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Exam (elaborations)

Midterm ACNP II- Questions & Answers

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  • ACNP
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  • ACNP

Midterm ACNP II- Questions & Answers

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  • November 11, 2024
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  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • ACNP
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Midterm ACNP II- Questions & Answers
What is VILI? Correct Ans-It is Ventilator Induced Lung Injury




How does one get VILI? Correct Ans-Volutrauma- Overdistention d/t uneven distribution of
tidal volume in good/disease lung (AKA: Barotrauma)



Atelectrauma- Repetivie opening and closing of non-compliant alveoli shear/tears them d/t loss
of surfactant



Biotrauma- Systemic release of cytoxines, endotoxins (bacteria), loss of elasticity



What is the Tidal Volume in ARDS treatment? Correct Ans-6-8ml/kg of PREDICTED BODY
WIEGHT



What is the lung protective strategy with low Tidal volume in ARDS? Correct Ans-Low TV
ventilation

-Vt 6ml/kg of PBW

-Keep PPlat <30cm H20

-Increase PEEEP to 10-15cm H20



What are the oxygen goals in lung protective strategy with low Tv? Correct Ans-FiO2 < 0.6

PaO2 > 60

, SaO2 ) 88%



We allow for permissive hypercapnia (adjust RR to increase MV while maintaining low TV)-
PaCO2 >45 and pH >7.25



What strategy do we use in ARDS to increase lung recrutiment? Correct Ans-Prone position-
improves oxygenation



When is proning contraindicated? Correct Ans-Increased ICP

Severe hemoptysis

Recent sternal surgery

Pregnancy

New DVT

Unstable fractures



What are recruitment maneuvers? Correct Ans-Temporary maneuvers to recruit alveoli (think
temporary hyperinflation)



When are recruitment maneuvers used cautiously? Correct Ans-Hypovolemia or shock




What does APRV do? Correct Ans-Airway Pressure Release Ventilation

-Long inspiratory time at elevated pressure

-Short expiratory tim at low pressure (not 0cm H20)

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