A patient arrives in the emergency Acute hypercapnic respiratory failure only
department with a respiratory rate of 4
breaths/minute. She is not intubated.
Overdose with a centrally acting nervous
system depressant is suspected. Which of
the following is the most likely finding on
the initial blood gas?
A patient is neurologically devastated, Begin formal conflict-resolution process
mechanically ventilated, and undergoing
dialysis. The neurology service says there
is no expectation of neurologic recovery
or improvement. The family is resistant to
any decision regarding limiting or
stopping any life-sustaining treatment.
Multiple discussions have occurred
during the past 6 weeks. Which of the
following is the most appropriate next
step?
,A 52-year-old man presents to the Decrease oxygen delivery and/or increased oxygen consumption
emergency department with shortness of
breath and new-onset lower extremity
edema. His vital signs are: temperature
37.0 °C (98.6 °F); heart rate 114 beats/min;
respiratory rate 28 breaths/min; blood
pressure 86/62 mm Hg; and oxygen
saturation as measured by pulse
oximetry, (SpO2) 92% on nonrebreather
mask. He is transferred to the ICU,
intubated, and a central line is placed.
His hemoglobin is 9.2 g/dL, lactic acid is
4.2 mg/dL, SpO2 has improved to 98%,
and central venous oxygen saturation is
(ScvO2) 43%. This Scvo2 level indicates
which of the following findings?
,A 75-year-old patient with severe chronic Ensure quantitative end-tidal CO2 monitoring during CPR
obstructive pulmonary disease (COPD)
has a cardiac arrest due to ventricular
fibrillation and requires CPR. The patient
is being ventilated at 10 breaths/min as
CPR ensues. A medical student believes
the patient has a do-not-resuscitate
(DNR) order on file. The nurse is
concerned that the patient has only 1
working IV line. Which of the following is
the most appropriate approach?
, A 52-year-old man presents to the Start vasopressors to increase systolic blood pressure
emergency department with shortness of
breath and new-onset lower extremity
edema. Vital signs are: temperature 37.0
°C (98.6 °F), heart rate 114 beats/min,
respiratory rate 28 breaths/min, blood
pressure 86/62 mm Hg, and oxygen
saturation as measured by pulse
oximetry (Spo2) 92% on nonrebreather
mask. He is transferred to the ICU,
intubated, and a central line is placed.
Transthoracic echocardiogram shows
significantly reduced left ventricular
function. Hemoglobin is 9.2 g/dL, lactic
acid 4.2 mg/dL, and central venous
oxygen saturation 43%. Which of the
following interventions will significantly
improve oxygen delivery?
Which of the following are expected Decreased functional residual capacity in the third trimester
physiologic changes during pregnancy?
department with a respiratory rate of 4
breaths/minute. She is not intubated.
Overdose with a centrally acting nervous
system depressant is suspected. Which of
the following is the most likely finding on
the initial blood gas?
A patient is neurologically devastated, Begin formal conflict-resolution process
mechanically ventilated, and undergoing
dialysis. The neurology service says there
is no expectation of neurologic recovery
or improvement. The family is resistant to
any decision regarding limiting or
stopping any life-sustaining treatment.
Multiple discussions have occurred
during the past 6 weeks. Which of the
following is the most appropriate next
step?
,A 52-year-old man presents to the Decrease oxygen delivery and/or increased oxygen consumption
emergency department with shortness of
breath and new-onset lower extremity
edema. His vital signs are: temperature
37.0 °C (98.6 °F); heart rate 114 beats/min;
respiratory rate 28 breaths/min; blood
pressure 86/62 mm Hg; and oxygen
saturation as measured by pulse
oximetry, (SpO2) 92% on nonrebreather
mask. He is transferred to the ICU,
intubated, and a central line is placed.
His hemoglobin is 9.2 g/dL, lactic acid is
4.2 mg/dL, SpO2 has improved to 98%,
and central venous oxygen saturation is
(ScvO2) 43%. This Scvo2 level indicates
which of the following findings?
,A 75-year-old patient with severe chronic Ensure quantitative end-tidal CO2 monitoring during CPR
obstructive pulmonary disease (COPD)
has a cardiac arrest due to ventricular
fibrillation and requires CPR. The patient
is being ventilated at 10 breaths/min as
CPR ensues. A medical student believes
the patient has a do-not-resuscitate
(DNR) order on file. The nurse is
concerned that the patient has only 1
working IV line. Which of the following is
the most appropriate approach?
, A 52-year-old man presents to the Start vasopressors to increase systolic blood pressure
emergency department with shortness of
breath and new-onset lower extremity
edema. Vital signs are: temperature 37.0
°C (98.6 °F), heart rate 114 beats/min,
respiratory rate 28 breaths/min, blood
pressure 86/62 mm Hg, and oxygen
saturation as measured by pulse
oximetry (Spo2) 92% on nonrebreather
mask. He is transferred to the ICU,
intubated, and a central line is placed.
Transthoracic echocardiogram shows
significantly reduced left ventricular
function. Hemoglobin is 9.2 g/dL, lactic
acid 4.2 mg/dL, and central venous
oxygen saturation 43%. Which of the
following interventions will significantly
improve oxygen delivery?
Which of the following are expected Decreased functional residual capacity in the third trimester
physiologic changes during pregnancy?
