An intubated patient is receiving mechanical ventilation with the following settings: VC-CMV, rate = 18, VT = 850 mL (10 mL/kg), PEEP = 5 cm H2O, flow rate = 40 L/min. The patient is se-dated and is not assisting the ventilator
During a patient-ventilator system check, the respiratory therapist observes the following venti-lator graphic:
The respiratory therapist should do which of the following?
a. Decrease the flow rate.
b. Increase the PEEP.
c. Decrease the rate.
d. Increase the VT.
ANS: C
The figure clearly shows air trapping, as evidenced by failure of the expiratory portion of the curve to return to zero. Auto-PEEP should be suspected whenever flow does not return to base-line in the flow-volume loop. Efforts to reduce auto-PEEP can be aided by reducing the inspira-tory time, minute ventilation, and Raw. Decreasing the rate in this case would decrease the minute ventilation. Decreasing the flow rate would increase the inspiratory time, worsening the air trap-ping, and auto-PEEP. Increasing PEEP may make it easier for the patient to trigger the ventilator, but it would not reduce the air trapping. Increasing the VT would worsen the air trapping.
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Which of the following is NOT a constituent element that forms a specific, individual E/M service?
a. Place of the E/M service b. Type of E/M service c. Individually listed code d. The language spoken by the patient
You have responded to a home where a man is complaining of chest pain. A woman answers the door and states that her husband, a terminal cancer patient, is experiencing chest pain and dyspnea. She says quietly that he only has a "little while left" and she wants him to be comfortable. Your assessment reveals a 66-year-old male in unstable ventricular tachycardia. He is somewhat coherent and is
adamant about not going to the hospital to die. What is your best course of action? A) This is a lethal rhythm and requires immediate ACLS. No directives have been produced. Be tactful but treat this patient like any other. B) Try and convert this rhythm and see what happens. If you can get him back into a perfusing normal sinus rhythm, he can sign a release. C) Call medical control and ask for advice. D) Explain to the woman that if she wants him to die at home, not to call 911 and just let nature take its course.
The heart has its own vascular system.
Answer the following statement true (T) or false (F)
An oral carbohydrate is necessary to reduce the symptoms of _________________ in a conscious patient
Fill in the blank(s) with correct word