A 2-year-old Caucasian child with a history of frequent pulm…
A 2-year-old Caucasian child with a history of frequent pulmonary infections, abnormal stool, cough productive of green sputum, and a general appearance of being malnourished is being evaluated. Among other studies, the respiratory therapist would be particularly interested in obtaining a
Read DetailsWhile examining the chest radiograph of a 5-day-old mechanic…
While examining the chest radiograph of a 5-day-old mechanically ventilated neonate, the respiratory care practitioner notes an elevated diaphragm on the right side accompanied by a mediastinal shift toward the right lung. There is a decrease in the spaces between the ribs on the right side, and a slight hyperinflation of the left lung. The most likely diagnosis is
Read DetailsA one-month-old male with a ventricular septal defect is ref…
A one-month-old male with a ventricular septal defect is referred for a surgical evaluation. Upon arrival, the infant is intubated and ventilated via pressure-limited, time-cycled ventilator with FIO2 of 50%, frequency 20 b/min, PIP 18 cmH2O and 5 cmH2O PEEP. Initial blood gas results are as follows: pH 7.31 PaCO2 58 mmHg HCO3 28 mEq/liter PaO2 68 mmHg Which of the following is the best recommendation?
Read DetailsA 33-week newborn is initiated on mechanical ventilation wit…
A 33-week newborn is initiated on mechanical ventilation with a time-cycled, pressure-limited ventilator. The following information is available: Peak pressure 28 cmH2O, Rate 55 b/min, Ti 0.5 sec, PEEP 3 cmH2O, flow 8 L/min, Fi02 55% Arterial blood gas results on the above settings are: pH 7.28 PaCO2 52 torr PaO2 65 torr HCO3 25 mEq/L On examination, the breath sounds are diminished with poor chest excursion. Which of the following would be the most appropriate action at this point?
Read DetailsAn infant in the NICU is receiving heated, humidified oxygen…
An infant in the NICU is receiving heated, humidified oxygen via a large closed oxyhood operating at 3 L/min. Arterial blood gas analysis reveals an arterial PCO2 of 55 mmHg. What should the neonatal respiratory care practitioner do at this time?
Read DetailsThe respiratory care practitioner is performing ventilator r…
The respiratory care practitioner is performing ventilator rounds in the PICU and observes the needle on the pressure manometer of a ventilator vibrating as it moves to the peak inspiratory pressure level during each inspiration. What is the probable cause of this situation?
Read DetailsA 32-week-old neonate is receiving nasal CPAP of 4 cmH2O wit…
A 32-week-old neonate is receiving nasal CPAP of 4 cmH2O with FiO2 of 0.35. Arterial blood gas (ABG) and acid-base data reveal the following: pH 7.44, PaC02 35, PaO2 85, HCO3 23 mEq/L, BE 0 mEq/L. What should the neonatal respiratory therapist do at this time?
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