Author Question: The advantages of using MI-E in conjunction with PPV include: 1. MI-E with PPV generates optimal ... (Read 25 times)

elizabeth18 · **on:** Jul 16, 2018

The advantages of using MI-E in conjunction with PPV include:

1. MI-E with PPV generates optimal peak cough expiratory flow (PCEF) for clearing airway se-cretions.
2. MI-E with PPV does not cause airway irritation or discomfort.
3. MI-E with PPV can be used with patients with bullous emphysema.
4. MI-E with PPV may improve vital capacity (VC) and arterial oxygen saturation (SaO2) associ-ated with mucous plugging.

a. 1, 2, and 4 only
b. 2, 3, and 4 only
c. 2 and 4 only
d. 1, 2, 3, and 4

Question 2

Respiratory failure is imminent in infants who demonstrate which of the following?

a. Substernal retractions
b. Tachypnea
c. Grunting
d. Nasal flaring

jojobee318 · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: A
The MI-E may be the most effective alternative for generating optimal peak cough expiratory flow (PCEF) and clearing airway secretions. PCEF has increased to as much as 6-10 L/sec during therapy and can be increased more if a manual abdominal thrust can be synchronized with exsuf-flation. MI-E does not cause the airway irritation and discomfort associated with tracheal suc-tioning and may actually decrease the production of airway secretions. Abnormal VC values, flows, and arterial oxygen saturation (SaO2) values can also significantly improve with clearing of mucous plugs by MI-E. No significant complications have been reported with the use of this de-vice. However, it is contraindicated in patients with bullous emphysema or pulmonary disorders that predispose a patient to barotrauma.

Answer to Question 2

ANS: C
Infants attempt to maintain a back pressure in the lungs to preserve the functional residual capac-ity by narrowing the glottis and maintaining respiratory muscle activity (active exhalation). This results in vocalization during exhalation, or grunting, which is often mistaken for crying. Grunting, which usually can be heard without auscultation, is a useful clinical sign of impending respiratory failure.