This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A neonate receiving inhaled nitric oxide (iNO) for the treatment of persistent pulmonary ... (Read 34 times)

geoffrey

  • Hero Member
  • *****
  • Posts: 880
on: Jul 16, 2018
A neonate receiving inhaled nitric oxide (iNO) for the treatment of persistent pulmonary hypertension is receiving 80 ppm of iNO, and an Fio2 of 0.80. What should be the therapist's concern in this situation?
 
  A. that the patient will develop O2 toxicity
  B. that the patient will develop ventilator induced lung injury
  C. that the patient will develop rebound vasoconstriction
  D. that the patient will develop methemoglobinemia

Question 2

How is methemoglobinemia treated?
 
  A. infusion of methylene blue
  B. decreased doses of iNO
  C. infusion of NADH methemoglobin reductase
  D. increasing the Fio2


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

TINA

  • Sr. Member
  • ****
  • Posts: 336
Reply #1 on: Jul 16, 2018
Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Methemoglobin (metHb) results when the iron atom in heme is oxidized from Fe2+ (ferrous ion) to Fe3+ (ferric ion). In the ferric state (oxidized form), iron is incapable of binding with O2, and the affinity of other heme groups for O2 increases (i.e., shifts the oxyhemoglobin curve to the left). The normal methemoglobin blood level (<2) may be due in part to metabolism of endogenous NO. Methemoglobin reductase within erythrocytes converts endogenously produced methemoglobin to normal hemoglobin. Methemoglobinemia is uncommon at the NO doses used for therapeutic (20 ppm) inhalation. A few cases of methemoglobinemia have been reported in association with iNO therapy, generally with high doses of iNO (e.g., 80 or more ppm). In patients with decreased methemoglobin reductase, methemoglobinemia will be more likely.
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: A
A. Correct response: The usual treatment of methemoglobinemia is infusion of methylene blue, which increases NADH methemoglobin reductase. Methemoglobinemia can also be treated with ascorbic acid (vitamin C). The production of methemoglobin in patients treated with iNO is dose-dependent; methemoglobinemia is rare at usual therapeutic doses of less than 20 ppm.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.


geoffrey

  • Hero Member
  • *****
  • Posts: 880
Reply #2 on: Jul 16, 2018
TY


TINA

  • Sr. Member
  • ****
  • Posts: 336
Reply #3 on: Jul 16, 2018
Happy to Help


« previous next »
 

Did you know?

The human body's pharmacokinetics are quite varied. Our hair holds onto drugs longer than our urine, blood, or saliva. For example, alcohol can be detected in the hair for up to 90 days after it was consumed. The same is true for marijuana, cocaine, ecstasy, heroin, methamphetamine, and nicotine.

Did you know?

Patients who cannot swallow may receive nutrition via a parenteral route—usually, a catheter is inserted through the chest into a large vein going into the heart.

Did you know?

More than 50% of American adults have oral herpes, which is commonly known as "cold sores" or "fever blisters." The herpes virus can be active on the skin surface without showing any signs or causing any symptoms.

Did you know?

The familiar sounds of your heart are made by the heart's valves as they open and close.

Did you know?

About one in five American adults and teenagers have had a genital herpes infection—and most of them don't know it. People with genital herpes have at least twice the risk of becoming infected with HIV if exposed to it than those people who do not have genital herpes.

The path of blood flow through the chambers of the left and right side of the heart, including the v The path of blood flow through the chambers of the left and right side of the heart, including the v
Transurethral resection of the prostate (TURP). As a treatment for BPH, part of the prostate gland i Transurethral resection of the prostate (TURP). As a treatment for BPH, part of the prostate gland i
IgG after treatment with urea plus mercaptoethanol. IgG after treatment with urea plus mercaptoethanol.
Drugs Used in the Treatment of Migraine Drugs Used in the Treatment of Migraine
Classification of Antidepressants: Treatment of Major Depressive Disorder Classification of Antidepressants: Treatment of Major Depressive Disorder
Massage is used as a complement to standard medical treatment in hospitals and skilled nursing ... Massage is used as a complement to standard medical treatment in hospitals and skilled nursing ...
Video: Cardiac Cycle (Part 1 of 4)

For a complete list of videos, visit our video library