’s chest will demonstrate diminished breath sounds on the side of the suspected pneumothorax. Transillumination of the chest will reveal the brightest light from the fiberoptic light source on the side with the pneumothorax. All of these techniques should not be dismissed as they are pertinent findings in the diagnosis of pneumothorax.
Question
Which of the following clinical diagnostic procedures is/are pertinent to the diagnosis of a pneumothorax?
a. Chest X-ray
b. Auscultation of the chest
c. Transillumination of the chest
d. All of the above
Answer
d. All of the above
Rationale
D. Rationale: Both the T-piece resuscitator and the flow-inflating bag can be used to perform continuous positive pressure ventilation. CPAP can be delivered through an endotracheal tube but not by the tube itself.
Question
Which of the following devices can deliver continuous positive airway pressure (CPAP)?
a. A self-inflating bag
b. A nebulizer
c. An endotracheal tube
d. A T-piece resuscitator
Answer
d. A T-piece resuscitator
Rationale
B. Rationale: The self-inflating bag is made of a material that retains its original shape when no pressure is being applied to it. Therefore, it does not need compressed gas to inflate it.
Question
Which of the following medical devices used for providing positive pressure ventilation spontaneously expands and fills with gas without any source of compressed air?
a. T-piece resuscitator
b. Self-inflating bag
c. Flow-inflating bag
d. Anesthesia bag
Answer
b. Self-inflating bag
Rationale
C. Rationale: The two-handed technique is the preferred method because it can achieve a tight seal while maintaining the head and neck of the newly born in a position that allows for airway patency. The provider uses both thumbs and index fingers to press the mask against the baby’s face.
Question
Which one of the following is the preferred method for delivering positive pressure ventilation to a newly born during neonatal resuscitation?
a. E-C clamp technique
b. One-handed technique
c. Two-handed technique
d. It does not matter which method to use because all are appropriate
Answer
c. Two-handed technique
Rationale
A. Rationale: Pneumothorax can be caused by over ventilating the patient’s lungs and causing trauma to the pleura. It creates a leak of air into the intrathoracic cavity, causing compression of the mediastinal structures and restriction of lung motion.
Question
Which one of the following medical conditions is known as air leakage from the lungs that causes an increase in intrathoracic pressure?
a. Pneumothorax
b. Pneumonia
c. Tamponade
d. Acute Respiratory Distress Syndrome
Answer
a. Pneumothorax