The respiratory therapist is performing a patient-ventilator system check on a patient who was in a motor vehicle accident 2 days earlier. The therapist gathers the following information from the flow sheet:
Day/Time 1/25:1720 1/26:0830 1/26:1840 1/27:0650
Mode VC-CMV VC-CMV VC-CMV VC-CMV
PIP (cm H2O) 21 28 32 41
Pplateau (cm H2O) 18 25 29 38
Which condition most likely has produced the changes reflected in these data?
a. Bronchospasm
b. Abdominal distention
c. Secretion retention
d. Mucosal edema
ANS: B
The difference between the PIP and Pplateau is consistent throughout the documentation (3 cm H2O). The Pplateau has increased over the course of the 36 hours, from 18 to 38 cm H2O. This in-dicates a decrease in static lung compliance. Causes of this condition include ARDS, pneumonia, pneumothorax, pleural effusions, abdominal distention, and ascites. Bronchospasm, secretion re-tention, and mucosal edema would increase the transairway pressure (PIP − Pplateau).
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