A patient with amyotrophic lateral sclerosis has a tracheostomy ...

[Caiter2013]

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]

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.

[Caiter2013]

TYSM

[Joy Chen]

Wow, this really help