A patient with acute cardiogenic pulmonary edema (ACPE), as evidenced by pink, frothy secre-tions, arrives in the emergency department (ED) by ambulance with a nonrebreather mask (NRM) at 15 L/min
An arterial blood gas sample is drawn in the ED while the patient is on the NRM; the values are: pH = 7.50, PaCO2 = 28 mm Hg; PaO2 = 43 mm Hg; SaO2 = 84%; HCO3? = 24 mEq/L. After evaluating the situation, the respiratory therapist should suggest which of the following thera-pies?
a. IPPB with supplemental oxygen
b. Mask CPAP with supplemental oxygen
c. Postural drainage to clear the secretions
d. NIV via nasal mask with postural drainage
ANS: B
The current recommendation for ACPE is for CPAP to be used initially. NIV should be used only in patients who were hypercapnic and continue to be hypercapnic in spite of the CPAP. This patient is not hypercapnic at this time; therefore, mask CPAP is the appropriate therapy. IPPB is not appropriate because the positive effects of the therapy will be lost after a few minutes off the therapy.
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Your patient only reports a few symptoms during an examination. Which of the following would be the fastest way to complete Form pages for this patient encounter?
a. Place a check mark in all of the N boxes. b. Skip all options that do not apply to the patient's HPI. c. Use free text to type a note: Pt is generally healthy, with few symptoms. d. Click on the "Negs" button in the Toolbar.