How should O2 therapy be administered to chronically hypercapnic ...

[dbose]

How should O2 therapy be administered to chronically hypercapnic patients?
 
  a. Avoid giving any supplemental O2.
  b. Give as much O2 as possible (60 to 100).
  c. Withhold O2 until the patient is intubated.
  d. Give as much O2 as required to maintain adequate oxygenation.

Question 2

What is the response of a patient with chronic hypercapnia to a sudden acute rise in carbon diox-ide?
 
  a. In almost all of these patients, there will be no response.
  b. The patient's drive to breathe will be in-creased.
  c. This will further depress his or her respir-atory centers.
  d. This will induce apnea and sudden death.

[sultana.d]

Answer to Question 1

ANS: D
Oxygen should never be withheld from acutely hypoxemic COPD patients for fear of inducing hypoventilation and hypercapnia. Tissue oxygenation is an overriding priority; O2 must never be withheld from exacerbated, hypoxemic COPD patients for any reason. This means the clinician must be prepared to mechanically support ventilation if O2 administration induces severe hypoventilation.

Answer to Question 2

ANS: B
Chronic hypercapnia does not mean that the medullary chemoreceptors cannot respond to further acute rises in PaCO2. A sudden elevation in PaCO2 immediately crosses the blood-brain barrier into the cerebrospinal fluid, generating H+ ions that subsequently stimulate the medullary chem-oreceptors. This will increase the drive to breathe.

[dbose]

TY

[sultana.d]

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