During initial mechanical ventilation of the chronic obstructive ...

[colton]

During initial mechanical ventilation of the chronic obstructive pulmonary disease (COPD) pa-tient with chronic hypercapnia, what PaCO2 is most likely used as a target value?
 
  a. 30 mm Hg
  b. 40 mm Hg
  c. 55 mm Hg
  d. 75 mm Hg

Question 2

What is the recommended response to a drop in PaO2 when the PEEP level is reduced in a me-chanically ventilated patient?
 
  a. Increase the FiO2.
  b. Return the PEEP to the previous level.
  c. Increase the rate of mechanical breaths.
  d. Do nothing.

[mcarey591]

Answer to Question 1

ANS: C
In the care of patients with acute exacerbation of COPD and accompanying chronic ventilatory failure, the clinician may target ventilatory support to achieve the patient's normal PaCO2 and pH. For COPD patients with chronic hypercapnia, this may mean a target PaCO2 of 50 to 60 mm Hg with a pH of 7.30 to 7.35.

Answer to Question 2

ANS: B
If the PaO2 decreases after PEEP is decreased the PEEP level should be returned to its prior set-ting.