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NUR417 Med Surge 2 Concordia University Exam Blueprint Questions
and Answers with Complete Solutions UPDATED!!!
ET Tube placement verification
EtCO2 detector - If high CO2, placement was good
2nd - Get chest x-ray - confirms tube location
PVC - What is it?
Priority Intervention?
Treatment?
If asymptomatic?
PVC = Premature Ventricular Contraction - Blood not circulating
throughout the body, causing abnormal wave.
Intervention: Hypoxia interventions
Tx: Amiodarone (Antiarrhythmic), lidocaine (Antiarrhythmic,
local anesthetic)
If asymptomatic: Just monitor. Teach pt to avoid caffeine,
alcohol, nicotine.
Mechanical Ventilation
What to do before placement?
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Labs?
Wean Assessment?
Before placement: Pre-oxygenate 3-5 mins before intubation.
Labs: Draw regular ABGs. Hgb normal = 7-10 mg/dL
Wean Assessment: Ready when pt breathes spontaneously, is
hemodynamically stable, and awake/alert, has hypoxic drive
PEEP
Function?
Downside?
Assessment of this downside?
PEEP = positive end-expiratory pressure
Function: To prevent alveoli from collapsing.
Downside: Can reduce cardiac output. Can cause barotrauma
(damaged lung/pneumothorax)
Reduced CO assessment: Reduced pulses, skin discoloration.
Mechanical Ventilator weaning evaluation of effectiveness -
What are we making sure of?
How are COPD patients tested for weaning?
What supplies available while weaning?
No stridor or hoarseness - s/s of airway closing
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Hemodynamically stable, V/S normal, no bleeding, adequate
oxygenation
COPD: Needs hypoxic drive for weaning
Supplies: Have spare intubation equipment ready to use if
airway is closing
Ventilator alarms
High-Pressure Alarms
Low-Pressure Alarms
Priority assessment when alarm goes off. What do you do first?
High-Pressure: Mucous, gagging, kinked tube, pneumothorax,
pulmonary edema, client fighting the ventilator
Low-Pressure: Leak or disconnected tube, ET displacement (In
this case, you would extubate)
Priority assessment: Look at the PATIENT first to see if they are
struggling to breathe. Could just be a leak.
Ventilatory Failure: Diagnostics for hypoxemic/hypercapnic
Also known as:
AKA: Hypercapnic respiratory failure (Ventilatory failure)
PaCO2 greater than 50 mm Hg w/ pH acidic (less than 7.35)
Body can't get rid of CO2
NUR417 Med Surge 2 Concordia University Exam Blueprint Questions
and Answers with Complete Solutions UPDATED!!!
ET Tube placement verification
EtCO2 detector - If high CO2, placement was good
2nd - Get chest x-ray - confirms tube location
PVC - What is it?
Priority Intervention?
Treatment?
If asymptomatic?
PVC = Premature Ventricular Contraction - Blood not circulating
throughout the body, causing abnormal wave.
Intervention: Hypoxia interventions
Tx: Amiodarone (Antiarrhythmic), lidocaine (Antiarrhythmic,
local anesthetic)
If asymptomatic: Just monitor. Teach pt to avoid caffeine,
alcohol, nicotine.
Mechanical Ventilation
What to do before placement?
,2|Page
Labs?
Wean Assessment?
Before placement: Pre-oxygenate 3-5 mins before intubation.
Labs: Draw regular ABGs. Hgb normal = 7-10 mg/dL
Wean Assessment: Ready when pt breathes spontaneously, is
hemodynamically stable, and awake/alert, has hypoxic drive
PEEP
Function?
Downside?
Assessment of this downside?
PEEP = positive end-expiratory pressure
Function: To prevent alveoli from collapsing.
Downside: Can reduce cardiac output. Can cause barotrauma
(damaged lung/pneumothorax)
Reduced CO assessment: Reduced pulses, skin discoloration.
Mechanical Ventilator weaning evaluation of effectiveness -
What are we making sure of?
How are COPD patients tested for weaning?
What supplies available while weaning?
No stridor or hoarseness - s/s of airway closing
, 3|Page
Hemodynamically stable, V/S normal, no bleeding, adequate
oxygenation
COPD: Needs hypoxic drive for weaning
Supplies: Have spare intubation equipment ready to use if
airway is closing
Ventilator alarms
High-Pressure Alarms
Low-Pressure Alarms
Priority assessment when alarm goes off. What do you do first?
High-Pressure: Mucous, gagging, kinked tube, pneumothorax,
pulmonary edema, client fighting the ventilator
Low-Pressure: Leak or disconnected tube, ET displacement (In
this case, you would extubate)
Priority assessment: Look at the PATIENT first to see if they are
struggling to breathe. Could just be a leak.
Ventilatory Failure: Diagnostics for hypoxemic/hypercapnic
Also known as:
AKA: Hypercapnic respiratory failure (Ventilatory failure)
PaCO2 greater than 50 mm Hg w/ pH acidic (less than 7.35)
Body can't get rid of CO2
