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A 36-Year-Old Woman Comes to the Emergency Department Because of Worsening

question 23

Multiple Choice

A 36-year-old woman comes to the emergency department because of worsening shortness of breath and cough for 4 days. Her medical problems include rheumatoid arthritis, interstitial lung disease on home oxygen, and pulmonary hypertension. Her trachea is cannulated because of respiratory distress and central venous access is obtained.
In the intensive care unit, her temperature is 37.2 C (99 F) , blood pressure is 99/67 mm Hg, and pulse is 120 /min. The patient's pulse oximetry shows 100% on assist control mode with tidal volumes of 300 mL, respiratory rate of 20/min, fraction of inspired oxygen (FiO₂) of 100%, and positive end-expiratory pressure (PEEP) of 5 cm H₂O. Examination reveals right-sided crackles and decreased breath sounds on the left. Heart sounds are regular with a loud second heart sound. The abdomen is soft and non-tender. Examination shows no peripheral edema.
Laboratory values are as follows:
$A 36-year-old woman comes to the emergency department because of worsening shortness of breath and cough for 4 days. Her medical problems include rheumatoid arthritis, interstitial lung disease on home oxygen, and pulmonary hypertension. Her trachea is cannulated because of respiratory distress and central venous access is obtained. In the intensive care unit, her temperature is 37.2 C (99 F) , blood pressure is 99/67 mm Hg, and pulse is 120 /min. The patient's pulse oximetry shows 100% on assist control mode with tidal volumes of 300 mL, respiratory rate of 20/min, fraction of inspired oxygen (FiO2) of 100%, and positive end-expiratory pressure (PEEP) of 5 cm H2O. Examination reveals right-sided crackles and decreased breath sounds on the left. Heart sounds are regular with a loud second heart sound. The abdomen is soft and non-tender. Examination shows no peripheral edema. Laboratory values are as follows: A chest radiograph is performed. Which of the following is the most appropriate next step in management? A) Increase PEEP B) Increase tidal volume C) Insert a chest tube D) Reposition the endotracheal tube E) Suction respiratory secretions$
A chest radiograph is performed.
$A 36-year-old woman comes to the emergency department because of worsening shortness of breath and cough for 4 days. Her medical problems include rheumatoid arthritis, interstitial lung disease on home oxygen, and pulmonary hypertension. Her trachea is cannulated because of respiratory distress and central venous access is obtained. In the intensive care unit, her temperature is 37.2 C (99 F) , blood pressure is 99/67 mm Hg, and pulse is 120 /min. The patient's pulse oximetry shows 100% on assist control mode with tidal volumes of 300 mL, respiratory rate of 20/min, fraction of inspired oxygen (FiO2) of 100%, and positive end-expiratory pressure (PEEP) of 5 cm H2O. Examination reveals right-sided crackles and decreased breath sounds on the left. Heart sounds are regular with a loud second heart sound. The abdomen is soft and non-tender. Examination shows no peripheral edema. Laboratory values are as follows: A chest radiograph is performed. Which of the following is the most appropriate next step in management? A) Increase PEEP B) Increase tidal volume C) Insert a chest tube D) Reposition the endotracheal tube E) Suction respiratory secretions$
Which of the following is the most appropriate next step in management?

Definitions:

Availability

The degree to which a product or service can be purchased or accessed by consumers at a given time.

Consumer Tastes

Preferences and likings of consumers that influence their purchasing decisions and are shaped by cultural, social, and individual factors.

Close Substitutes

Products or services that can easily replace each other in the eyes of the consumer due to their similarities in function or utility.

Oligopoly

A market structure in which a few firms dominate, leading to limited competition and potentially higher prices and levels of cooperation.