An 80-year-old male patient presents to the hospital on supplemental oxygen with the following arterial blood gas: pH of 7.24, Paco2 of 70 mmHg, and Pao2 of 63 mmHg. He shows evidence of which of the following?

Which statement is true about veins?

A 56-year-old male with advanced idiopathic pulmonary fibrosis presents to the ICU in respiratory distress. He is put on high flow nasal cannula with 50 L flow, 80% FiO2. ABG obtained has a pH significant for 7.32, PaO2 of 80 mm Hg, PaCO2 of 20 mm Hg, HCO3 of 30. Given his underlying disease, what is the primary physiological aberration leading to the patient’s hypoxemia?

A 36-year-old man is admitted for alcohol withdrawal. The patient is initially treated with lorazepam injection as needed based on the Clinical Institute Withdrawal Assessment (CIWA) scale but develops respiratory depression, requiring transfer to the ICU and mechanical ventilation. To treat the symptoms of withdrawal, the patient was started on fentanyl infusion, midazolam infusion, and propofol infusion. Attempts to lower the sedation were met with extreme agitation and dyssynchrony with the ventilator. After 5 days, dexmedetomidine was introduced. A few hours later, the patient became bradycardic and hypotensive. A crystalloid bolus was started. The electrocardiogram (ECG) shows a second degree heart block. Laboratory analysis shows the following: Labs1.jpgAdditionally, his serum osmolality gap is elevated. Which is the responsible medication for the abnormal laboratory values?

A 65-year-old female is scheduled for spinal surgery. She has a past medical history of CAD and HTN, atrial fibrillation. Her pre-op CXR is shown below. CXR4.jpg Which of the following is most helpful in predicting her risk of postoperative of respiratory failure?

The AG-ACNP is seeing a patient who is initiating breaths on SIMV. The SpO2 is 98% on 40% fraction of inspired oxygen. The AG-ACNP notices that the patient’s spontaneous tidal volumes are 130 mL per breath, and the patient is getting mildly tachycardic and is complaining of fatigue. Respiratory muscle fatigue can best be reduced by:

A 45-year-old previously healthy female presents to the emergency department with 3 days of fevers and progressive dyspnea and is admitted to the intensive care unit (ICU) for influenza infection complicated by severe hypoxemia. She is intubated, and chest radiograph following intubation demonstrates an appropriately placed endotracheal tube with bilateral patchy opacities and interstitial markings throughout all lung fields, without effusions. Her bedside echocardiogram reveals a left ventricular ejection fraction of 0.75 with otherwise normal findings. Her ventilator settings are volume control, tidal volume (VT) 500 mL, respiratory rate (RR) 14 breaths per minute, FiO2 1.0, and positive end-expiratory pressure (PEEP) 5 cm H2O. An initial arterial blood gas (ABG) is pH 7.30 PCO2 45 mm Hg and PO2 80 mm Hg. Which of the following therapies has been best shown to improve the survival of patients such as this woman?

A 62-year-old male patient with a history of COPD presents to the office with a complaint of cough and “body aches” for 3 days. He tests positive for influenza A.For this patient, the current CDC recommendation to treat influenza is to begin therapy with:

1. Which of the following nutrients provides the most energy per gram?

A 62-year-old male patient with a history of COPD presents to the office with a complaint of cough and “body aches” for 3 days. He tests positive for influenza A.For this patient, the current CDC recommendation to treat influenza is to begin therapy with: