Rc 279 Quiz Project

Simple spirometry is not able to measure residual volume due to the fact that residual volume cannot be exhaled and therefore cannot be measured by a spirometer.

In a situation where a patient is severely agitated and has a depressed level of consciousness, obtaining the patient's current prescription vials from the family is the most reliable way to obtain an accurate medication history. This allows healthcare providers to know exactly what medications the patient is currently taking.

In a mild asthma attack, the patient would likely have respiratory alkalosis with a slightly elevated pH, decreased PCO2, and normal PO2. Option C accurately reflects this pattern.

The correct answer, the intraventricular catheter, is considered the gold standard for monitoring intracranial pressure due to its direct measurement capabilities within the ventricular system.

When a patient has an arterial pH of 7.28, it indicates acidosis which leads to a right shift in the oxyhemoglobin dissociation curve. This means that for a given PO2, the SaO2 will be less than normal, resulting in poor oxygen transport capacity.

The correct answer is A. Pulmonary arterial hypertension. This condition is characterized by high velocity tricuspid regurgitation, a dilated right ventricle, and an enlarged right atrium on an ECG. It is important to differentiate between pulmonary arterial hypertension and other conditions like hypertrophic cardiomyopathy, acute respiratory distress syndrome, and congestive heart failure based on the clinical presentation and diagnostic findings.

In cases of an expanding subdural hematoma, the loss of the clear P1 waveform component is a characteristic change observed in the monitored intracranial pressure.

When obtaining a medication history for a patient with asthma, the focus should be on factors directly related to the patient's condition and treatment, rather than whether they use generic or brand name medications.

Observing gliding or shimmering of the pleural layer while the patient is breathing rules out an underlying pneumothorax as pneumothorax would typically present with absent lung sliding on ultrasound.

The social history section of a patient's chart typically includes information about the patient's cultural and religious background, which can have a significant impact on the provision of care.

Pack-years is calculated by multiplying the number of packs smoked per day by the number of years the person has smoked. In this case, 1.5 packs per day for 30 years equals 45 pack-years.

In this scenario, the best course of action would be to gently shake the patient's arm to try and awaken them. This is a non-invasive method of attempting to rouse the patient without causing harm or distress. Waiting an hour may be too long in a potentially urgent situation, calling for help should be done after assessing the patient's responsiveness, and administering a sternal rub is a more aggressive approach that should only be done if gentler methods fail.

The given blood gas results with pH > normal range, PaCO2

In this scenario, the correct intervention would be chest tube insertion to manage a possible pneumothorax which is indicated by the tracheal deviation, decreased breath sounds, and hyperresonance on the left side.

The correct answer, 3500 ml, takes into account the patient's height and weight to approximate the normal vital capacity. Incorrect options may either be too low or too high based on the given information.

To calculate tidal volume, the formula is Tidal Volume = Flow * Inspiratory Time. Therefore, Tidal Volume = 50 L/min * 1.5 sec = 75 L/sec = 1200 ml (1.2 L).

The correct answer is Patient B because based on the ABG results, they are showing severe respiratory acidosis indicating significant respiratory distress and the urgent need for ventilator support.

In electrocardiography, lead V4 should be placed in the 5th intercostal space in order to obtain accurate readings. The incorrect answers represent other leads which are not positioned correctly for this purpose.

In this scenario, since the patient's PaO2 is 81 torr, increasing the FIO2 would help improve oxygenation without affecting the patient's respiratory rate or tidal volume. Increasing the FIO2 will provide more oxygen to the patient without changing other settings.

When correcting a patient's gas values during mechanical ventilation, decreasing the tidal volume (Vt) is the appropriate action to take. This helps prevent complications such as barotrauma and volutrauma in postoperative patients.

In this scenario, the discrepancy between SpO2 and SaO2 levels indicates the presence of carbon monoxide poisoning. Carbon monoxide has a higher affinity for hemoglobin than oxygen, leading to a falsely elevated SpO2 reading despite low SaO2 levels. This is a classic presentation of carbon monoxide poisoning.

When air bubbles are present in the blood gas sample, they can alter the pH reading, leading to a false high result. This is due to the introduction of gases that are not part of the natural blood composition, impacting the overall measurement.

When SpO2 drops during fiberoptic bronchoscopy, giving oxygen through the scope's open channel is the most appropriate action to improve oxygenation without interfering with the procedure.

When the oximeter low alarm sounds immediately after attaching a new probe and the SpO2 reading significantly drops, it is likely that the probe is taped too tightly, leading to inaccurate readings. Loosening the probe can help improve the accuracy of the oximeter readings.

The correct answer is D. Yankauer tip. This device is commonly used for oral suctioning as it allows for effective removal of oral secretions without damaging the surrounding tissues. The incorrect options A, B, and C are not suitable for this purpose.

When a bubble humidifier is not bubbling during oxygen therapy, the issue is likely related to a leak in the connection between the flowmeter and the humidifier. Checking the flowmeter-humidifier connection for leaks will help identify and resolve the problem.

The correct action to take when a nebulizer is delivering large droplets is to replace the nebulizer, as indicated in reference (II. A. 4.). Adding a heating collar, water, or dismantling and cleaning the nebulizer are not effective solutions to the problem of large droplet delivery.

The correct course of action in this scenario is to take the ventilator out of service and replace it with a fully functional device to ensure patient safety and proper functionality of the equipment.

In the given scenario, the patient exhibits respiratory alkalosis (pH 7.52, PaCO2 28) with adequate oxygenation (PaO2 81, SaO2 96%). To address the underlying issue of hyperventilation leading to low PaCO2, the most appropriate action is to add mechanical deadspace to help increase the PaCO2 levels and restore acid-base balance.

Adjusting the nasal mask to ensure a better fit with no pressure loss is the correct course of action as it directly addresses the issue of loud snoring and periods of apnea. Going to the hospital ED would not be necessary at this stage. Switching to an electronically-powered home vent or suggesting sleeping with both the CPAP and an oropharyngeal airway are not the immediate steps to take in this situation.