PCCN Review - Pulmonary Exam Questions and Answers(A+ Solution guide)

Your patient had an exacerbation of COPD. The rapid response team was called and is currently intubating the patient and preparing him for transfer to ICU. When the family visits, they are shocked to see the people working with the patient. No one had told them the patient had deteriorated and required intubation. After the patient is intubated and is being wheeled past them, family members try to communicate verbally with the patient, but he does not respond except to gesture. The nurse should tell the family members: -They must leave the area because they are exciting the patient. -The tube used for breathing prevents the patient from speaking -They must speak with the doctor, who will explain why the patient cannot speak -The patient is very ill and may die. - Answer The tube used for breathing prevents the patient from speaking This is a case where communication is clearly the problem. The family should have been informed by someone that the patient needed assistance with breathing and that they should expect a transfer. It should also have been mentioned how the patient might look in the ICU. In addition, it could have been communicated about the patient's inability to speak. The other answers are all non-theraputic responses. The family is clearly distressed, so a simple explaination in best. Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and restless. Ben states, "I can't be here now. What if something like this happens to me again?" The nurse's best response would be: -The nurses in our unit can take care of you -We are not very far away at the nurses' station -Your insurance will not cover another day there -You sound concerned about leaving the ICU - Answer You sound concerned about leaving the ICUTheraputic communication occurs when the patient's feelings are validated. This response allows for the patient to express the concerns he has about the transfer. The other answers are closed and judgmental and do not allow for any expression of feeling from the patient. Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and restless. A set of blood gases drawn just prior to his transfer show: pH 7.52, PaCO2 31, HCO3 22, PaO2 87. These results would indicate: -Respiratory acidosis -Respiratory alkalosis -Metabloic acidosis -Metabolic alkalosis - Answer Respiratory alkalosis