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End-Tidal Carbon Dioxide Monitoring

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1.  A non-intubated patient needs an ETCO2 measurement, and the authorized practitioner asks for the best method. The Respiratory Therapist should suggest using which of the following? A mainstream capnometer A humidity block sensor A specialized nasal cannula An ETCO2 device to which a heating element can be attached

2.  A 48-year-old patient with ARDS gradually has increased ETCO2. The patient is currently hypoventilating while on a neuromuscular blockage. The patient’s temp is 38.8 degree Celsius. The factors most likely to be contributing to the patient’s increased ETCO2 are: Hypoventilation, chemical paralysis, hyperthermia, and inadequate minute ventilation A widening of the arterial-alveolar carbon dioxide Increased oxygen demand Large body surface index

3.  While assessing a patient with a continuous ETCO2 monitor, the respiratory therapist notes an exponential decrease of 20% in the ETCO2 along with agitation and decompensation of the patient’s arterial oxygen saturation (Sao2). The most appropriate action is to: Immediately prepare for chest tube insertion Suction the patient to establish that no airway obstruction exists Hyperoxygenate and assess the patient for a pulmonary embolism and severe hypoperfusion Check the placement and patency of the airway adapter

4.  An intubated patient receiving mechanical ventilation and being monitored via continuous capnography suddenly has a significant drop in the ETCO2 level. In addition, the waveform drops to baseline. The Respiratory Therapist should: Sedate the patient to decrease the risk of tube dislodgement Prepare for emergent creation of a tracheostomy because the airway is obstructed Continue to assess the patient closely , but this is normal Assess the ventilator for alarms and if none is found, assess the ETCO2 system for leaks or malfunction

5.  The authorized practitioner asks the respiratory therapist to suggest the most accurate, noninvasive way to measure CO2. The RT should suggest the following: Paco2 measurement ETCO2 measurement Mixed venous sample SVO2