This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A neonate receiving inhaled nitric oxide (iNO) for the treatment of persistent pulmonary ... (Read 75 times)

geoffrey

  • Hero Member
  • *****
  • Posts: 880
on: Jul 16, 2018
A neonate receiving inhaled nitric oxide (iNO) for the treatment of persistent pulmonary hypertension is receiving 80 ppm of iNO, and an Fio2 of 0.80. What should be the therapist's concern in this situation?
 
  A. that the patient will develop O2 toxicity
  B. that the patient will develop ventilator induced lung injury
  C. that the patient will develop rebound vasoconstriction
  D. that the patient will develop methemoglobinemia

Question 2

How is methemoglobinemia treated?
 
  A. infusion of methylene blue
  B. decreased doses of iNO
  C. infusion of NADH methemoglobin reductase
  D. increasing the Fio2


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

TINA

  • Sr. Member
  • ****
  • Posts: 336
Reply #1 on: Jul 16, 2018
Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Methemoglobin (metHb) results when the iron atom in heme is oxidized from Fe2+ (ferrous ion) to Fe3+ (ferric ion). In the ferric state (oxidized form), iron is incapable of binding with O2, and the affinity of other heme groups for O2 increases (i.e., shifts the oxyhemoglobin curve to the left). The normal methemoglobin blood level (<2) may be due in part to metabolism of endogenous NO. Methemoglobin reductase within erythrocytes converts endogenously produced methemoglobin to normal hemoglobin. Methemoglobinemia is uncommon at the NO doses used for therapeutic (20 ppm) inhalation. A few cases of methemoglobinemia have been reported in association with iNO therapy, generally with high doses of iNO (e.g., 80 or more ppm). In patients with decreased methemoglobin reductase, methemoglobinemia will be more likely.
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: A
A. Correct response: The usual treatment of methemoglobinemia is infusion of methylene blue, which increases NADH methemoglobin reductase. Methemoglobinemia can also be treated with ascorbic acid (vitamin C). The production of methemoglobin in patients treated with iNO is dose-dependent; methemoglobinemia is rare at usual therapeutic doses of less than 20 ppm.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.


geoffrey

  • Hero Member
  • *****
  • Posts: 880
Reply #2 on: Jul 16, 2018
TY


TINA

  • Sr. Member
  • ****
  • Posts: 336
Reply #3 on: Jul 16, 2018
Happy to Help


« previous next »
 

Did you know?

Dogs have been used in studies to detect various cancers in human subjects. They have been trained to sniff breath samples from humans that were collected by having them breathe into special tubes. These people included 55 lung cancer patients, 31 breast cancer patients, and 83 cancer-free patients. The dogs detected 54 of the 55 lung cancer patients as having cancer, detected 28 of the 31 breast cancer patients, and gave only three false-positive results (detecting cancer in people who didn't have it).

Did you know?

Though newer “smart” infusion pumps are increasingly becoming more sophisticated, they cannot prevent all programming and administration errors. Health care professionals that use smart infusion pumps must still practice the rights of medication administration and have other professionals double-check all high-risk infusions.

Did you know?

There are 60,000 miles of blood vessels in every adult human.

Did you know?

When intravenous medications are involved in adverse drug events, their harmful effects may occur more rapidly, and be more severe than errors with oral medications. This is due to the direct administration into the bloodstream.

Did you know?

About 60% of newborn infants in the United States are jaundiced; that is, they look yellow. Kernicterus is a form of brain damage caused by excessive jaundice. When babies begin to be affected by excessive jaundice and begin to have brain damage, they become excessively lethargic.

A guinea pig being examined by a veterinary medical officer for general health and pulmonary conditi A guinea pig being examined by a veterinary medical officer for general health and pulmonary conditi
Term neonate. Term neonate.
Pulmonary arterial catheter Pulmonary arterial catheter
Withdrawal Symptoms and Treatment for Selected Drugs of Abuse Withdrawal Symptoms and Treatment for Selected Drugs of Abuse
Classification of Antidepressants: Treatment of Major Depressive Disorder Classification of Antidepressants: Treatment of Major Depressive Disorder
Seasonal Depression Treatment Seasonal Depression Treatment
Video: Mechanisms for chromosome movement Animation

For a complete list of videos, visit our video library