A 59-Year-Old Patient Is in Severe Respiratory Distress in the Emergency

Multiple Choice

A 59-year-old patient is in severe respiratory distress in the emergency department.The patient is being treated for congestive heart failure and pulmonary edema.Vital signs are pulse 98 beats/min,respiratory rate 23 breaths/min,and BP 138/98 mm Hg.The patient's ABG results on a nonrebreather mask are as follows: pH 7.35; partial PₐCO₂ 45 mm Hg; PₐO₂ 49 mm Hg; SₐO₂ 79%; and HCO₃⁻ 24 mEq/L.The respiratory therapy that is most appropriate at this time is which of the following?

A) 6 L/min nasal cannula
B) 50% air entrainment mask
C) Mask continuous positive airway pressure (CPAP) with 100% oxygen
D) Intubate and mechanically ventilate