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Lindsey Jones TMC Questions And Answers The following arterial blood gas results are available for a patient receiving volume controlled ventilation. pH 7.21 PaCO2 53 torrPaO2 72 torrHCO3- 23 mEq/LBE -2 mEq/L Current ventilator settings are: Mode Assist/control VT 550 mL Mandatory rate 12Tota...

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  • October 26, 2024
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Lindsey Jones TMC Questions And Answers

The following arterial blood gas results are available for a patient receiving volume controlled

ventilation.

pH 7.21 PaCO2 53 torrPaO2 72 torrHCO3- 23 mEq/LBE -2 mEq/L

Current ventilator settings are:

Mode Assist/control VT 550 mL Mandatory rate 12Total rate 12FIO2 1.0PEEP 20 cm H2O




The respiratory therapist should recommend:




A. increasing PEEP

B. decreasing tidal volume

C. decreasing FIO2


D. increasing mandatory rate D. This patient's blood gas reveals hypoventilation and

hypoxemia. Of these two problems, ventilation should be addressed first. Because PaCO2 is off

target by more than 4 mmHg the best option would be to increase mandatory rate.




A decreasing CvO2 while CaO2 remains constant is most closely associated with




A. increasing tissue oxygen consumption

, Lindsey Jones TMC Questions And Answers
B. decreasing SVR

C. increasing PVR


D. decreasing oxygen consumption A. If CvO2 is decreasing while CaO2 remains the

same, there is a widening between the arterial and venous oxygen content difference C(a-v)O2. A

bigger gap between these numbers, or an increase in the C(a-v)O2, is associated with decreasing

tissue oxygen consumption which is also associated with a decrease in cardiac output.




What is the static compliance in mL/cm H2O, given the following data on a patient receiving VC

AC ventilation?




Plateau pressure 15 cm H2O Peak pressure 25 cm H2OVT 500 mLPEEP 5 cm H2O




A. 25

B. 20

C. 50


D. 33 C. To determine static compliance, tidal volume is divided by plateau pressure after

subtracting any PEEP. In this case, (500/(15-5) = 50 cm H2O.

, Lindsey Jones TMC Questions And Answers
A homeless patient reports to a clinic with hemoptysis and emaciation, as well as other

symptoms consistent with tuberculosis. Which of the following exams would be most

appropriate to further assess the patient?




A. Mantoux test

B. eosinophil count

C. FeNO exhaled gas analysis


D. serum creatinine blood level A. A Mantoux test (also called a TB test) is helpful in

determining the patient's exposure to the tubercle bacilli. Although not diagnostic for TB, it is a

quick screening method that is appropriate.




A patient with confirmed Guillain-Barre' Syndrome is being monitored every 4 hours. The

following data is available:




10 am 2 pm 6 pm VC (L) 1.6 1.4 0.8VT (mL) 500 485 260MIP (cm H2O) -48 -35 -24




The respiratory therapist should recommend




A. intubate and initiate mechanical ventilatory support

, Lindsey Jones TMC Questions And Answers
B. administer systemic steroid medication

C. continue to monitor the patient closely


D. check the protein level in the spinal fluid A. A patient with Guillain-Barre' Syndrome

experiences a slow onset of paralysis of the ventilatory muscles and will ultimately require

mechanical ventilatory support. The point at which ventilatory support is needed is when vital

capacity falls below 1 L. In this case, vital capacity is 0.8 L indicating the patient should be

intubated and receive mechanical ventilatory support.




A patient with a history of hyper-reactive airway disease is having difficulty expectorating

because the sputum is thick and tenacious. Which of the following medications should the

respiratory therapist recommend?




A. Solu-Mederol

B. Acetylcysteine (mucomyst)

C. Spiriva (tiotropium bromide)


D. Beclamethasone (Beclovent) B. Hyperactive airway disease is associated with diseases

such as asthma and consist of bronchoconstriction and inflammation. This patient appears to

have difficulty with bronchoconstriction and thick secretions. Therefore, a mucolytic, such as

acetylcysteine, and Solu-Medrol are appropriate.

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