The RT assesses the flow-time scalar from an apneic patient ...

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The RT assesses the flow-time scalar from an apneic patient mechanically ventilated in the VC-CMV mode. The most appropriate action for this patient is to do which of the following?
 
  a. Decrease the set flow rate.
  b. Reduce the set ventilator rate.
  c. Increase the inspiratory time.
  d. Decrease the set tidal volume.

Question 2

A patient with asthma is being ventilated in PSV, 5 cm H2O, with CPAP of 5 cm H2O. The pa-tient has chest wall retractions on most breaths and appears to have an increased WOB.
 
  The following graphic occurred the entire time the respiratory therapist was assessing the patient. What does this graphic demonstrate?
 
  a. Trigger asynchrony
  b. Mode asynchrony
  c. PEEP asynchrony
  d. Cycle asynchrony

[bookworm410]

Answer to Question 1

ANS: B
Because the patient is apneic, all the breaths are time triggered. The flow-time scalar shows that the ventilator rate is 40 breaths/min. The scalar also shows that air trapping is present. To alleviate this problem, the ventilator rate must be reduced to an acceptable level, such as 12-14 breaths/min.

Answer to Question 2

ANS: A
The flow-time scalar shows that some breath initiations made by the patient are not triggering the ventilator; this is known as trigger asynchrony. In this particular patient, it could be caused by auto-PEEP. Patients experiencing asthmatic episodes have increased airway resistance, which can lead to auto-PEEP, which can affect the ventilator's ability to sense the patient's efforts.

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Gracias!

[ktidd]

TYSM