Author Question: A patient with amyotrophic lateral sclerosis has a tracheostomy tube in place. He has been unable to ... (Read 41 times)

Caiter2013 · **on:** Jul 16, 2018

A patient with amyotrophic lateral sclerosis has a tracheostomy tube in place. He has been unable to perform an SBT successfully and has been receiving mechanical ventilation for 4 months.

An appropriate recommendation for this patient might be which of the following?
1. Transfer to a long-term care facility
2. Evaluation for the use of noninvasive ventilation (NIV)
3. Termination of ventilation
4. Waiting until the primary cause of respiratory failure has been resolved
a. 1 and 2 only
b. 2 and 3 only
c. 1, 2, and 3 only
d. 1, 2, and 4 only

Question 2

The American College of Chest Physicians (ACCP) considers long-term ventilator-assisted pa-tients to be those who require mechanical ventilation for at least _______ hours per day for _______ days or more.

a. 4; 7
b. 6; 14
c. 6; 21
d. 8; 21

milbourne11 · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: A
Unless evidence of irreversible disease exists, a patient who requires prolonged ventilatory sup-port should not be considered permanently ventilator dependent until 3 months have passed and all weaning attempts during that time have failed. Those failing to wean may require placement in a long-term care facility.

Answer to Question 2

ANS: C
The ACCP considers LTV-assisted patients to be those who require mechanical ventilation for at least 6 hours a day for 21 days or longer.