The respiratory assessment of a 44-year-old female patient diagnosed with myasthenia gravis shows: vital capacity 475 mL,maximum inspiratory pressure (MIP)-18 cm H₂O.The patient is 5 feet 6 inches tall and weighs 188 lbs.The most recent arterial blood gas on a 2 L/min nasal cannula is pH 7.32,partial pressure of carbon dioxide (P_aCO₂)49 mm Hg,partial pressure of oxygen (P_aO₂)77 mm Hg,arterial oxygen saturation (S_aO₂)95%,bicarbonate (HCO₃^-)24 mEq/L.The most appropriate recommendation for this patient is which of the following?

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Quizplus · Accepted Answer

The arterial blood gas result for this patient shows an acute respiratory acidosis.That along with a vital capacity of 7.4 mL/kg and the maximum inspiratory pressure (MIP)of -18 cm H₂O point to the fact that this patient is also showing signs of muscle weakness that is progressively worsening.This requires prompt intubation and support to prevent acute respiratory failure.The 50% air entrainment mask and the continuous positive airway pressure (CPAP)will not provide support for this patient's ventilatory problems.Noninvasive positive pressure ventilation (NPPV)is not appropriate for this patient because of the patient's decreasing muscle strength.

The Respiratory Assessment of a 44-Year-Old Female Patient Diagnosed with Myasthenia