Why should the therapist be reluctant to provide excess protein ...

[Zulu123]

Why should the therapist be reluctant to provide excess protein to a COPD patient who is being weaned from mechanical ventilation and who has an increased ventilatory drive?
 
  A. Hypoventilation may occur.
  B. The patient may overventilate.
  C. Pulmonary perfusion may decrease.
  D. Anaerobic respiration may be induced.

Question 2

Which of the following diets, given to patients with ARDS, reduces the number of ventilator days, ICU days, and the number of days requiring supplemental O2?
 
  A. omega-6 fatty acid-20 diet
  B. a 70:30, fat:carbohydrate diet
  C. EPA-plus-GLA diet
  D. A 20:80, protein:carbohydrate diet

[katara]

Answer to Question 1

ANS: A
A. Correct response: Theoretically, increasing protein provision may be used to stimulate ventilatory drive in weaning efforts. However, in pushing too hard with protein infusion in a patient with COPD, who already has an increased ventilatory drive, may precipitate fatigue and dyspnea. The fatigue and failure may lead to lower minute ventilation and a further increased Paco2.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: A specific enteral formula for mechanically ventilated patients with acute respiratory distress syndrome (ARDS) has been introduced. This formula (Oxepa) relies on the use of anti-inflammatory specific fatty acids to modulate the inflammatory response. Fatty acids, such as eicosapentaenoic acid (EPA; omega-3 fatty acid, 20:5n3), have been used successfully to dampen inflammation in several chronic diseases. The clinical benefits observed in patients given EPA plus GLA were a significant reduction in ventilator days and ICU days, and a decrease in supplemental O2 days.
D. Incorrect response: See explanation C.