A patient is receiving a continuous positive airway pressure of 10 cm H2O via mask from a Downs continuous positive airway pressure generator. During each inspiration, the pressure ma-nometer decreases to 3 cm H2O

The patient is diaphoretic, tachypneic, and tachycardic. To correct this situation, the respiratory therapist should do which of the following?
a. Increase the gas flow c. Tighten the fit of the mask
b. Increase the pres-sure d. Replace the spring-loaded valve

ANS: A
The patient is pulling in more than the flow of the continuous positive airway pressure system is able to provide. This is evident by the swing in pressures between 10 cm H2O and 3 cm H2O. In-creasing the flow would decrease the patient's work of breathing. Increasing pressure would make the patient work harder because of the inadequate flow rate. If there was a leak through an improperly fitting mask, very little pressure could be maintained. Replacement of the spring-loaded valve would not solve this problem.