FULL TEST BANK For Pilbeam's Mechanical Ventilation: Physiological and Clinical Applications 7th Edition by James latest Update Graded A+

29. How often must the respiratory therapist reposition the sensor of a transcutaneous monitor? a. 30 minutes to 1 hour b. 1-3 hours c. 4-6 hours d. 7-9 hours ANSWERS C Burns can occur because the site of measurement needs to be heated to between 42° C and 45° C. Repositioning the sensor every 4-6 hours will help avoid this problem. 174 30. The clinical data that must be recorded when making transcutaneous measurements include which of the following? 1. Electrode temperature 2. Skin temperature 3. Probe placement 4. Fractional inspired oxygen (FIO2) a. 1 and 3 only b. 1 and 2 only c. 2, 3, and 4 only d. 1, 2, 3, and 4 ANSWERS D The electrode temperature must be documented to ensure that the temperature stays within the range of 42-45° C. The skin temperature must be noted to assess the patient’s peripheral perfusion. The probe placement must be noted to ensure that the probe is being moved to different sites every 4-6 hours. The fractional inspired oxygen (FIO2) must be documented to determine the need for an increase or decrease in the amount of supplemental oxygen the patient is receiving. 174 31. Components of an indirect calorimeter may include which of the following? 1. Pressure manometer 2. Pneumotachometer 3. Pressure-sensitive transducer 4. Oxygen and carbon dioxide analyzers a. 1 and 2 only b. 2 and 4 only c. 2, 3, and 4 only d. 1, 2, 3, and 4 ANSWERS B Indirect calorimeters contain analyzers for measuring the concentration of inspired and expired gases, oxygen (O2) and carbon dioxide (CO2), pneumotachometers, turbine flowmeters, or ultrasonic vortex flowmeters to measure volume and flow, temperature- sensitive, solid-state transducers to measure barometric pressure and exhaled gas temperatures. 174 | 175 32. An energy expenditure (EE) of 60 kcal/hr/m2 for an adult is indicative of which of the following conditions? a. Burns b. Sedation c. Starvation d. Hypothermia ANSWERS A An energy expenditure (EE) of 30-40 kcal/hr/m2 is normal for an adult. The EE of 60 kcal/hr/m2 is greater than 120% of predicted and is considered a hypermetabolic state. Burns create a hypermetabolic state. Starvation, sedation, and hypothermia create hypometabolic states. 177 33. An energy expenditure (EE) of 20 kcal/hr/m2 for an adult is indicative of which of the following conditions? a. Pregnancy b. Starvation c. Hyperthyroidism d. Stimulant drugs ANSWERS B An energy expenditure (EE) of 30-40 kcal/hr/m2 is normal for an adult. The EE of 20 kcal/hr/m2 is less than 80% of predicted and is considered a hypometabolic state. Starvation creates a hypometabolic state. Pregnancy, hyperthyroidism, and stimulant drugs create hypermetabolic states. pgs. 175-177 34. The respiratory quotient (RQ) value associated with substrate utilization patterns in normal, healthy individuals is which of the following? a. 0.7 b. 0.8 c. 0.9 d. 1.0 ANSWERS B A healthy adult consuming a typical American diet will have a respiratory quotient (RQ) range from 0.80-0.85. An RQ of 0.7 is indicative of lipid metabolism as seen in prolonged starvation or severe sepsis. The RQ for the metabolism of pure carbohydrates is 1.0. An RQ of 0.9 would mean that the individual is consuming a higher amount of carbohydrates than a normal diet. 175 35. A patient whose carbon dioxide (CO2) production is 390 mL/min and oxygen (O2) consumption is 375 mL/min is most likely experiencing which of the following? a. Ketosis b. Severe sepsis c. Hyperventilation d. Too much carbohydrate intake ANSWERS C The respiratory quotient (RQ) is the ratio of carbon dioxide (CO2) production to oxygen (O2) consumption. This patient has an RQ (390/375) of 1.04. Ketosis causes the RQ to be less than 0.7. Severe sepsis is associated with RQ levels of approximately 0.7. Hyperventilation is associated with RQ levels greater than 1.0. Pure carbohydrate RQ is 1.0. pgs. 175-177