NSG 252 Study Guide | 2026 Update Questions with
complete solutions.
Communication and support for a mechanically ventilated patient.
Assess the patient's understanding and initiate a form of communication. This decreases anxiety
and allows the patient to make their needs known.
A communication board is a good choice.
Risk factors for ARDs
~ Sepsis
~ Aspiration
~ Oxygen toxicity
~ Severe pancreatitis
~ Pneumonia
~ Near drowning events
~ Trauma
Usually major systemic inflammation
Manifestations of ARDs
• Severe Dyspnea
• Non cardiogenic pulmonary edema (lung sounds- crackles)
• Tachypnea/use of accessory muscles
• Reduced lung compliance
• Dense patchy bilateral pulmonary infiltrates "white out"
,• Severe hypoxemia despite administration of 100% oxygen
(refractory hypoxemia)
Fast onset - air hunger and crackles are earliest signs
Low PaO2 and initially low PaCO2 due to hyperventilation (alkalosis) that changes to high
PaCO2 with fatigue. pH will drop as RESPIRATORY ACIDOSIS develops.
Nursing care of ARDs
~ Observe and document hypoxemic neurological status
~ Maintain a patent airway
~ Re-position the patient often and observe for hypotension, increased secretions, and elevated
temp (signs of deterioration)
• Assess the patient's respiratory status
• Implement strategies
Positioning and turning schedule
Oral care
Skin care
Range of motion of extremities
DVT prophylaxis
Administer corticosteroids and antibiotics
, Mechanical ventilation may be necessary with a high PEEP 10 to 20 mmHg. (risk for
barotruama)
Nursing care for pnuemothorax
• O2 therapy & Monitor respiratory status
• Heart, lung sounds and VS every 4 hours
• Document ventilator settings if on vent
• Position high Fowler's if possible (90 degrees)
• Monitor chest tube drainage
• Provide emotional support
• Administer medications
• Monitor for infection
• Monitor pain
• I and O
• Referral services- home health, resp. services (portable O2)
Chest tube
~ Monitor the client's vital signs, LOC, their ability to breathe on their own, and lung sounds.
~ Observe for signs of infection such as redness, swelling, or drainage from the insertion site.
Also, look for indications of hemolysis (RBC breakdown), such as increased heart rate or low
blood pressure.
~ Fluid intake and output including how much fluid comes out through the tube. Bright red
drainage in an old tube can indicate a problem. Over 100 mL an hour is excessive.
complete solutions.
Communication and support for a mechanically ventilated patient.
Assess the patient's understanding and initiate a form of communication. This decreases anxiety
and allows the patient to make their needs known.
A communication board is a good choice.
Risk factors for ARDs
~ Sepsis
~ Aspiration
~ Oxygen toxicity
~ Severe pancreatitis
~ Pneumonia
~ Near drowning events
~ Trauma
Usually major systemic inflammation
Manifestations of ARDs
• Severe Dyspnea
• Non cardiogenic pulmonary edema (lung sounds- crackles)
• Tachypnea/use of accessory muscles
• Reduced lung compliance
• Dense patchy bilateral pulmonary infiltrates "white out"
,• Severe hypoxemia despite administration of 100% oxygen
(refractory hypoxemia)
Fast onset - air hunger and crackles are earliest signs
Low PaO2 and initially low PaCO2 due to hyperventilation (alkalosis) that changes to high
PaCO2 with fatigue. pH will drop as RESPIRATORY ACIDOSIS develops.
Nursing care of ARDs
~ Observe and document hypoxemic neurological status
~ Maintain a patent airway
~ Re-position the patient often and observe for hypotension, increased secretions, and elevated
temp (signs of deterioration)
• Assess the patient's respiratory status
• Implement strategies
Positioning and turning schedule
Oral care
Skin care
Range of motion of extremities
DVT prophylaxis
Administer corticosteroids and antibiotics
, Mechanical ventilation may be necessary with a high PEEP 10 to 20 mmHg. (risk for
barotruama)
Nursing care for pnuemothorax
• O2 therapy & Monitor respiratory status
• Heart, lung sounds and VS every 4 hours
• Document ventilator settings if on vent
• Position high Fowler's if possible (90 degrees)
• Monitor chest tube drainage
• Provide emotional support
• Administer medications
• Monitor for infection
• Monitor pain
• I and O
• Referral services- home health, resp. services (portable O2)
Chest tube
~ Monitor the client's vital signs, LOC, their ability to breathe on their own, and lung sounds.
~ Observe for signs of infection such as redness, swelling, or drainage from the insertion site.
Also, look for indications of hemolysis (RBC breakdown), such as increased heart rate or low
blood pressure.
~ Fluid intake and output including how much fluid comes out through the tube. Bright red
drainage in an old tube can indicate a problem. Over 100 mL an hour is excessive.
