Your adult respiratory insufficiency patient's respirations are shallow and irregular at six times per minute. His SpO2 is 76 mm Hg, and you suspect carbon dioxide retention due to the decreased respiratory effort. Which of the following should you suspect?

Correct Answer: B

Rationale: The correct answer is B: Respiratory acidosis. In this scenario, the patient's shallow and irregular respirations indicate hypoventilation, leading to carbon dioxide retention and decreased pH levels, causing respiratory acidosis. The low SpO2 level further supports inadequate oxygen exchange. Choices A, C, and D are incorrect as they do not align with the hypoventilation and CO2 retention observed in the patient. Option A (Respiratory alkalosis) would be characterized by increased respiratory rate and low CO2 levels. Option C (Metabolic acidosis) involves non-respiratory causes like kidney dysfunction. Option D (Metabolic alkalosis) results from excessive loss of acids like vomiting.

Correct Answer: A

Rationale: The correct answer is A: "Air splints." Air splints are not typically used in the immobilization of a patient with suspected spinal cord injury. The rationale behind this is that air splints do not provide adequate support and stabilization for potential spinal injuries. On the other hand, choices B, C, and D are commonly used in spinal immobilization. "Bolstering devices" help maintain proper alignment of the spine. "A long spine board" is used to safely transfer the patient while keeping the spine in a neutral position. "A scoop-style stretcher" allows for easy and gentle transfer of the patient onto a backboard without compromising spinal alignment. In summary, the use of air splints is not recommended for spinal immobilization due to inadequate support, while bolstering devices, a long spine board, and a scoop-style stretcher are appropriate tools for immobilizing a patient with suspected spinal cord injury.

Correct Answer: B

Rationale: The correct answer is B: Direct pressure on the wound. Direct pressure is the initial step to control bleeding from a wound. It helps to compress blood vessels and stop bleeding. A tourniquet (A) is not necessary and can lead to complications if used inappropriately. Packing the wound with gauze (C) may not be effective in controlling bleeding from a large wound and can cause further trauma. Direct pressure on the femoral artery at the groin (D) is not recommended as a primary measure and can be difficult to perform effectively in an emergency setting.

Correct Answer: A

Rationale: The correct answer is A: "The trachea is relatively short." During infant endotracheal intubation, the trachea in infants is shorter compared to adults, making it easier for the endotracheal tube to be inadvertently inserted into the right or left mainstem bronchus. This is due to the anatomy of infants where the distance from the vocal cords to the mainstem bronchi is shorter, increasing the risk of bronchial intubation. Summary: B: The distance from the lips to the larynx being short is not directly related to the risk of bronchial intubation. C: The use of tubes without cuffs is not a primary factor leading to bronchial intubation. D: The angulation of the mainstem bronchi is not a significant factor in the increased risk of bronchial intubation during infant endotracheal intubation.

Correct Answer: A

Rationale: The correct answer is A: "Perform needle cricothyroidotomy with jet insufflation". In this scenario, the infant is in respiratory distress with unsuccessful intubation. Needle cricothyroidotomy is the most appropriate procedure as it provides a rapid and effective way to establish a patent airway in an emergency. Jet insufflation helps provide oxygenation. Administering heliox and racemic epinephrine (B) is not appropriate for this immediate airway management situation. Nasotracheal intubation (C) is not recommended in the case of failed oral intubation and the urgency of the situation. Surgical cricothyroidotomy (D) is more invasive and time-consuming compared to needle cricothyroidotomy in this critical condition.