A patient with COPD is on ventilation with a Puritan Bennett…
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?
Read DetailsA 72-year-old male patient (height 6’2″, weight 95 kg) with…
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?
Read DetailsA patient has recovered from severe pneumonia that required…
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?
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