What are the causes of continued ventilator dependency in a patient whose respiratory failure stabilizes and begins to reverse? I. gas exchange concerns II. mechanical issues III. inappropriate ventilator settings IV. inability to ascertain time to initiate weaning
A. I, II only
B. III, IV only
C. I, III, IV only?D. I, II, III, IV
ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: As respiratory failure stabilizes and begins to reverse, clinical attention should shift to the ventilator withdrawal process. In these patients, continued ventilator dependency is caused by two fundamental problems: (1) disease-imposed problems, such as mechanical/gas exchange issues that continue to require positive-pressure ventilation, and (2) clinician-imposed issues, including either clinician delay in recognizing the ability of a patient to have the ventilator discontinued or inappropriate ventilator settings that overload respiratory muscles, preventing recovery.?
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