A hemodynamically stable patient, receiving mechanical ...

[lracut11]

A hemodynamically stable patient, receiving mechanical ventilatory support with an Fio2 of 0.4, and a PEEP of 5 cm H2O, has an MIP of 25 cm H2O and an Spo2 of 96. What should the therapist do in this situation?
 
  A. Eliminate the PEEP.
  B. Increase this patient's ventilatory support.
  C. Initiate the weaning process.
  D. Continue mechanically ventilating the patient with the current settings.

Question 2

A patient is being evaluated for readiness to wean from mechanical ventilation. The values of which of the following mechanical factors would tend to predict successful liberation from the ventilator? I. minute ventilation:greater than 10 L/minute II. vital capacity:greater than 5 ml/kg III. maximum inspiratory pressure: less than 25 cm H2O IV. RSBI: less than 105
 
  A. II, III only
  B. III, IV only
  C. I, II, IV only
  D. II, III, IV only

[GCabra]

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Generally, when a patient's underlying respiratory disease begins to stabilize and reverse, consideration for ventilator discontinuation should begin. Recently, an evidence-based task force has recommended that a patient should be considered a candidate for withdrawal if: (1) the lung injury is stable/resolving, (2) gas exchange is adequate with low Fio2 (0.4 to 0.5) and low PEEP (5 to 8 cm H2O) requirements, (3) no need for vasopressor and hemodynamically stable, and (4) capable of initiating spontaneous ventilation.
D. Incorrect response: See explanation C

Answer to Question 2

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: The following mechanical factors and their recommended values used to predict success for the discontinuation of mechanical ventilation include:
  Minute ventilation: less than 15 L/minute
  Maximum inspiratory pressure: less than 25 cm H2O
  Vital capacity: greater than 10 ml/kg
  Rapid shallow breathing index (f/Vt): less than 105
  Work: less than 5 joules/minute (exclusive of ETT work)
  Pressure-time index: less than 0.15
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B

[lracut11]

Excellent

[aliotak]

TYSM