A 61-year-old male patient is post-abdominal surgery and has been on a high-flow nasal cannula at 20 L/min for three days. The patient’s ABG results are as follows:
belongs to book: ABG PRACTICE QUESTIONS|Respiratory Therapy Zone|| Chapter number:1| Question number:31
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Medicine
The first thing you need to do is interpret the ABG results. The acid-base status is normal because the pH, PaCO2, HCO3, and BE are all within the normal range.
However, the PaO2, on the other hand, is too high. So you know that you need to decrease this value, and you can do so by decreasing the FiO2.
In general for a high-flow nasal cannula, you need a flow of at least 20-30 L/min in order to deliver the set FiO2 to adult patients. So if you were to decrease the flow below 20 L/min, it’s not going to provide the set FiO2.
And in general, you should avoid adjusting two parameters at the same time.
So by using our ABG interpretation skills, as well as what we know about high-flow nasal cannulas, you know that the correct answer has to be B.
The correct answer is: B. Decrease the FiO2
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