Author Question: A pediatric patient intubated with a 3.5-mm endotracheal tube is receiving pressure support ... (Read 56 times)

erika

  • Hero Member
  • *****
  • Posts: 522
A pediatric patient intubated with a 3.5-mm endotracheal tube is receiving pressure support ven-tilation. The respiratory therapist notes patient-ventilator asynchrony and a rapid deceleration of flow that prematurely ends inspiration.
 
  The most appropriate action to alleviate this is which of the following?
  a. Increase the PS level.
  b. Increase the rise time.
  c. Decrease the PS level.
  d. Increase the flow cycle.

Question 2

A preterm neonate is being supported with nasal SiPAP.
 
  The baseline CPAP level is set at 6 cm H2O, the high CPAP level at 10 cm H2O, the rate is 20 sigh breaths, and the FIO2 is 0.8. The baby's PaO2 on these settings has been steadily declining and is now 48 mm Hg. The physician and respiratory therapist decided to use nasal HFV before intubating and using mechanical ventilation. The initial settings for NHFV for this patient should include which of the following?
  a. MAP = 10 cm H2O; frequency = 8 Hz; FIO2 = 1.0
  b. MAP = 10 cm H2O; frequency = 10 Hz; FIO2 = 0.8
  c. MAP = 6 cm H2O; frequency = 8 Hz; FIO2 = 0.8
  d. MAP = 6 cm H2O; frequency = 10 Hz; FIO2 = 1.0



bubulittle310@msn.cn

  • Sr. Member
  • ****
  • Posts: 281
Answer to Question 1

ANS: B
ET tubes smaller than 4.5 mm may provide excessive resistance during PS. This can cause pres-surization of the ventilator circuit before sufficient flow enters the patient's airway. The result is a rapid deceleration of flow, which may prematurely end the inspiratory phase (premature pres-sure support termination PPST). This phenomenon does not allow the augmentation of VT, and patient-ventilator asynchrony may result. When PPST is suspected, a slower rise time can be used, which may reduce or eliminate the problem.

Answer to Question 2

ANS: D
The initial mean airway pressure for nasal HFV is usually set to equal the previous level of CPAP, with a frequency of 10 Hz. Because the nasal SiPAP baseline level was set at 6 cm H2O, the NHFV should be set at that level. The only option with those two set parameters includes the FIO2 of 1.0, which should be titrated down when oxygenation improves.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
 

Did you know?

Approximately one in three babies in the United States is now delivered by cesarean section. The number of cesarean sections in the United States has risen 46% since 1996.

Did you know?

There are immediate benefits of chiropractic adjustments that are visible via magnetic resonance imaging (MRI). It shows that spinal manipulation therapy is effective in decreasing pain and increasing the gaps between the vertebrae, reducing pressure that leads to pain.

Did you know?

The Centers for Disease Control and Prevention has released reports detailing the deaths of infants (younger than 1 year of age) who died after being given cold and cough medications. This underscores the importance of educating parents that children younger than 2 years of age should never be given over-the-counter cold and cough medications without consulting their physicians.

Did you know?

Aspirin is the most widely used drug in the world. It has even been recognized as such by the Guinness Book of World Records.

Did you know?

Nearly all drugs pass into human breast milk. How often a drug is taken influences the amount of drug that will pass into the milk. Medications taken 30 to 60 minutes before breastfeeding are likely to be at peak blood levels when the baby is nursing.

For a complete list of videos, visit our video library