08-06-2005, 07:14 AM
A 67-year-old woman has been intubated for 1 week after undergoing a left lobectomy for lung cancer. She has chronic obstuctive pulmonary disease. Her preoperative fuctional vital capacity was 40% of predicted. She is awake and alert.Her blood pressure is 130/75 mm Hg, and pulse is 72/min. The ventilator settings are a synchronized intermittent mandatory ventilation of 8/min, FIO2 of 40%, and positive-end expiratory pressure of 5 cm H2O. Arterial blood gas analysis shows
pH 7.42
PCO2 47 mm Hg
PO2 90mm Hg
O2saturation 96%
which of the following is the most appropriate next step in management?
A.Antibiotic therapy
B.Bronchodilator therapy
C.Chest physiotherapy
D.Decrese inothopes
E.Diuretic therapy
F.Fiberoptic bronchoscopy
G.Heparin therapy
H.Incentive spirometry
I.Increase FIo2
J.Increase inotropes
K.Increase respiratory rate
L.Placement of thoracostomy tube
M.Tracheostomy
N.Wean from the ventilator
pH 7.42
PCO2 47 mm Hg
PO2 90mm Hg
O2saturation 96%
which of the following is the most appropriate next step in management?
A.Antibiotic therapy
B.Bronchodilator therapy
C.Chest physiotherapy
D.Decrese inothopes
E.Diuretic therapy
F.Fiberoptic bronchoscopy
G.Heparin therapy
H.Incentive spirometry
I.Increase FIo2
J.Increase inotropes
K.Increase respiratory rate
L.Placement of thoracostomy tube
M.Tracheostomy
N.Wean from the ventilator