A patient with respiratory failure has arterial pressurebased ...

[laurencescou]

A patient with respiratory failure has arterial pressurebased cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O.
 
  Which information indicates that a change in the ventilator settings may be required?
  a. The arterial pressure is 90/46.
  b. The heart rate is 58 beats/minute.
  c. The stroke volume is increased.
  d. The stroke volume variation is 12.

Question 2

A nurse is weaning a 68-kg male patient who has chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Which patient assessment finding indicates that the weaning protocol should be stopped?
 
  a. The patient's heart rate is 97 beats/min.
  b. The patient's oxygen saturation is 93.
  c. The patient respiratory rate is 32 breaths/min.
  d. The patient's spontaneous tidal volume is 450 mL.

[Koolkid240]

Answer to Question 1

ANS: A
The hypotension suggests that the high intrathoracic pressure caused by the PEEP may be decreasing venous return and (potentially) cardiac output. The other assessment data would not be a direct result of PEEP and mechanical ventilation.

Answer to Question 2

ANS: C
Tachypnea is a sign that the patient's work of breathing is too high to allow weaning to proceed. The patient's heart rate is within normal limits, although the nurse should continue to monitor it. An oxygen saturation of 93 is acceptable for a patient with COPD. A spontaneous tidal volume of 450 mL is within the acceptable range.