ICU PRACTICE QUESTIONS AND ANSWERS

When planning care for a patient on a mechanical ventilator, the nurse understands that the application of positive end-expiratory pressure (PEEP) to the ventilator settings has which therapeutic effect? ~Increased inflation of the lungs ~Prevention of barotrauma to the lung tissue ~Prevention of alveolar collapse during expiration ~Increased (FIO2 ) fraction of inspired oxygen concentration administration - Answer-Prevention of alveolar collapse during expiration The nurse is caring for a 34-year-old woman with acute decompensated heart failure who has a pulmonary artery catheter. Which assessment best indicates that the patient's condition is improving? ~Cardiac output (CO) is 3.5 L/minute. ~Central venous pressure (CVP) is 10 mm Hg. ~Pulmonary artery wedge pressure (PAWP) is 10 mm Hg. ~Systemic vascular resistance (SVR) is 1500 dynes/sec/cm-5 . - Answer-~Pulmonary artery wedge pressure (PAWP) is 10 mm Hg. A 68-year-old male patient diagnosed with sepsis is orally intubated on mechanical ventilation. Which action is most important for the nurse to take? ~Use the open-suctioning technique. ~Administer morphine for discomfort. ~Limit noise and cluster care activities. ~Elevate the head of the bed 30 degrees. - Answer-~Elevate the head of the bed 30 degrees. The nurse is caring for a 65-year-old man with acute respiratory distress syndrome (ARDS) who is on pressure support ventilation (PSV), fraction of inspired oxygen (FIO2) at 80%, and positive end-expiratory pressure (PEEP) at 15 cm H2O. The patient weighs 72 kg. What finding would indicate that treatment is effective? ~PaO2 of 60 mm Hg ~Tidal volume of 700 mL ~Cardiac output of 2.7 L/minute ~Inspiration to expiration ratio of 1:2 - Answer-~PaO2 of 60 mm Hg The nurse is admitting a 45-year-old asthmatic patient in acute respiratory distress. The nurse auscultates the patient's lungs and notes cessation of the inspiratory wheezing. The patient has not yet received any medication. What should this finding most likely suggest to the nurse?