MS2 FINAL (ALL SOLVED 100% ACCURATE)

The nurse is caring for a patient who is being mechanically ventilated due to respiratory failure. For what complications should the nurse closely monitor? Select all that apply. a. barotrauma b. volotrauma c. hypoxemia d. renal failure e. ventilator required pneumonia correct answers a, b, e rationale: Mechanical ventilation can result in alveolar injuries due to the overdistension of the lungs, which can result in barotrauma. Volutrauma is a complication caused by a mechanical ventilator set on large tidal volumes. Ventilator-associated pneumonia occurs in patients who receive mechanical ventilation for a prolonged period of time. Hypoxemia is caused by acute respiratory distress syndrome (ARDS). Renal failure is a renal complication that occurs from decreased renal tissue oxygenation. A nurse is monitoring a patient with stiff lungs due to acute respiratory distress syndrome (ARDS). What compensatory clinical events may the nurse expect in this patient? Select all that apply. a. hypoventilation b. respiratory alkalosis c. increase in cardiac output d. accumulation of carbon dioxide e. increase in respiratory rate and decrease in tidal volume correct answers b,c, e rationale: The breathing pattern of stiff lungs increases carbon dioxide removal, producing respiratory alkalosis. Cardiac output increases in response to hypoxemia, a compensatory effort to increase pulmonary blood flow. Hypoxemia and the stimulation of juxtacapillary receptors in the stiff lung parenchyma initially cause an increase in respiratory rate and a decrease in tidal volume. Hypoventilation occurs after compensatory failure. Carbon dioxide does not accumulate; instead, there may be increased removal of carbon dioxide. A patient with acute respiratory distress syndrome is on a ventilator. Which protocols should the nurse follow to prevent ventilator-associated pneumonia? Select all that apply. a. prevent venous thromboembolism b. maintain hygiene and oral care daily c. elevate HOB 55 degrees d. conduct readiness assessment to extubatne e. maintain sedation holiday on alternate days correct answers a, b, d, rationale: The nurse should take preventive measures to reduce the risk of venous thromboembolism in patients hospitalized for critical illnesses like acute respiratory distress syndrome. When in contact with the patient, oral care and hygiene should be maintained with chlorhexidine solution. The nurse should conduct a readiness test to determine if the patient is set for extubation on a daily basis. As per the components of the ventilator care bundle, the head of the bed should be elevated 30 to 45 degrees. The nurse should stop the sedation at daily intervals so that the patient has a break from being unconscious.