ARF/ARDS questions and complete solutions

ARF/ARDS

erlobepneumonia.Whichposi-
1. 3. A patient with respiratory
,f ,f ,f ,f ,f



,f ,f ,f ,f




failure has a respiratory rate
,f , f , f , f , f




of 6 breaths/minute and an
,f ,f ,f ,f ,f




oxygen saturation (SpO2) of
,f ,f ,f ,f




88%. The patient is increasing-
,f ,f ,f ,f ,f




ly lethargic.Which
,f ,f ,f




interventionwill the nurse
,f ,f ,f ,f




anticipate?
,f




a. Administration of 100%oxy- ,f ,f ,f




gen by non-rebreather mask
,f ,f ,f ,f




b. Endotrachealintubation ,f




andpositive pressure
,f ,f ,f




ventilation
,f




c. Insertion of a mini-tra- ,f ,f ,f




cheostomywithfrequentsuc-
,f ,f ,f ,f




tioning
,f




d. Initiation of continuous ,f ,f




positive pressure
,f ,f




ventilation(CPAP)
,f ,f




2. 4. The oxygen saturation
,f ,f ,f




(SpO2) for a patient with left
,f ,f ,f ,f ,f ,f




lower lobe pneumonia is 90%.
,f ,f ,f ,f ,f




Thepatienthasrhonchi,aweakc
,f ,f ,f ,f ,f ,f ,f




ough effort, and complains ,f ,f ,f




offatigue.Whichactionisaprior-
,f ,f ,f ,f ,f ,f ,f




ity for the nurse to take?
,f ,f ,f ,f ,f ,f




a. Position the patient on ,f ,f ,f




theleft side.
,f ,f ,f




b. Assist the patient ,f ,f




withstaged coughing.
,f ,f ,f




c. Place a humidifier in the pa- ,f ,f ,f ,f ,f




tient's room.
,f ,f




d. Schedule a 2-hour rest peri- ,f ,f ,f ,f




od for the patient.
,f ,f ,f ,f




3. 5. A nurse is caring for an obese
,f ,f ,f ,f ,f ,f ,f




patient with right low-
,f ,f ,f ,f





,f ,f

, ARF/ARDS

OBJ:SpecialQuestions:PrioritizationTOP:N
ANS:B
,f ,f ,f ,f ,f




ursing Process:Implementation
,f




Thepatient'slethargy,lowrespiratory
,f ,f




MSC:NCLEX:Physiological Integrity
,f ,f ,f ,f




rate,and SpO2 indicate the need for
,f ,f ,f



,f ,f ,f ,f ,f ,f ,f




mechani- calventilationwithventilator-
,f ,f ,f ,f ,f


ANS:A ,f




controlledres-piratory rate. ,f ,f ,f


The patient should be positioned with
,f ,f ,f ,f ,f




Administration of high flow oxygen will
,f ,f ,f ,f ,f ,f


the"good" lung in the dependent position to
,f ,f ,f ,f ,f ,f ,f ,f




not be helpful because the patient's
,f ,f ,f ,f ,f ,f




respiratory rate is so low. Inser- tion of
,f ,f ,f ,f ,f ,f ,f ,f




a mini-tracheostomy will facilitate
,f ,f ,f ,f




removalofsecretions,butitwillnotimpr
,f ,f ,f ,f ,f ,f ,f ,f




ovethe patient's respiratory rate or
,f ,f ,f ,f ,f




oxygena- tion. CPAP requires that the
,f ,f ,f ,f ,f ,f




patient initiatean adequate
,f ,f ,f ,f




respiratory rate to allow ade-quate
,f ,f ,f ,f ,f ,f




gas exchange.
,f ,f




DIF:Cognitive Level:Apply ,f ,f ,f




(application)
,f




REF:1658 | 1662 ,f ,f ,f




TOP:Nursing Process:Planning ,f ,f ,f




MSC:NCLEX:Physiological
,f ,f ,f




Integrity
,f




ANS:B ,f




Thepatient'sassessmentindicatesthat ,f ,f ,f ,f ,f




as-sisted coughing is needed to help
,f ,f ,f ,f ,f ,f




remove
,f




secretions,whichwillimproveoxygena
,f ,f ,f ,f ,f




tion.A 2-hour rest period at this time ,f ,f ,f ,f ,f ,f ,f




may allowthe oxygen saturation to
