A 60-year-old man with a 90 pack-years smoking history arrives in the emergency department on a nonrebreathing mask with an SpO2 of 88%
The arterial blood gas results at this time indicate a pH of 7.38, PCO2 of 58, and partial pressure of oxygen (PO2) of 54. Which action should the respiratory therapist take at this time?
a. Keep the nonrebreathing mask on the pa-tient.
b. Administer an 80:20 heliox concentration.
c. Place a nasal cannula set at 6 L/min.
d. Place an air-entrainment mask on the pa-tient that delivers 0.40 FIO2.
ANS: D
An air-entrainment device is the best delivery device for a patient with chronic obstructive pul-monary disease because of its ability to provide a precise FIO2. The other choices have a greater likelihood of causing CO2 retention and knocking out the patient's hypoxic drive.
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