Author Question: The respiratory therapist is assessing a mechanically ventilated patient for whom the high pressure ... (Read 138 times)

rosent76 · **on:** Jul 16, 2018

The respiratory therapist is assessing a mechanically ventilated patient for whom the high pressure alarm is active and the flow-volume loop shows the following:

The action that could alleviate this problem is which of the following?
a. Place a bite block into the patient's mouth.
b. Perform a recruitment maneuver and in-crease PEEP.
c. Administer a fast-acting bronchodilator and suction the ET tube.
d. Insert a 14-gauge needle into the second intercostal space, midclavicular line, and right side.

Question 2

Which of the following can activate an apnea alarm?

a. Secretions
b. Auto-PEEP
c. Loss of PEEP
d. Active inhalation

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

Answer to Question 1

ANS: C
The flow-volume loop shows increased expiratory resistance; this plus activation of the high pressure alarm indicates increased airway resistance. Increased airway resistance can be caused by bronchospasm, which can be alleviated by a bronchodilator and suctioning. Although a patient biting the tubing would cause a high pressure alarm, no or very little volume would enter the pa-tient, and the flow-volume loop would not be as large. The flow-volume loop is not indicative of low compliance, which would necessitate a recruitment maneuver and increased PEEP. The ex-piratory flow would not be scooped out if low compliance were a problem. Because the signs indicate increased airway resistance, needle decompression is not appropriate.

Answer to Question 2

ANS: B
In a spontaneous mode, the presence of auto-PEEP can cause the patient difficulty in triggering the ventilator. As a result, the patient's efforts can go undetected, and the ventilator misinterprets this as apnea.