Page 303 - Clinical Application of Mechanical Ventilation

Monitoring in Mechanical Ventilation 269

12. Metabolic acidosis (low bicarbonate) with a(n) _______ anion gap is called hyperchloremic metabolic
–
–
acidosis because the excessive chloride (Cl ) ions _______ the deficiency of bicarbonate (HCO ) ions in
3
the plasma.
A. normal, offset C. abnormal, offset
B. normal, aggravate D. abnormal, aggravate

13. A patient who has been undergoing the weaning process from mechanical ventilation suddenly stops
breathing spontaneously. The therapist should expect to see the following changes on the next set of
blood gas results except:

A. increase in PO . C. decrease in pH.
2
2
B. increase in PCO . D. decrease in HCO .
2
3
14. In blood gas interpretation, the PaCO is primarily used to assess a patient’s _______ status, and the PO
2
2
is useful for the _______ status.
A. ventilatory, acid-base C. acid-base, oxygenation
B. ventilatory, oxygenation D. acid-base, ventilatory

15 to 17. Match the causes of hypoxemia with the characteristics that may be used to distinguish these abnor-
malities. Use each answer only once.

Cause of Hypoxemia Characteristics

15. Hypoventilation A. Normal or low PaCO ; hypoxemia does not
2
respond to high levels of oxygen.
16. V/Q mismatch or diffusion defects B. High PaCO ; hypoxemia improves
2
with ventilation and low levels of oxygen.
17. Intrapulmonary shunt C. Normal or low PaCO ; hypoxemia responds
2
very well to moderate levels of oxygen.

18. A patient rescued from a house fire has an admitting diagnosis of severe smoke inhalation. She is breath-
ing spontaneously and receiving 100% oxygen via a non-rebreathing mask. Due to her condition, pulse
oximetry _______ be done because _______.
A. should, of cost savings
B. should, continuous monitoring is being done
C. should not, the SpO reading will be higher than actual SaO 2
2
D. should not, the SpO reading will be required lower than actual SaO 2
2
19. In metabolic acidosis, patients with adequate lung function are capable of compensating for this condi-
tion by _______. This would cause the end-tidal CO readings to be _______ than normal.
2
A. hyperventilation, higher C. hypoventilation, higher
B. hyperventilation, lower D. hypoventilation, lower

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