Comprehensive HESI Review Exit Test Bank 2022/2023 (Over 2000 Questions and Answers)

Comprehensive HESI Review Exit Test Bank 2022/2023 (Over 2000 Questions and Answers) Acute Respiratory Distress Syndrome (ARDS) The exchange of oxygen for carbon dioxide in the lungs is inadequate for oxygen consumption and carbon dioxide production within the body's cells Characteristics of ARDS Hypoxemia that persists even when 100% oxygen is given; decreased pulmonary compliance; dyspnea; non-cardiac associated bilateral pulmonary edema; dense pulmonary infiltrates on X-ray ARDS No abnormal breath sounds are present in this disorder on auscultation because the edema occurs first in the interstitial spaces and not the airways. ARDS Unexpected, catastrophic pulmonary complication occurring in a person with no pervious pulmonary problems. ARDS Common laboratory finding is a lowered pO2; not responsive to high concentrations of oxygen and often need intubation and mechanical ventilation with PEEP PEEP Positive end-expiratory pressure The instillation and maintenance of small amounts of air into the alveolar sacs to prevent then from collapsing each time the client exhales; amount of pressure can be set and is usually around 5-10cm of water Nursing Assessment of ARDS Dyspnea, hyperpnea; intercostals retractions; cyanosis, pallor; hypoxemia; diffuse pulmonary infiltrates seen on chest radiograph as "white-out" appearance; verbalized anxiety, restlessness Hypoxemia PO2 50mmHg with FiO2 60% Common causes of respiratory failure COPD; pneumonia; tuberculosis; contusion; aspiration; inhaled toxins' emboli; drug OD; fluid overload; DIC; shock Suction When providing care to a patient with ARDS, only do this when secretions are present 7.35-7.45 PH normal value 35-45 mmH PCO2 normal value 22-26 mEq HCO3 normal value 80-100mm PO2 normal value 95-100% O2 normal value Allen Test Perform this test before drawing an ABG from the radial artery Common cause of respiratory failure in children Congenital heart disease; respiratory distress syndrome; infection, sepsis; neuromuscular diseases; trauma and burns; aspiration; fluid overload and dehydration; anesthesia and narcotic OD Nursing assessment of child in respiratory failure Kid just "looks bad;" very slow or very rapid RR, dyspnea, apnea, gasping; tachycardia; cyanosis, pallor, or mottled color; irritability and lethargy; retractions, nasal flaring, poor air movement; hypoxemia, hypercapnia, respiratory acidosis Respiratory Failure PCO2 45 or PO2 60 on 50% O2; a child in severe distress should be on 100% O2 Shock Widespread, serious reduction of tissue perfusion which, if prolonged, leads to generalized impairment of cellular functioning System Hypotension Marked reduction in either cardiac output or peripheral vasomotor tone, without a compensatory elevation in the other results in this Early signs of shock Agitation and restlessness that results from cerebral hypoxia Hypovolemic Shock Related to external or internal blood or fluid loss Cardiogenic Shock Related to ischemia or impairment in tissue perfusion resulting from MI, serious arrhythmia, or HF; all cause decrease CO Vasogenic Shock Related to allergens, spinal cord injury, or peripheral neuropathies, all resulting in venous pooling and decreased blood return to the heart, which decreases cardiac output over time Septic Shock Related to endotoxins released by bacteria, which cause vascular pooling, diminished venous return, and reduced CO High fowler position with legs down Position to reduce venous return in order to decrease further venous return to the left ventricle Medical treatment for shock Rapid infusion of volume-expanding fluids such as whole blood, plasma, plasma substitutes; isotonic, electrolyte IV solutions; CVP artery catheters; CVP measurements, urine output, HR, clinical and mental state; immediate attendtion to improvement of perfusion; administration of drugs is withheld until circulating volume has been restores; O2 administration Pulmonary edema