Author Question: An adult patient in respiratory failure has the following blood gases on a nasal cannula at 5 L/min: ... (Read 18 times)

kellyjaisingh · **on:** Jul 16, 2018

An adult patient in respiratory failure has the following blood gases on a nasal cannula at 5 L/min: pH = 7.20; PaCO2 = 67 mm Hg; HCO3= 27 mEq/L; PaO2 = 89 mm Hg.

The attending physician orders intubation and ventilatory support. What FiO2 would you rec-ommend to start with?
a. 0.21
b. 0.30
c. 0.50
d. 0.90

Question 2

In which of the following conditions is PEEP likely to be useful? 1. ARDS 2. Pulmonary edema 3. Acute lung injury 4. Neuromuscular disease

a. 1 and 3 only
b. 1, 2, and 3 only
c. 3 and 4 only
d. 2, 3, and 4 only

matt · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: C
Patients who have undergone previous blood gas measurement or oximetry who are doing well clinically and patients with disease states or conditions that normally respond to low to moderate concentrations of O2 may begin ventilation with 50 to 70 O2.

Answer to Question 2

ANS: B
PEEP and continuous positive airway pressure are effective techniques for improving and main-taining lung volume and improving oxygenation for patients with acute restrictive disease such as acute lung injury, pneumonia, pulmonary edema, and ARDS.
A PaO2 less than 50 to 60 mm Hg with an FiO2 greater than 0.40 to 0.50 is a good general start-ing place for considering use of PEEP or continuous positive airway pressure.