A 55-year-old male with acute dyspnea is admitted to the hos…

A 55-year-old male with acute dyspnea is admitted to the hospital. He is alert and oriented. His physical examination reveals: heart rate (HR) 120 and regular, blood pressure (BP) 146/88, temperature 38° C, respiratory rate (RR) 28 shallow and labored. Breath sounds are decreased throughout with fine late crackles on inspiration, chest expansion is decreased in both bases. The patient is not coughing. The arterial blood gas (ABG) on room air is: pH 7.52, partial pressure of carbon dioxide (PaCO2) 30 mm Hg, partial pressure of oxygen (PaO2 ) 42 mm Hg, Hb-O2 80%, bicarbonate (HCO3-) 24 mEq/L. This patient is retired after working in a steel factory for 38 years and he has a 50 pack-year history of smoking. The most appropriate action for the respiratory therapist to take is which of the following?                              2:4:5

A male patient (74-kg IBW) is being ventilated with PC-CMV,…

A male patient (74-kg IBW) is being ventilated with PC-CMV, f = 12/min, PIP = 20 cm H2O, TI = 1.5 seconds; the resulting flow-time scalar is shown below. The patient’s measured VT is 435 mL. ABG results on these settings are: pH 7.32, PaCO2 54 mm Hg, HCO3- 25 mEq/L. The most appropriate action to take is which of the following?

A 45-year-old female (58-kg IBW) with a past medical history…

A 45-year-old female (58-kg IBW) with a past medical history of asthma arrives at the emergency department short of breath, anxious, diaphoretic, and unable to perform a peak expiratory flow measurement. She also has a combined acidosis. Breath sounds reveal the patient is not moving much air. The patient is intubated, stabilized, and transported to the ICU. The ventilator settings are: PC-CMV, f = 12/min, PIP = 30 cm H2O, FIO2 = 0.6, and PEEP = 3 cm H2O. The patient is sedated and paralyzed; the resulting ABGs are: pH 7.17, PaCO2 69.3 mm Hg, PaO2 90 mm Hg, and HCO3- 21 mEq/L after continuous bronchodilator therapy. The respiratory rate is increased to 20/min, and the next ABG results are: pH 7.26, PaCO2 58 mm Hg, PaO2 96 mm Hg, and HCO3- 22 mEq/L. The respiratory therapist should suggest which of the following at this time?