Page 642 - Clinical Application of Mechanical Ventilation

608 Chapter 18

SUMMARY

Mechanical ventilation in nontraditional settings differs from that delivered in the hos-
pital. Outside the hospital, one major difference is the lack of an array of monitors,
specialized equipment, and medical support personnel. Providers of mechanical ven-
tilation in nontraditional settings often work alone or with a small team. They must be
knowledgeable, adaptive, and able to make appropriate ventilator adjustments based
on the unusual or changing environment.

Self-Assessment Questions

1. Dr. Kingston asks the therapist to evaluate a patient in the long-term care unit for continuation of ven-
tilator care in the home. The therapist should evaluate all of the following except :
A. age of patient. C. type of ventilator suitable for the patient.
B. clinical stability of the patient. D. laboratory and clinical assessment of the patient.

2. A patient with COPD has an admitting diagnosis of lobar pneumonia affecting three of five lobes. When
this pulmonary problem triggers a rapid deterioration of the patient’s clinical status, it is called:

A. acute respiratory acidosis. C. chronic ventilatory failure.
B. acute exacerbation of COPD. D. combined acidosis.

3. Which of the following arterial blood gas (ABG) reports reflects a condition of exacerbation of COPD?
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A. pH 5 7.26, PaCO 5 78 mm Hg, PaO 5 44 mm Hg, HCO 5 34 mEq/L
3
2
2
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B. pH 5 7.40, PaCO 5 45 mm Hg, PaO 5 81 mm Hg, HCO 5 27 mEq/L
3
2
2
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C. pH 5 7.38, PaCO 5 54 mm Hg, PaO 5 56 mm Hg, HCO 5 31 mEq/L
3
2
2
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D. pH 5 7.49, PaCO 5 30 mm Hg, PaO 5 43 mm Hg, HCO 5 22 mEq/L
3
2
2
4. Ms. Lange has been receiving around-the-clock mechanical ventilation for two months due to a head
injury sustained in an automobile accident. Prior to transfer to her home for ventilator care, which of the
following is the most essential requirement, based on her condition?
A. high and low pressure alarms C. backup ventilator
B. live-in health care assistance D. insurance coverage
5. In a mass casualty incident, START or JumpStart is done to:
A. recharge the crash cart battery.
B. calculate the joules level for defibrillation.
C. categorize patients based on medical condition.
D. speed up the rescue efforts.

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