Your patient is a 52-year-old male complaining of shortness of breath. He is sitting up, alert, and oriented and appears to be in moderate respiratory distress. He states that he "always gets a chest cold in the winter" and describes a three-week history of productive cough and increasing shortness of breath. Physical examination reveals coarse rhonchi to the upper lobes bilaterally, air movement
is decreased in the bases, and his skin is cool with peripheral cyanosis. You note that he is overweight and describes an 18-pack-a-year smoking history. Based on these clinical exam findings, the most clinically relevant finding you might also expect is:
A) pursed-lipped breathing.
B) JVD, ankle edema, and hepatic congestion.
C) pulmonary edema and hypotension.
D) barrel chest and increased anterior/posterior chest diameter.
B
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You are assessing a 47-year-old woman who fell about 20 feet from a chair lift. When you palpate her pelvis you note instability, and she complains of pain. Which of the following is your primary concern for a patient who has a potential pelvic fracture?
a. Risk of infection b. Internal blood loss c. Severe pain d. Permanent deformity
When starting flow-limited ventilatory support on an adult patient, which of the following in-spiratory flow settings would you initially select?
a. 60 L/min b. 50 L/min c. 40 L/min d. 30 L/min