« previous next »

Author Question: A patient in the subacute care unit is receiving NIV with a PTV system, with an IPAP of 10 cm H2O ... (Read 60 times)

roselinechinyere27m

  • Hero Member
  • *****
  • Posts: 557
on: Jul 16, 2018
A patient in the subacute care unit is receiving NIV with a PTV system, with an IPAP of 10 cm H2O and an EPAP of 3 cm H2O.
 
  The patient's latest arterial blood gas values reveal an increase in the PaCO2. The most appropriate action to take is which of the following?
  a. Increase the IPAP.
  b. Decrease the IPAP.
  c. Increase the EPAP and IPAP.
  d. Intubate and mechanically ventilate.

Question 2

If oxygen is bled into each of the following portable PTVs at the same rate, which of the follow-ing combinations will provide the highest oxygen concentration?
 
  a. Leak port at mask, oxygen bleed at mask, IPAP 8 cm H2O, EPAP 16 cm H2O
  b. Leak port at mask, oxygen bleed at ma-chine outlet, IPAP 6 cm H2O, EPAP 18 cm H2O
  c. Leak port in circuit, oxygen bleed at mask, IPAP 5 cm H2O, EPAP 10 cm H2O
  d. Leak port in circuit, oxygen bleed in cir-cuit, IPAP 5 cm H2O, EPAP 15 cm H2O


Joy Chen

  • Sr. Member
  • ****
  • Posts: 354
Reply #1 on: Jul 16, 2018
Answer to Question 1

ANS: C
The EPAP of 3 cm H2O is not providing enough continuous flow of gas through the system to minimize the rebreathing of CO2. Increasing both the EPAP and IPAP will provide enough flow to wash out the CO2 and keep the pressure support DIF consistent.

Answer to Question 2

ANS: C
The highest oxygen concentration will occur when the IPAP and EPAP DIFs are lower. The lowest DIF in this question is an IPAP of 5 cm H2O and an EPAP of 10 cm H2O. Also, if the leak port is in the circuit, higher oxygen concentrations are obtained when the oxygen is bled into the patient's mask.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
« previous next »
 

Did you know?

Oxytocin is recommended only for pregnancies that have a medical reason for inducing labor (such as eclampsia) and is not recommended for elective procedures or for making the birthing process more convenient.

Did you know?

Amphetamine poisoning can cause intravascular coagulation, circulatory collapse, rhabdomyolysis, ischemic colitis, acute psychosis, hyperthermia, respiratory distress syndrome, and pericarditis.

Did you know?

Normal urine is sterile. It contains fluids, salts, and waste products. It is free of bacteria, viruses, and fungi.

Did you know?

The most dangerous mercury compound, dimethyl mercury, is so toxic that even a few microliters spilled on the skin can cause death. Mercury has been shown to accumulate in higher amounts in the following types of fish than other types: swordfish, shark, mackerel, tilefish, crab, and tuna.

Did you know?

Adolescents often feel clumsy during puberty because during this time of development, their hands and feet grow faster than their arms and legs do. The body is therefore out of proportion. One out of five adolescents actually experiences growing pains during this period.

Schematic of an automated external defibrillator (AED) attached to a patient. Schematic of an automated external defibrillator (AED) attached to a patient.
Divisions of the nervous system Divisions of the nervous system
A nurse communicates with her non–English-speaking patient through an interpreter A nurse communicates with her non–English-speaking patient through an interpreter
The digestive system: functions of the small intestine and large intestine (colon) The digestive system: functions of the small intestine and large intestine (colon)
Health care setting. Health care setting.
Overview of the Digestive System Overview of the Digestive System
Video: Exercise and cardiac output

For a complete list of videos, visit our video library