A patient receiving mechanical ventilation via pressure-regulated volume control (PRVC) has a set target volume of 500 mL with an upper pressure limit setting of 35 cm H2O
During the respiratory therapist's first patient ventilator system check, 25 cm H2O was needed to deliver the set volume. Several hours later the pressure to deliver the set volume is 15 cm H2O. The respiratory therapist should do which of the following?
a. Switch the patient to pressure support ventilation (PSV).
b. No action should be taken.
c. The set volume should be reduced.
d. The upper pressure limit should be re-duced.
ANS: D
The upper pressure limit should be reduced so that the lungs are protected from pressures that would be too high for the recovering lungs. There is nothing in this scenario that gives any clues to the fact that the patient should be switched to PSV. Not taking any action in this situation could cause harm to the patient if the pressure were to rise suddenly, as with a cough or forcible exhalation.
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