A 28-year-old female was admitted last night for weakness and what appears to be ascending muscle paralysis

Question

The patient is alert and oriented. Physical findings reveal: pulse 96 beats/min, regular; blood pressure 134/83 mm Hg; temperature 37° C; respiratory rate 24 breaths/min shallow with bilateral decrease in air entry; and no adventitious breath sounds. The patient's ABG results on room air are: pH 7.46; PaCO2 39 mm Hg; PaO2 80 mm Hg; Sat 97%; and HCO3? 26 mEq/L on room air. The most appropriate suggestion that the respiratory therapist should make for this patient in-cludes which of the following?
a. Vital capacity every 2 hours
b. Continuous positive airway pressure
c. Noninvasive positive pressure ventilation
d. Peak expiratory flow rate

Answer 1

ANS: A
Although this patient is suffering from a neuromuscular disease, the patient's arterial blood gas results are within normal limits and therefore do not warrant the use of continuous positive air-way pressure (CPAP) or noninvasive positive airway pressure (NPPV). Peak expiratory flow rate is most frequently used to assess airway resistance for patients with acute asthma. This patient requires frequent monitoring to assess her respiratory muscle strength, and that would be within the vital capacity.