A patient receiving mechanical ventilation has a history of…

A patient receiving mechanical ventilation has a history of renal failure and diabetes.  The patients IBW is 65 kg.  Fluid status: 4800ml input and 2700 ml output.  Breath sounds reveal rates ½ way up on both sides.  Vent settings are AC/VC mode, rate of 10/min, VT 520ml, fi02 0.40.  PEEP 5 cmH20.  Total RR is 37/min and sp02 97%, PIP is 27 cmH20.  Abg’s:  pH 7.31, paC02 22 torr, pa02 82 torr, HC03 14, Base deficit -9.  Which of the following would you recommend? I.  Increase the set rate to 16/min Recommend diuresis/dialysis Recommend administration of NAHC03 Decrease tidal volume to 450 ml Switch the patient to PRVC

An RT is called to the ICU to assess a patient whose ventila…

An RT is called to the ICU to assess a patient whose ventilator low pressure alarm is sounding.  The volume display shows exhaled tidal volumes varying from breath to breath. SIMV mode, Rate of 12/minute, VT 400 ml,  Fi02 0.40. The patient has no spontaneous effort.  After manual ventilation is initiated, the therapist should:

A patient is intubated in the ICU for airway management post…

A patient is intubated in the ICU for airway management post intracranial hemorrhage.    Ventilator settings are PRVC rate of 18/min, VT 600ml, fi02 .30, PEEP 5 cmH20.  The patient’s IBW is 75 kg.   ΔP is 22 cmH20.   Abg’s on these settings:  sp02 97%, pH 7.58, paC02 22torr, pa02 90 torr, HC03 22 meq/L, Base Excess -2.  What changes would you recommend, if any?

Which of the following strategies are utilized to ventilate…

Which of the following strategies are utilized to ventilate a patient with ARDS:    Allow for prolonged exhalation.   Use tidal volumes of 6 – 8 ml’s/kg IBW.   Allow permissive hypercapnea to reduce barotrauma.   Ventilate with tidal volumes of 4 – 6 ml’s/kg of IBW.