A 66-Year-Old Man in the Emergency Department Has a History

question 15

Multiple Choice

A 66-year-old man in the emergency department has a history of COPD and CO₂ retention. He is conscious and cooperative but in distress, and receiving oxygen by nasal cannula at 2 L/min. He is breathing in a tripod position and using accessory muscles. His vitals are: heart rate = 102 beats/min, blood pressure = 127/77 mm Hg, temperature = 37.5°C, respiratory frequency = 20 breaths/min with prolonged expiration and using pursed lip-breathing. Bilateral sounds with crackles and wheezing. Which of the following is most appropriate?

• A) Change to a Venturi mask and coach the patient to breathe.
• B) Intubate and ventilate.
• C) Change to a nonrebreather mask.
• D) Evaluate for NIV.

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Definitions:

Distortionary Tax

A type of tax that causes consumers and producers to change their behavior in order to avoid paying the tax.

Tax Distortion

Describes how taxes can alter market behavior and lead to efficiency loss compared to an untaxed market.

Optimal Taxation

The theory or practice of determining the most efficient and effective way of levying taxes to generate government revenue with minimal economic distortion or inefficiency.

Excess Burden

The societal expense resulting from market inefficiency, which arises when supply and demand are not in balance.