SET 1. A. Mr. Frank is a 60 year-old with pneumonia. He is admitted with dyspnea, fever, and chills.

His blood gas is below: pH 7.28 CO2 56 PO2 70 HCO3 25 SaO2 89% What is your interpretation? What interventions would be appropriate for Mr. Frank? B. Ms. Strauss is a 24 year-old college student. She has a history of Crohn's disease and is complaining a of a four day history of bloody-watery diarrhea. A blood gas is obtained to assess her acid/base balance: pH 7.28 CO2 43 pO2 88 HCO3 20 SaO2 96% What is your interpretation? What interventions would be appropriate for Ms. Strauss? C. Mrs. Lauder has a fully-compensated respiratory acidosis with hypoxemia. Full compensation is evidenced by the normal pH in spite of her acid/base disorder. This is her baseline and doesn't require treatment. pH 7.37 CO2 63 pO2 58 HCO3 35 SaO2 89% What is your interpretation? What interventions would be appropriate for Mrs. Lauder?

SET 1 ANSWERS A. Mr. Frank has an uncompensated respiratory acidosis with hypoxemia as a result of his pneumonia. This is due to inadequate ventilation and perfusion. The treatment goals for Mr. Frank would be to improve both ventilation and oxygenation. Ventilation may improve with the use of bronchodilators and pulmonary hygiene. If not, Mr. Frank may require CPAP, BiPAP, or intubation and mechanical ventilation. Oxygen therapy should consist of only the minimal amount necessary to increase his oxygen saturation to normal (95%). B. Ms. Strauss has an uncompensated metabolic acidosis. This is due to excessive bicarbonate loss from her diarrhea. It is interesting to note that she has no compensation. Normally, the respiratory center compensates quickly for metabolic disorders. However, in Ms. Strauss' case she would have to hyperventilate in order to compensate. This may not be possible in her present condition, and should be evaluated further. Treatment would consist of control of the diarrhea and bowel rest. It should not be necessary to administer bicarbonate in her present condition. C. Mrs. Lauder has a fully-compensated respiratory acidosis with hypoxemia. Full compensation is evidenced by the normal pH in spite of her acid/base disorder. This is her baseline and doesn't require treatment.

SET 2 A. Ms. Aquino is a 17 year-old with intractable vomiting. She has some electrolyte abnormalities, so a blood gas is obtained to assess her acid/base balance. pH 7.50 CO2 36 pO2 92 HCO3 27 SaO2 97% What is your interpretation? What interventions would be appropriate for Ms. Steele? B. Mr. Alba is a 18 year-old comatose, quadriplegic patient who has the following ABG done as part of a medical workup: pH 7.48 CO2 22 pO2 96 HCO3 16 SaO2 98% What is your interpretation? What interventions would be appropriate for Mr. Longo? C. Mrs. Lapel has a fully-compensated respiratory acidosis with hypoxemia. Full compensation is evidenced by the normal pH in spite of her acid/base disorder. This is her baseline and doesn't require treatment. pH 7.37 CO2 63 pO2 58 HCO3 35 SaO2 89% What is your interpretation? What interventions would be appropriate for Mrs. Lauder?

SET 2 ANSWERS A. Ms. Aquino has an uncompensated metabolic alkalosis. This is due to vomiting that results in excessive loss of stomach acid. Treatment consists of fluids, anti-emetics, and management of her electrolyte disorders. B. As a result of his neurologic condition, Mr. Alba has chronic hyperventilation syndrom. His blood gas shows a fully-compensated respiratory alkalosis. This is a chronic and stable condition for him and probably requires no treatment. C. Mrs. Lapel has a fully-compensated respiratory acidosis with hypoxemia. Full compensation is evidenced by the normal pH in spite of her acid/base disorder. This is her baseline and doesn't require treatment.

SET 3 A. Ms. Jose is a 24 year-old college student. She has a history of Crohn's disease and is complaining a of a four day history of bloody-watery diarrhea. A blood gas is obtained to assess her acid/base balance: pH 7.28 CO2 43 pO2 88 HCO3 20 SaO2 96% What is your interpretation? What interventions would be appropriate for Ms. Strauss? B. Ms. Garys is a 17 year-old with intractable vomiting. She has some electrolyte abnormalities, so a blood gas is obtained to assess her acid/base balance. pH 7.50 CO2 36 pO2 92 HCO3 27 SaO2 97% What is your interpretation? What interventions would be appropriate for Ms. Steele? C. Mr. Davies is a 60 year-old with pneumonia. He is admitted with dyspnea, fever, and chills. His blood gas is below: pH 7.28 CO2 56 PO2 70 HCO3 25 SaO2 89% What is your interpretation? What interventions would be appropriate for Mr. Frank?

