Question

A 173-cm (5-ft 8-in), 65-kg (143-lb) male is receiving PC, A/C ventilation on the following settings:

PEEP 15 cm H2O Set inspiratory pressure 22 cm H2O
Mandatory rate 16
Total rate 16
FIO2 0.50
I:E 1:3
VT (exhaled) 725 mL
ABG are as follows:
pH 7.54 PaCO2 25 torr
PaO2 108 torr
HCO3- 22 mEq/L
BE +1 mEq/L
A respiratory therapist should recommend a decrease in which of the following?
A. mandatory rate
B. inspiratory pressure
C. PEEP
D. I:E

Answer 1

option a,The respiratory therapist should recommend a decrease in the mandatory rate to correct the patient's respiratory alkalosis, as indicated by high pH and low PaCO2 on the arterial blood gas report.

Step-by-step explanation:

The student's question pertains to a clinical scenario involving a male patient receiving mechanical ventilation. Given that the patient has a high arterial blood gas (ABG) pH of 7.54 and a low PaCO2 of 25 torr, it suggests that the patient is experiencing respiratory alkalosis. The presence of respiratory alkalosis often indicates that ventilation settings are too aggressive, causing more carbon dioxide than necessary to be expelled. With a mandatory rate of 16 (which matches the total rate), a decrease in the mandatory rate would help to increase PaCO2 towards normal levels and correct the alkalosis, assuming there are no other contributing factors.

Considering the patient's stable FIO2 (fraction of inspired oxygen) at 0.50 and adequate oxygenation with a PaO2 of 108 torr, adjustments in PEEP (positive end-expiratory pressure), set inspiratory pressure, or the I:E (inspiratory to expiratory ratio) seem less urgent since they are not directly responsible for the primary concern of low CO2 levels.