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Author Question: Overall, when mechanically ventilating a patient who has airflow obstruction, which of the following ... (Read 14 times)

Kikoku

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on: Jul 16, 2018
Overall, when mechanically ventilating a patient who has airflow obstruction, which of the following issues should the therapist bare in mind when managing this type patient compared with a person with normal lungs?
 
  A. This patient may require less minute ventilation.
  B. This patient may need to receive elevated peak inspiratory pressures.
  C. The delivery of lower than usual inspiratory flows should be expected.
  D. The acceptable oxygenation (Pao2) level of this type patient will lie in the range of 70 to 80 mm Hg.

Question 2

Which of the following physiologic and/or mechanical changes can the therapist expect a patient who is receiving volume-controlled ventilation for airflow obstruction to experience as a result of having narrowed airways? I. increased peak airway pressures II. overdistention injury to distal airways III. reduced risk for volutrauma IV. increased alveolar dead space
 
  A. I, IV only
  B. II, III only
  C. I, II, IV only
  D. I, III, IV only


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brittanywood

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Reply #1 on: Jul 16, 2018
Answer to Question 1

ANS: A
A. Correct response: The therapist must realize that managing the mechanical ventilation of patients who have airflow obstruction, characterized by (1) air trapping and auto-PEEP, and (2) narrowed airways causing high resistance to airflow, may involve significant reduction of minute ventilation and resulting hypercapnia. This situation may be entirely normal for this type of patient who may be a CO2 retainer.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Narrowed airways produce a high resistance to flow that can cause high peak pressures. Much of this pressure is dissipated in providing gas flow through obstructed airways, and therefore does not overdistend distal alveoli. However, the heterogeneous distribution of airflow obstruction seen in most airways diseases means that less obstructed alveolar regions may be transiently exposed to these high peak pressures and be at risk for overdistention injury. Therefore the therapist should realize that a high peak pressure, even in the presence of a plateau pressure less than 30 cm H2O, should be prevented. Perhaps auto-PEEP causes overdistention injury as well.
D. Incorrect response: See explanation C.


Kikoku

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Reply #2 on: Jul 16, 2018
Correct answers!


brittanywood

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Reply #3 on: Jul 16, 2018
Great! Please up vote :D


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