A patient who requires prolonged ventilatory support should not ...

[codyclark]

A patient who requires prolonged ventilatory support should not be considered permanently ven-tilator dependent until ________ month(s) has/have passed and all weaning attempts during that time have failed.
 
  a. 1
  b. 3
  c. 6
  d. 9

Question 2

A patient being actively weaned from mechanical ventilation currently is receiving the following ventilatory support: pressure support = 15 cm H2O,
 
  spontaneous VT = 575 mL, spontaneous rate = 14 breaths/min, spontaneous VT = 500 mL, FIO2 = 35, PEEP = 5 cm H2O. The arterial blood gas results are: pH = 7.42, PaCO2 = 38 mm Hg, PaO2 = 94 mm Hg, SaO2 = 98, HCO3 = 24 mEq/L. What should the respiratory therapist do next?
  a. Reduce PEEP to zero.
  b. Reduce the FIO2 to 30.
  c. Reduce the PS to 10 cm H2O.
  d. Extubate the patient.

[medine]

Answer to Question 1

ANS: B
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.

Answer to Question 2

ANS: C
At this point, the ABG results show no acid-base imbalance and no hypoxemia. The parameter that should be reduced is the pressure support. When pressure support is reduced to about 5 cm H2O, the pressure level is not high enough to contribute significantly to ventilatory support. Once at PS 5 cm H2O, the patient will be ready for a cuff leak test.