A patient with acute cardiogenic pulmonary edema (ACPE), as evidenced by pink, frothy secre-tions, arrives in the emergency department (ED) by ambulance with a nonrebreather mask (NRM) at 15 L/min
An arterial blood gas sample is drawn in the ED while the patient is on the NRM; the values are: pH = 7.50, PaCO2 = 28 mm Hg; PaO2 = 43 mm Hg; SaO2 = 84%; HCO3? = 24 mEq/L. After evaluating the situation, the respiratory therapist should suggest which of the following thera-pies?
a. IPPB with supplemental oxygen
b. Mask CPAP with supplemental oxygen
c. Postural drainage to clear the secretions
d. NIV via nasal mask with postural drainage
ANS: B
The current recommendation for ACPE is for CPAP to be used initially. NIV should be used only in patients who were hypercapnic and continue to be hypercapnic in spite of the CPAP. This patient is not hypercapnic at this time; therefore, mask CPAP is the appropriate therapy. IPPB is not appropriate because the positive effects of the therapy will be lost after a few minutes off the therapy.
You might also like to view...
The services covered under the four parts of Medicare include all of the following EXCEPT:
a. Part A is considered the basic plan or hospital insurance. b. Part B is the medical (supplementary, voluntary) insurance. c. Part C is the Medicare advantage portion and includes coverage exclusively for ESRD. d. Part D is the prescription drug component (effective 2006) introduced by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
What reveals the general circumstances surrounding and contributing to an incident?
A) Expert testimony B) Direct information C) Corroborative evidence D) Indirect information
Which code represents exploratory supratentorial craniectomy?
a. 61304 b. 61305 c. 61314 d. 61320
According to Dr. William H. Thomas, which stage has the most emphasis on "doing"?
a. Adolescent b. Adult c. Senescence d. Elderhood