Sarah, a 45-year-old woman with a 10-year history of COPD, presents with a pH of 7.30, PaO2 of 50, and PaCO2 of 60. She is currently taking tiotropium bromide. Which Interventions are most appropriate? Select all that apply.

Administer intravenous bicarbonate.

Initiate mechanical ventilation.

Consider reducing the dose of tiotropium.

Administer supplemental oxygen cautiously.

Administer intravenous corticosteroids

Answer and Explanation

Correct Answer : B,D,E

A.   Intravenous bicarbonate is not typically indicated in the management of COPD because it can cause metabolic alkalosis and paradoxical intracellular acidosis.
B.   Mechanical ventilation improves her gas exchange and correct her acid-base imbalance.
C.   Reducing the dose of tiotropium is not appropriate because it is a long-acting bronchodilator that can help prevent bronchospasm and improve airflow in COPD patients.
D.   Sarah's low PaO2 indicates hypoxemia, and supplemental oxygen is essential for correcting this. However, in COPD patients, oxygen therapy should be administered cautiously to avoid worsening hypercapnia.
E.   Intravenous corticosteroids would reduce the inflammation and mucus production in her airways.

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Correct Answer is D

Explanation

A. Decreased lung compliance doesn't directly enhance gas diffusion; it may impair it due to decreased lung expansion.

B. Decreased lung compliance doesn't necessarily indicate compromised pulmonary blood supply; it's more related to the lung's ability to expand and contract.
C. Decreased lung compliance suggests that ventilation may be impaired because the lungs are less able to expand and contract effectively.
D. Decreased lung compliance means the lungs are stiffer, requiring more effort to breathe, thus increasing the work of breathing.

A. Tonsillitis B. Laryngitis C. Acute Otitis Media D. Allergic Rhinitis

Correct Answer is C

Explanation

A. Tonsillitis typically presents with sore throat, difficulty swallowing, and inflamed tonsils, but it does not involve ear pain or tympanic membrane abnormalities.
B. Laryngitis presents with hoarseness or loss of voice due to inflammation of the larynx, not ear pain or tympanic membrane abnormalities.

C. Acute otitis media commonly presents with ear pain, dull tympanic membrane, and may be preceded by an upper respiratory tract infection. Tender, enlarged postauricular lymph nodes can also be present.
D. Allergic rhinitis typically presents with nasal congestion, sneezing, and itchy, watery eyes, but not with ear pain or tympanic membrane abnormalities.

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Sarah, a 45-year-old woman with a 10-year history of COPD, presents with a pH of 7.30, PaO2 of 50, and PaCO2 of 60. She is currently taking tiotropium bromide. Which Interventions are most appropriate? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Brian, a 58-year-old patient, is noted to have a decreased lung compliance during his pulmonary function tests. What does this suggest about the physiology of his respiration?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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