ECCO Caring for Patients with Pulmonary Disorders: Part 2 fully solved 2023

ECCO Caring for Patients with Pulmonary Disorders: Part 2 fully solved 2023A patient has been on mechanical ventilation for two days. After two hours on an SBT, RR is 7, and SpO2 is 90%. Which is indicated? - correct answer Stop the trial, and place the patient back on ventilator. The patient can continue the trial as long as the RR stays <35 or >8 and the oxygen saturation is > or = 88%. Which is true about tracheostomy tube placement? - correct answer The surgical approach varies from the percutaneous approach primarily in that an incision is made during the procedure rather than a puncture through the skin. In caring for a patient on mechanical ventilation, how can a nurse reduce over-sedation, immobility, and the development of delirium? - correct answer Implement ABCDEF bundle. In performing an SAT, which assessment should prompt the nurse to restart sedation at half the previous dose and titrate to goal? - correct answer Respiratory rat 38 per minute A patient is on mechanical ventilation and the SAT is in progress. The patient develops RR 36 and SpO2 87%. Which is indicated? - correct answer Stop the SAT and restart sedation at half the pretrial rate. Which nursing intervention is indicated immediately after the patient is intubated emergently. - correct answer Assess vital signs. While weaning a patient from short-term ventilation, the nurse should observe for which indications that the patient is not tolerating the weaning? - correct answer The SBT and weaning should be stopped for any of the following: RR >35 or <8, oxygen saturation <88%, respiratory distress, mental status change, decreasing spontaneous Vt, and acute cardiac dysrhythmias. Which is indicated for patients requiring ongoing tracheostomy management? - correct answer Keep a spare tracheostomy at the bedside. Which intervention prevents complications for a patient experiencing neuromuscular blockade while undergoing mechanical ventilation? - correct answer Interventions that prevent complications for patients with neuromuscular blockade include frequent turning, range of motion, VTE prevention, stress ulcer prevention, and eye lubrication. Mr. Kearley is on Day Two of mechanical ventilation, and his FiO2 is 0.50. Which assessments indicate he is ready for weaning? - correct answer Weaning parameters that indicate a patient is likely to succeed are: RR <30 with RSBI <105, VC > or =10 mL/kg, Vt needs to be > or = mL/kg, and NIP (NIF) at least -20 cm H2O. Ms. Julie Gadley passed the SAT safety screen and began the SAT. The propofol has been off for 30 minutes. Fentanyl is at 50 mcg/hr. Her pain and agitation scores include CPOT 7 and RASS +3 (very agitated). Her vital signs are BP 92/56 (68), HR 125, and RR 38. Then ventilator is alarming for high PIP. What nursing actions are indicated? - correct answer Stop the SAT and restart propofol at half the previous dose. What practices should the nurse perform in caring for a patient who has an ETT? - correct answer Routine care promotes patient safety and optimal outcomes during endotracheal intubation by promoting patient communication and preventing skin breakdown, ETT displacement, airway injury, and VAEs. Which form of mechanical ventilation should a nurse anticipate for a patient with acute respiratory distress syndrome (ARDS) who has PaO2 51 mm Hg? - correct answer When a patient has noncompliant lungs with poor oxygenation, PCV delivers a set rate of ventilations with a limit on the amount of pressure allowed. Patients with acute respiratory distress syndrome are an example of the type of patient likely to need this type of ventilation. Which statement is true? - correct answer Volume ventilation delivers gas at a preset tidal volume. With volume ventilation modes, the set Vt is supplied by the ventilator at a constant flow. In caring for a patient on mechanical ventilation, which strategy should a nurse anticipate to prevent volutrauma and barotrauma? - correct answer Use Vt less than 6-10 mL/kg of PBW (4-6 mL/kg of PBW in ARDS patients). A nurse observes that a patient admitted for trauma is lethargic, with PaO2 57 mm Hg. The presence of which other factor(s) should lead the nurse to anticipate endotracheal intubation? - correct answer Impaired ability to swallow A patient is on positive pressure ventilation (PPV) for acute respiratory distress syndrome (ARDS). Which action is indicated? - correct answer Monitor for blood-tinged sputum and crackles. A 70 kg (154.3 lb) patient has been on mechanical ventilation for two days. Which indicates readiness to wean? - correct answer Rapid shallow breathing index 85