Mechanical Ventilation Patient Assignment Help: How to Answer This Question

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Original Question

To mechanical ventilation, a patient with severe loss of elastic recoil of the lungs should A. hold each breath for a short time B. inhale slowly, C. exhale slowly C. breathe as deeply as possible 2. A 65-year-old, 68-kg (150-Ib) patient is receiving PS ventilation. The following data are available FiO2_______________ 0.40 HR_________________84/min RR_________________12/min BP_________________140/90 mm hg Vt_________________450 mL PEEP______________5 cm H2O PS_________________20 cm H2O pH___________7.38 PaCO2 ________42 mm Ho PaO2 __________ 88 mm Ho HCO3 _________ 25 mEg1 BE____________ 0 mEgL Sa0, (caic)________ 97% A respiratory therapist decreases the PS to 10 cm H/O. The respiratory rate increases to 20/min, and the VT decreases to 400, and Vital signs are unchanged. The therapist should recommend A. increasing PS to 20 cm H/O B. increasing PEEP to 10 cm H,0 C. maintaining the current ventilator settings D. instituting SIMV. 3. A large-volume nebulizer used for continuous aerosol delivery is found to have fluctuations in the oxygen concentration atthe outlet port. Which of the following should a respiratory therapist do? A. Add a heater to the nebulizer. D. Check the patency of the air-entrainment port. C. Check the fluid level in the nebulizer. D. Decrease the liter flow. 4. Which of the following is obtained using hemoximetry (CO-oximetry)? A. SaO2 B. PAO2 C. P(A-a)O2 D. pH 5. A 60 kg (110Ib). 157 cm (5-ft 2-in) female patient was admitted to the ICU with ARDS following exposure to chlorine gas. She is intubated and receiving VC, A/C ventilation. The following data are observed: FIO2________0.60 Mandatory rate_____12 Vt______________300 ml Inspiratory flow_____60 L/min PEEP____________5 cm H,O Sensitivity_______-2 cm H,O ABG analysis results are: pH_____7.32 PCO2____60 mm Hg PO2______60 mm Hg HCO3_________26 mEgl BE_______-1 mEg/L Sao2, (calc)______ 85% Which of the following should a respiratory therapist recommend? A. Increase the peak flow B. Increase the PEEP C. Switch to PSV. D. Switch to SIMV 6. A 70-kg (1544b) patient was recently intubated and VC, SIMV was initiated with the following settings Mandatory rate___10 Total rate_____12 VT__________400 mL Inspiratory time__1.0 sec PEEP___________5 cm Hg The end-tidal CO2 has increased from 40 to 56 mm Hg over a 2-hour period. Which of the following should a respiratory therapist recommend? A Increase mandatory rate to 16. B. Increase to 8 cm H,O PEEP. C. Decrease inspiratory time to 0.4 seconds. D. Decrease V, to 300 mL 7. A patient with COPD is receiving VC ventilation. The flow does not return to baseline on the flow-time curve. Which of the following should be increased? A. tidal volume B. high pressure alarm limit C. expiratory time D. inspiratory time 8. During suctioning of a patient who is intubated, a respiratory therapist notes the secretions have become thicker, pursuer and more abundant than the day before. Which of the following should the therapist do? 1. Document findings in the medical record. 2. Administer a bronchodilator. 3. Instill normal saline. 9. NPPV is Initiated for a patient by nasal mask. To ensure adequate humidification, a respiratory therapist should recommend A. bubble humidifier: B. pneumatic nebulizer. C. heated humidification system. D. heat moisture exchanger. 10. A respiratory therapist reviews the following blood gas analysis results for a patient receiving an Fio2 0.30 pH________7.41 PaCO2______ 35 mm Ho PaO2________110 mm Ho HCO3_______22 mEgL RE___________-2 mEq/L SaO2 (cale)___98% Pb___________760 mm Hg The P(A-a)O2 is A. 120 mm Hg. B. 60 mm Hg C. 200 mm Hg. D. 10 mm Mg 11. The medical emergency team to called to the bedside of a patient who is recovering from an endoscopy procedure that required sedation. SpO2 is 83% ob a 6 L/min nasal cannula. The patient is noted to be obtunded and the end-tidal CO2 display reads 64 mm Hg. The patient has bilateral chest wall movement with loud snoring. Which of the following should respiratory therapist do FIRST? A. Obtain an ABG sample B. Insert an LMA. C. Perform a head bit with chin lift. D. Administer aerosolized albuterol. 12. À patient with an acute exacerbation of COPD has been receiving mechanical ventilation in the A/C mode for 48 hours. Ventilatory support is changed to Fio2 of 0.35, PS of 5 cm H20, and 5 cm H,0 PEEP. The patient is alert and oriented. The fowling data are obtained: RSBI. 64 HR. 82/MIN RR. 22 min PH. 7.37 PaCO2. 63 cum Hg PaO2. 68 mm Hg HCO3 31 mEgt BE +4 mEat SaO2 (mess). 94% Which of the following is the most appropriate recommendation? A. Discontinue PEEP B Maintain the current settings. C. Extubate the patient. D. Change to SIMV. 13. Which of the following types of ventilators should be used for a premature infant who has persistent pulmonary air leaks? A. negative pressure B. high frequency C. noninvasive D. pressure limited; time cycled 14. A previously healthy 3-year-old child presented in the ED with right-sided wheezing. Which of the following should a respiratory therapist recommend as the FIRST intervention? A. Perform chest physiotherapy. B. Administer an aerosolized beta-agonist C. Obtain a chest radiograph D. Perform an esophagoscopy. 15. À 45-year -old patient has a diagnosis of pulmonary hypertension. The patient is scheduled for a right heart catheterization toelsess pulmonary vascular reactivity. During the procedure, a respiratory therapist should expect to titrate inhaled A. heliox B. nitric oxide. C. oxygen. D. carbon dioxide 16. A patient receiving mechanical ventilation is evaluated for weaning. The patient can generate á spontaneous vital capacity of 700 mL and a maximum inspiratory pressure of -14 cm H.0. Which of the following is the most appropriate recommendation? A. increase the level of ventilatory support B. Initiate weaning. C. Maintain the current therapy D. Extubate the patient. 17. Which of the following is the most appropriate suctioning procedure to perform for a patient who is awake, has an ineffective cough, and has copious secretions? A. nasopharyngeal B. orotracheal C. oropharyngeal D. Nasotracheal

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