SET 3 ANSWERS A. Ms. Jose has an uncompensated metabolic acidosis. This is due to excessive bicarbonate loss from her diarrhea. It is interesting to note that she has no compensation. Normally, the respiratory center compensates quickly for metabolic disorders. However, in Ms. Strauss' case she would have to hyperventilate in order to compensate. This may not be possible in her present condition, and should be evaluated further. Treatment would consist of control of the diarrhea and bowel rest. It should not be necessary to administer bicarbonate in her present condition. B. Ms. Garys has an uncompensated metabolic alkalosis. This is due to vomiting that results in excessive loss of stomach acid. Treatment consists of fluids, anti-emetics, and management of her electrolyte disorders C. Mr. Davies has an uncompensated respiratory acidosis with hypoxemia as a result of his pneumonia. This is due to inadequate ventilation and perfusion. The treatment goals for Mr. Frank would be to improve both ventilation and oxygenation. Ventilation may improve with the use of bronchodilators and pulmonary hygiene. If not, Mr. Frank may require CPAP, BiPAP, or intubation and mechanical ventilation. Oxygen therapy should consist of only the minimal amount necessary to increase his oxygen saturation to normal (95%).

SET 1 A.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation B.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation

SET 2 A.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation B.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation C.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation

SET 3 A.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation B.

What is the Heart rate? What is the PR Interval? What is the QRS interval? What is the Rhythm ? What is your interpretation C.

What is the Heart rate? What is the PR Interval? What is the QRS interval?

What is the Rhythm ? What is your interpretation 1. Delivers pre-set volumes at a pre-set rate and a pre-set flow rate. The patient CANNOT generate spontaneous volumes, or flow rates in this mode. Each patient generated respiratory effort over and above the set rate are delivered at the set volume and flow rate. Answer: Assist/Control Mode 2. Delivers a pre-set number of breaths at a et volume and flow rate. Allows the patient to generate spontaneous breaths, volumes, and flow rates between the set breaths. Detects a patients spontaneous breath attempt and doesnt initiate a ventilatory breath prevents breath stacking Answer: SYCHRONIZED INTERMITTENT MANDATORY VENTILATION 3. This is a volume targeted, pressure limited mode Each breath is delivered at a set volume with a variable flow rate and an absolute pressure limit. The vent delivers this pre-set volume at the LOWEST required peak pressure and adjust with each breath ANSWER: PRESSURE REGULATED VOLUME CONTROL 4. This IS a mode and simply means that a pre-set pressure is present in the circuit and lungs throughout both the inspiratory and expiratory phases of the breath Answer: Continuous Positive Airway Pressure

SET 1 IDENTIFICATION: A. This is a volume targeted, pressure limited mode Each breath is delivered at a set volume with a variable flow rate and an absolute pressure limit. The vent delivers this pre-set volume at the LOWEST required peak pressure and adjust with each breath B. Delivers a pre-set number of breaths at a set volume and flow rate. Allows the patient to generate spontaneous breaths, volumes, and flow rates between the set breaths. Detects a patients spontaneous breath attempt and doesnt initiate a ventilatory breath prevents breath stacking C. Delivers pre-set volumes at a pre-set rate and a pre-set flow rate. The patient CANNOT generate spontaneous volumes, or flow rates in this mode. Each patient generated respiratory effort over and above the set rate are delivered at the set volume and flow rate.

SET 2 A. This IS a mode and simply means that a pre-set pressure is present in the circuit and lungs throughout both the inspiratory and expiratory phases of the breath B. This is a volume targeted, pressure limited mode Each breath is delivered at a set volume with a variable flow rate and an absolute pressure limit. The vent delivers this pre-set volume at the LOWEST required peak pressure and adjust with each breath C. Delivers a pre-set number of breaths at a et volume and flow rate. Allows the patient to generate spontaneous breaths, volumes, and flow rates between the set breaths. Detects a patients spontaneous breath attempt and doesnt initiate a ventilatory breath prevents breath stacking

SET 3 A. Delivers a pre-set number of breaths at a et volume and flow rate. Allows the patient to generate spontaneous breaths, volumes, and flow rates between the set breaths. Detects a patients spontaneous breath attempt and doesnt initiate a ventilatory breath prevents breath stacking B. This is a volume targeted, pressure limited mode Each breath is delivered at a set volume with a variable flow rate and an absolute pressure limit. The vent delivers this pre-set volume at the LOWEST required peak pressure and adjust with each breath C. This IS a mode and simply means that a pre-set pressure is present in the circuit and lungs throughout both the inspiratory and expiratory phases of the breath