Page 81 - Clinical Application of Mechanical Ventilation

Effects of Positive Pressure Ventilation 47

16. A patient in the renal dialysis unit has recently been placed on a ventilator because of ventilatory and
oxygenation failure. In caring for this patient, which of the following laboratory results would indicate
that the patient’s renal functions are failing?
A. blood urea nitrogen of 30 mg/dL C. potassium of 3 mEq/L
B. creatinine of 1.0 mg/dL D. sodium of 140 mEq/L

17. For patients with renal ___ or failure, the drug concentration in the circulation is usually ___ than nor-
mal when clearance of those drugs is dependent on proper renal perfusion.
A. hyperperfusion, higher C. hypoperfusion, higher
B. hyperperfusion, lower D. hypoperfusion, lower

18. Perfusion to the liver is usually affected by a high level of ___ and hepatic failure may be present when the ___.
A. positive pressure ventilation, bilirubin level is less than 50 mg/L
B. positive pressure ventilation, albumin level is less than 20 mg/L
C. positive end-expiratory pressure, bilirubin level is greater than 50 mg/L
D. positive end-expiratory pressure, albumin level is greater than 20 mg/L

19. Cardiovascular, renal, and pulmonary dysfunction may occur in patients with an intra-abdominal
pressure ___ when positive end-expiratory pressure ___ is used during mechanical ventilation.
A. greater than 15 mm Hg, greater than 15 cm H O
2
B. greater than 20 mm Hg, greater than 15 cm H O
2
C. less than 15 mm Hg, greater than 15 cm H O
2
D. greater than 20 mm Hg, less than 15 cm H O
2
20. Gastrointestinal (GI) complications during mechanical ventilation may be caused by all of the following
conditions except:
A. increased intrathoracic pressure. C. hypoperfusion of the GI viscera.
B. increased cardiac output. D. use of opiates and sedatives.

21. For patients with increased work of breathing and CO retention, the caloric intake should be ___ than
2
normal and the source of nutrition should be ___ based so as to provide maximum calorie intake and
minimum CO production.
2
A. higher, fat C. lower, fat
B. higher, dextrose D. lower, dextrose

22. Hyperventilation is sometimes provided for patients with increased intracranial pressure. This is done
because respiratory ___ can reduce the intracranial pressure by ___ the cerebral blood vessels.
A. acidosis, dilating C. alkalosis, dilating
B. acidosis, constricting D. alkalosis, constricting

23. Headache, drowsiness, and irritability are some signs of altered ___ status resulting from hypoxemia and
hypercapnia.

A. renal C. nutritional
B. hepatic D. neurologic

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