Practice Quiz

Respiratory Therapist

Category - Initiation and Modification of Interventions

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An emphysematous patient is on a nasal cannula oxygen at 6 L/min and becomes lethargic. ABGs reveal pH of 7.28, PCO2of 83 and PO2of 82.

What is the proper adjustment to patient’s therapy at this point?
  1. Place patient on 100% non-rebreather.
  2. Intubate the patient.
  3. Place patient on a venturi mask at 24% oxygen.
  4. Continue therapy with nasal cannula at 6 L/min.
Explanation
Answer: C-The proper adjustment to patient’s therapy at this point is to place patient on a venturi mask at 24% FIO2.

The patient is lethargic because the FIO2 on a 6 L/min nasal cannula is greater than 40%. Such high oxygenation is too high for a patient with emphysema. Over-oxygenation will diminish the patient’s respiratory drive, increasing the CO2 and cause lethargy. If patient’s condition continues to diminish, intubation may be needed but first the therapist should place patient on a lower FIO2.
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