,f ,f ,f ,f ,f ,f




drop further. Hu- midification will not
,f ,f ,f ,f ,f ,f




be helpful unless the
,f ,f ,f ,f




secretionscanbemobilized.Positionin
,f ,f ,f ,f ,f




gonthe left side may cause a further
,f ,f ,f ,f ,f ,f ,f ,f




decreaseinoxygensaturationbecaus
,f ,f ,f ,f ,f




eperfusionwillbe directed more
,f ,f ,f ,f ,f




toward the more poorly ventilated
,f ,f ,f ,f ,f




lung.
,f




DIF:Cognitive Level:Apply ,f ,f ,f




(application)
,f




REF:1661-1662 ,f





,f ,f

, ARF/ARDS
Study online at https://quizlet.com/_8i28fk ,f ,f ,f




tion will bebest to improve ,f ,f ,f ,f improvethematchbetweenventilationandpe ,f ,f ,f ,f ,f ,f




gasexchange?
,f ,f rfusion. The obese patient's abdomen will ,f ,f , f , f ,f




a. On the left side ,f ,f ,f limit respiratory excursion when sittingin the
,f ,f ,f ,f ,f ,f ,f




b. On the right side ,f ,f ,f high-Fowler's or tripod positions.
,f ,f ,f ,f




c. In the tripod position ,f ,f ,f DIF:Cognitive Level:Apply ,f ,f ,f




d. Inthehigh-Fowler'sposition ,f ,f ,f (application)REF:1662
,f ,f ,f




TOP:Nursing ,f




Process:ImplementationMSC:NCLEX:
,f ,f ,f ,f ,f




Physiological Integrity ,f




4. 6.When admitting a pa-
,f ,f ,f ,f




tient with possible respirato- ry ,f ,f ,f ,f ANS:A ,f




failure with a high PaCO2,
,f ,f ,f ,f ,f Increasing somnolence will decrease the ,f ,f ,f ,f




whichassessmentinformation
,f ,f ,f ,f patient's respiratory rate and further in-
,f ,f ,f ,f ,f ,f




should be immediately report- ,f ,f ,f crease the PaCO2and respiratory failure.
,f ,f ,f ,f ,f




ed to the health care provider?
,f ,f ,f ,f ,f ,f Rapid action is needed to prevent respira-
,f ,f ,f ,f ,f ,f ,f




a. The patient is somnolent. ,f ,f ,f tory arrest. An SpO2 of 90%, weakness,
,f ,f ,f ,f ,f ,f ,f




b. The patient complains ,f ,f andelevatedbloodpressureallrequireon-
,f ,f ,f ,f ,f ,f ,f




ofweakness.
,f ,f going monitoring but are not indicators of
,f ,f ,f ,f ,f ,f ,f




c. The patient's blood ,f ,f possible impending respiratory arrest.
,f ,f ,f ,f




pressureis 164/98.
,f ,f ,f DIF:Cognitive Level:Apply ,f ,f ,f




d. The patient's oxygen satura- ,f ,f ,f (application)REF:1660
,f ,f ,f




tion is 90%.
,f ,f ,f TOP:Nursing Process:Assessment ,f ,f ,f




MSC:NCLEX:Physiological Integrity
,f ,f ,f ,f




5. 7.A patient with acute respira-
,f ,f ,f ,f ,f




ANS:B ,f




torydistresssyndrome(ARDS) Gentamicin, which is one of the aminogly-
,f ,f ,f ,f ,f ,f ,f ,f ,f ,f




andacutekidneyinjuryhasthe coside antibiotics, is potentially nephrotox-
,f ,f ,f ,f ,f ,f ,f ,f ,f ,f




following medications ordered. ic,andthenurseshouldclarifythedrugand ,f ,f ,f ,f ,f ,f ,f ,f ,f ,f ,f




Which medication should d. Methylprednisolone(Solu- ,f ,f ,f




the nurse discuss with the
,f Medrol) 60 mg IV
,f ,f ,f ,f ,f ,f ,f




health care provider before
,f ,f ,f ,f




giving?
,f




a. Pantoprazole (Protonix) 40 ,f ,f ,f




mg IV ,f




b. Gentamicin (Garamycin) 60 ,f ,f ,f




mg IV ,f




c. Sucralfate (Carafate) 1 g ,f ,f ,f




pernasogastric tube
,f ,f ,f





,f ,f