Mr. Flowers a 65 year old man with COPD who is intubated for acute respiratory failure. He was placed on Volume Control on A/C 14, Vt 500 mL, FiO2 35%, PEEP 5 cmH2O and a flow 60 L/min. ABGs on the vent settings were: pH 7.44, PaCO2 34 torr, PaO2 110 torr, SvO2 0.77 and C(a-v)O2 4.4 vol%. Shortly after intubation he developed hypotension and a BTFDC was inserted at bedside. The following measurements are obtained:PAP:        45/24 mmHgPCWP:     6 mmHgCVP:        1 torrB/P:          90/60 (mean 70)SVR:         930 dynes.sec.cm-5C.O.:          3.8 L/minWhich of the following is the MOST likely cause for his condition?

Order: Dexamethasone 1 mg PO at 0800 and 0.5 mg PO at 1600. Available: Dexamethasone 0.5 mg/5 mL oral solution What volume will the nurse administer for the morning dose? Round your answer to the tenths. 

Order: Metoprolol 6.25 mg PO daily Available: Metoprolol 25 mg tablets The tablets are scored. How many tablets will the nurse administer? Round your answer to the hundredths.

Order: 250 mL of Lactated Ringer’s to infuse in 1 hour.  IV tubing drop factor is 15 gtt/mL. Calculate the gtt/min. Round your answer to the nearest whole number. 

All of the following injuries would be consistent with a diagnosis of flail chest EXCEPT:

Patient-ventilator dyssynchrony, variable pressure readings on the manometer around the baseline PEEP setting, severe tracheal tug and a dipping in the flow/time waveform may be signs of ________.

When Estar is combined with adjectives, it describes conditions and emotions.  Use the correct form of the verb estar and choose the best adjective from the word bank provided to describe the following situations: nervioso          triste     cansado     enojado    alegre    sucio    enamorado     ocupado Mi hermano Joaquín [1] [2] porque trabaja quince horas diarias y no tiene tiempo para sus amigos. Rodrigo y yo [3] muy [4], y queremos hacer planes para el futuro. Yo [5] muy [6] porque tengo un examen de estadística mañana a  las ocho de la mañana. Mis padres [7] [8] porque mis notas en la escuela son malas. No me gusta estudiar. Mi perro Misterio [9] [10] porque no le gusta el agua y huele (smells) muy mal.  

Percutaneous dilatational tracheostomy absolute contraindication is:

Early complications of the placement of a tracheostomy are all of the following EXCEPT:

BONUS: What is considered the hallmark of cardiac contractility?