A 52-year-old male with a medical history of congestive hear…

A 52-year-old male with a medical history of congestive heart failure and hypertension arrives in the emergency department because of an acute onset of dyspnea. The patient has pink frothy secretions at the mouth. A rapid physical assessment reveals a pulse of 128 beats/min, respiratory rate 28 breaths/min and labored, and blood pressure 82/56 mm Hg. Bilateral coarse crackles are heard in the lung bases. Arterial blood gas results on a 12 L/min nonrebreather mask are: pH 7.32, PaCO2 49 mm Hg, PaO2 50 mm Hg, arterial SaO2 74%. The most appropriate recommendation for this patient is which of the following?

A 75-year-old, 5-foot, 7-inch female patient with an exacerb…

A 75-year-old, 5-foot, 7-inch female patient with an exacerbation of COPD is placed on the following NPPV settings: IPAP = 8 cm H2O, EPAP = 4 cm H2O, rate = 12 breaths/min, FIO2 = 0.3. The resulting VT is 255 mL. An arterial blood gas sample is drawn 1 hour later, and the results are: pH = 7.33, PaCO2 = 70 mm Hg, PaO2 = 58 mm Hg, HCO3- = 35 mEq/L. What action should the respiratory therapist take at this time?