Author Question: A 39-year-old, 5'4, 138 lb female patient requires intubation and mechanical ventilation. Her body ... (Read 31 times)

danielfitts88 · **on:** Jul 16, 2018

A 39-year-old, 5'4, 138 lb female patient requires intubation and mechanical ventilation. Her body temperature is 39 C. She has no history of lung disease. The appropriate initial minute ven-tilation for this patient is which of the following?

a. 5.7 L/min
b. 6.8 L/min
c. 7.6 L/min
d. 13.8 L/min

Question 2

A patient having an acute, severe asthma exacerbation is intubated and set up on vol-ume-controlled continuous mandatory ventilation (VC-CMV).

To ensure volume delivery at the lowest peak pressure while providing for better air distribution, which flow waveform should be used?
a. Sine
b. Constant
c. Ascending ramp
d. Descending ramp

ms_sulzle · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: B
First calculate ideal body weight (IBW) for a female, using the formula 105 + 5(ht 60). This patient's IBW is 57 kg. Minute ventilation is about 100 mL/kg IBW, which would be 57,000 mL/min or 5.7 L/min. VE would have to be increased by 10 for each degree above 37 C: a to-tal increase of 20 of 5.7 = 1.14; therefore, the new minute ventilation (VE) would be 5.7 + 1.14 = 6.8 L/min.

Answer to Question 2

ANS: D
In patients with high airway resistance (Raw), the descending pattern is more likely to deliver a set tidal volume (VT) at a lower pressure and provide for better distribution of air through the lung than a constant or an accelerating flow.