Wyjaśnień na temat cyklu „Powtórka z ROSHrywki” udzielam tutaj. Tak na zachętę przedstawię pytanie testowe i towarzyszące mu objaśnienia. Przy następnej okazji odpowiedzi pojawią się z kilkudniowym opóźnieniem.

MERITUS

Question #1: You are caring for a 66-year-old man who has a history of lung cancer who presented to the ED with massive hemoptysis. You obtain the chest radiograph as seen below. His condition continues to deteriorate and you make the decision to perform endotracheal intubation. While you prepare for intubation, what is the best position for you to place the patient in to optimize gas exchange?

Pytanie #1 (question 587200)

  1. (A) Left lateral decubitus
  2. (B) Right lateral decubitus
  3. (C) Supine
  4. (D) Trendelenburg

Correct Answer ( B )

Explanation:

This patient has complete ?white-out? of his right lung, which is related to his history of lung cancer. It appears that there is a large pleural effusion on the chest radiograph. To optimize gas exchange, the patient should be placed in the right lateral decubitus position so that the ?white-out? lung is down and the ?good lung? is up. This will help to prevent blood from entering the unaffected lung. 

Placing the patient in Trendelenburg (D) and supine (C) position increases the likelihood of aspiration. If the patient is in the left lateral decubitus position (A), gravity will cause fluid to enter the left hemothorax compromising his good lung.

Category: THORACIC-RESPIRATORY DISORDERS
Subcategory: TUMORS
Question: 587200