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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.

Enter (A) for True or (B) for False:  Helium is a great gas for aerosolizing albuterol.

Read p.172-173, Presentation Strategies, in your Textbook.   Match the things you should do to rehearse your presentation with the correct descriptions.

Do you need to change the patient’s dosing regimen why or why not?   If changing what would a new regimen be? Remember to explain your answer.  

A 60 year old 90kg (198 lb.) man is admitted to the ICU following smoke inhalation.  The RR is 28/min and the patient is on a NRM.   ABG’s are as follows:   pH 7.58, paC02 22torr, pa02 90 torr, HC03 22 meq/L, Base Excess -2.  What is your recommendation?

Patient #1   Charlie Fox is a 25-year-old male admitted to Parks Hall Hospital for a craniotomy and developed a post-op craniotomy infection (cerebrospinal fluid (CSF) shunt infection) positive for MRSA. Patient is having shunt drainage but is otherwise doing well and in no distress. The prescriber has ordered vancomycin to treat his infection and has consulted pharmacy for dosing and monitoring per hospital policy. Using the patient’s profile answer the following questions.    Patient information:   Weight – 80 kg  Height – 5’4’’  Allergies – NKDA   Problem list   TBI/SAH/SDH s/p decompressive craniotomy  Respiratory failure s/p trach Skull Fractures   Current Labs   BUN – 8mg/dL CO2 – 26 mmol/L SCr – 0.53 mg/dL Glucose 112 mg/dL  Cl – 99 mmol/L K – 3.9 mEq/L Na – 138 mEq/L  *Patient already received a loading dose, 1st maintenance dose is due tonight at 1800.  

A neonatal patient receiving HFOV is on the following settings:  12 Hz, MAP 8cmH20, Amplitude 16cmH20, fi02 50%.  How can you tell if the amplitude is the correct setting?

The #19 arrow is pointing to which part of the organ? IMG_2811 (2).JPG [BLANK-1]

The #13 arrow is located on which structure? IMG_2807.JPG [BLANK-1]

A patient receiving mechanical ventilation has a history of renal failure and diabetes.  The patient weighs 65 kg.  Fluid status: 4800ml input and 2700 ml output.  Breath sounds reveal rates ½ way up on both sides.  Vent settings are AC 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.  Indicate the problems in this scenario.