A patient with COPD is on ventilation with a Puritan Bennett 840 ventilator. Ventilator parameters are VC-CMV: flow = 40 L/min with descending ramp flow waveform; VT = 0.65; FIO2 = 0.3. At 2:00 p.m., total f = 10 breaths/min, PIP = 28 cm H2O, there are no assisted breaths, and the pressure–time curve is normal. At 4:00 p.m., total f = 20 breaths/min, PIP = 37 cm H2O, the patient is actively assisting and using accessory muscles to breathe, and the pressure–time graphic shows a concave appearance. What do you think has caused the changes in the patient’s condition? What would you do to correct this situation?

A 72-year-old male patient (height 6’2″, weight 95 kg) with a history of congestive heart failure (CHF) presents to the emergency department complaining of shortness of breath and inability to lie down to sleep. Physical assessment reveals a very anxious patient with a pulse of 140, respirations 32, and labored with diaphoresis. Breath sounds are decreased with bibasilar coarse crackles. The patient has a productive cough of pink frothy secretions. The patient is placed on a nonrebreather mask and the resulting arterial blood gases (ABG) show: pH 7.25, partial pressure of carbon dioxide (PaCO2) 55 mm Hg, partial pressure of oxygen (PaO2) 54 mm Hg, oxygen saturation (SaO2) 86%, bicarbonate (HCO) 24 mEq/L. The most appropriate immediate action to take includes which of the following?

What did the economic and demographic problems of Germany impact that country’s policies the 1930s and World War II? (NOTE: Answer should be 50-75 words)

A patient has recovered from severe pneumonia that required 8 days of PC-CMV ventilation. The patient is now conscious and responsive. She is triggering every breath and has a strong cough. What should the therapist suggest to the physician?

The mechanical ventilator event that is considered potentially life-threatening or a level two event is which of the following?

India and China were very rich and populous regions in Asia.  European powers wanted to control the trade with these countries.  Explain why the Europeans were attracted to these two regions.  What were the differences between the two regions?  Which region experienced the earliest and more prolonged European imperialism and why?  Why did the other region able to resist longer?

What was the role of science and technology in Europe’s continued explorations of the world and its dominance of Asia and Africa?  Why were Europeans able to develop scientific and technological superiority?   Did technology create vulnerabilities for the Europeans?

Evaluate the radical expression. Express your answer in simplified form. If the expression does not represent a real number, indicate “Not a Real Number”.−49

Evaluate the radical expression. Express your answer as an integer, simplified fraction, or a decimal rounded to two decimal places. If the expression does not represent a real number, indicate “Not a Real Number”.14

The AV junction consists of the AV node and the nonbranching portion of the bundle of His.