Mechanical Ventilation Management Flashcards

A patient on volume-control ventilation suddenly shows a rising peak inspiratory pressure with an unchanged plateau pressure. What does this indicate?

Answer: An airway resistance problem such as secretions or bronchospasm

A rise in peak pressure with a stable plateau pressure reflects increased airway resistance, not a compliance change.

Which finding best confirms correct endotracheal tube placement after intubation?

Answer: Sustained waveform capnography (ETCO2)

Sustained ETCO2 on waveform capnography is the most reliable confirmation of tracheal placement.

A patient develops auto-PEEP (intrinsic PEEP). Which ventilator change most directly addresses it?

Answer: Decrease respiratory rate to lengthen expiratory time

Lowering the rate (and thus extending expiratory time) allows fuller exhalation, reducing air trapping.

In ARDS, lung-protective ventilation targets which tidal volume?

Answer: 6 mL/kg of predicted body weight

ARDSNet protocol uses 6 mL/kg of predicted body weight to limit volutrauma.

Plateau pressure should be maintained below which value to limit ventilator-induced lung injury?

Answer: 30 cm H2O

Keeping plateau pressure under 30 cm H2O reduces alveolar overdistension and barotrauma.

A ventilated patient becomes acutely hypotensive with distended neck veins, absent breath sounds on one side, and tracheal deviation. What is the priority intervention?

Answer: Immediate needle decompression for tension pneumothorax

These signs indicate tension pneumothorax, a life threat requiring immediate decompression, not imaging delay.

Which intervention is a core component of the ventilator-associated pneumonia (VAP) prevention bundle?

Answer: Elevate the head of bed 30–45 degrees

Semi-recumbent positioning reduces aspiration risk and is a key VAP bundle element.