Author Question: What pitfall or drawback occurs when placing a mechanically ventilated patient in a lateral ... (Read 8 times)

audragclark · **on:** Jul 16, 2018

What pitfall or drawback occurs when placing a mechanically ventilated patient in a lateral decubitus position with the healthy lung in the dependent position? I. increasing dead space in the nondependent lung II. causing more perfusion to enter the nondependent lung III. causing shunting in the dependent lung IV. inducing hemidiaphragmatic fatigue of the nondependent portion of the diaphragm

A. I only
B. I, II only
C. I, III only
D. III, IV only

Question 2

The therapist is initiating mechanical ventilation on a patient who previously had a right-sided pneumonectomy. How should the therapist position this patient during mechanical ventilation?

A. supine
B. left lateral decubitus
C. right lateral decubitus
D. prone

jesse.fleming · **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: When patients are positioned with the good lung down (healthy lung down), the greater perfusion in the dependent lung may cause shunting in the dependent lung. Similarly, increased alveolar dead space may arise in the nondependent lung, which would be receiving more ventilation and less perfusion.
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Perfusion and ventilation are normally preferentially distributed to the dependent portions of the lungs. For a patient with unilateral lung disease, clinicians tend to ventilate the patient with the good lung down. This positioning amounts to a lateral decubitus position to improve oxygenation in both spontaneously breathing and mechanically ventilated patients. The patient in this problem has no right lung and would benefit from the left lateral decubitus position, which would make the remaining left lung dependent.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.