Exam 5: Initiation of Mechanical Ventilation

A combination of pressure-limited breaths with a volume target is called:

Which of the following arterial blood gas parameters is considered the best indicator of a patient's ventilatory status?

A sudden increase in the PaCO₂ to 53 mm Hg accompanied by a pH of 7.24 is best described as which of the following?

A 62-year-old man was admitted for a suspected myocardial infarction. Current ABG values on room air are as follows: PaO₂ = 56 mm Hg, PaCO₂ = 34 mm Hg, pH = 7.47, and HCO₃⁻ = 26 mEq/L. Which of the following is the most appropriate form of respiratory therapy for this patient?

Which of the following breathing patterns is the most common sign of ventilatory failure associated with increased work of breathing and fatigue of respiratory muscles?

A 36-year-old man is taken to the emergency department after a motorcycle accident. He is unconscious and unresponsive. ABGs obtained while the patient is receiving oxygen via a nonrebreathing mask show the following: PaO₂ = 48 mm Hg, PaCO₂ = 90 mm Hg, pH = 7.10, and HCO₃⁻ = 27 mEq/L. Which of the following would the therapist recommend?

A 31-year-old motor vehicle accident victim is admitted to the hospital with crushed chest injuries and a fractured leg. Two days later the patient's PaO₂ is 55 mm Hg while breathing 85% oxygen, and the respiratory rate is 34 breaths/min. Based on the history and these findings, which of the following does the patient most likely need?

Acute ventilatory failure is specifically _________, whereas respiratory insufficiency could be inadequate lung function with either hypoxia or hypercapnia.

The critical care team for patient safety and quality improvement wants to ensure that newly published national guidelines for initiating mechanical ventilation are implemented as quickly as possible by staff on all shifts. Which of the following would likely yield the best results?

A patient admitted to the emergency department with unknown history has the following blood gas results on room air: pH = 7.23, PaCO₂ = 80 mm Hg, HCO₃⁻ = 33 mEq/L, PaO₂ = 43 mm Hg, and SaO₂ = 72%. With no other data available, which of the following forms of therapy is indicated?

A patient with sudden onset of hypoxemia, hypercapnia, and a normal bicarbonate value also has a normal P_(A-a)O₂ value. This would most likely be due to which one of the following?

A 50-year-old woman admitted to the emergency department demonstrates tachypnea, tachycardia, and appears pale. Breath sounds reveal bilateral crackles. ABG results with the patient using a nonrebreathing mask are as follows: PaO₂ = 48 mm Hg, PaCO₂ = 32 mm Hg, pH = 7.49, and HCO₃⁻ = 23 mEq/L. Which of the following is the most appropriate initial treatment for this patient?

Which of the following is the absolute contraindication to mechanical ventilation?

A 27-year-old man with food poisoning is beginning to develop progressive paralysis. The respiratory therapist has been monitoring the patient's MIP and VC every 2 hours. The most recent results show that the patient continues to deteriorate: MIP = −17 cm H₂O, VC = 31 mL/kg. Which of the following could be appropriately recommended?

A 66-year-old man in the emergency department has a history of COPD and CO₂ retention. He is conscious and cooperative but in distress, and receiving oxygen by nasal cannula at 2 L/min. He is breathing in a tripod position and using accessory muscles. His vitals are: heart rate = 102 beats/min, blood pressure = 127/77 mm Hg, temperature = 37.5°C, respiratory frequency = 20 breaths/min with prolonged expiration and using pursed lip-breathing. Bilateral sounds with crackles and wheezing. Which of the following is most appropriate?

Which of the following suggests the presence of acute respiratory failure and the need for ventilatory support? I. MIP of −16 cm H₂O II. VC of 2.2 L for a 70-kg man III. PaCO₂ of 80 mm Hg and pH of 7.19 IV. PaO₂ of 65 mm Hg on room air

A 72-year-old patient with COPD who has acute-on-chronic respiratory failure is supported with noninvasive ventilation. The patient is becoming more confused. Blood gas values are as follows: PaO₂ = 46 mm Hg, PaCO₂ = 57 mm Hg, pH = 7.22, and HCO₃⁻ = 22 mEq/L. Which of the following would be appropriate treatment for this patient?

A 45-year-old man who weighs 166 lbs (75.5 kg) and has myasthenia gravis is beginning to develop progressive weakness of the muscles. The respiratory care practitioner has been monitoring MIP and VC every 4 hours. The most recent results show that the patient continues to deteriorate despite treatment with anticholinesterase drugs: MIP = −35 cm H₂O, VC = 23 mL/kg. Which of the following would be appropriate to recommend?

Which of the following are goals of mechanical ventilation? I. Provide breaths to maintain an adequate level of alveolar ventilation II. Reduce patient work of breathing until the cause of respiratory failure can be remedied. III. Restore arterial blood gas levels to normal IV. Increase immune response

A 32-year-old woman is seen in the emergency department. She demonstrates paralysis of the lower extremities that is progressively worsening. After several hours, during which she was monitored frequently, her VC has decreased to 12 mL/kg and MIP is −29 cm H₂O. The results of blood gas evaluations are not yet available. What type of therapy is most likely needed?