A 67-year-old woman has been intubated for 1 week after undergoing a left lobectomy for lung cancer.

Discussion in 'USMLE Step 2 CK' started by samuel, Nov 16, 2014.

  1. samuel

    samuel New Member

    A 67-year-old woman has been intubated for 1 week after undergoing a left lobectomy for lung cancer. She has chronic obstructive pulmonary disease. Her preoperative functional vital capacity was 40% of predicted. She is awake and alert. Her blood pressure is 130/75 mm Hg, and pulse is 72/min. The ventilator settings are a synchronized intermittent mandatory ventilation of 8/min, FIO2 of 40%, and positive-end expiratory pressure of 5 cm H2O. Arterial blood gas analysis shows:

    pH 7.42
    PCO2 47 mm Hg
    PO2 90 mm Hg
    O2 saturation 96%

    Which of the following is the most appropriate next step in management?

    A
    ) Antibiotic therapy

    B
    ) Bronchodilator therapy

    C
    ) Chest physiotherapy

    D
    ) Decrease inotropes

    E
    ) Diuretic therapy

    F
    ) Fiberoptic bronchoscopy

    G
    ) Heparin therapy

    H
    ) Incentive spirometry

    I
    ) Increase FIO2

    J
    ) Increase inotropes

    K
    ) Increase respiratory rate

    L
    ) Placement of thoracostomy tube

    M
    ) Tracheostomy

    N
    ) Wean from the ventilator

Share This Page