NSG 252 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS
Communication and support for a mechanically ventilated patient. - CORRECT ANSWER✅✅Assess the
patient's understanding and initiate a form of communication. This decreases anxiety and allows the
patient to make their needs known.
A communication board is a good choice.
Risk factors for ARDs - CORRECT ANSWER✅✅~ Sepsis
~ Aspiration
~ Oxygen toxicity
~ Severe pancreatitis
~ Pneumonia
~ Near drowning events
~ Trauma
Usually major systemic inflammation
Manifestations of ARDs - CORRECT ANSWER✅✅• Severe Dyspnea
• Non cardiogenic pulmonary edema (lung sounds- crackles)
• Tachypnea/use of accessory muscles
• Reduced lung compliance
• Dense patchy bilateral pulmonary infiltrates "white out"
• Severe hypoxemia despite administration of 100% oxygen
(refractory hypoxemia)
Fast onset - air hunger and crackles are earliest signs
Low PaO2 and initially low PaCO2 due to hyperventilation (alkalosis) that changes to high PaCO2 with
fatigue. pH will drop as *RESPIRATORY ACIDOSIS* develops.
,Nursing care of ARDs - CORRECT ANSWER✅✅~ Observe and document hypoxemic neurological status
~ Maintain a patent airway
~ Re-position the patient often and observe for hypotension, increased secretions, and elevated temp
(signs of deterioration)
• Assess the patient's respiratory status
• Implement strategies
Positioning and turning schedule
Oral care
Skin care
Range of motion of extremities
DVT prophylaxis
Administer corticosteroids and antibiotics
Mechanical ventilation may be necessary with a high PEEP 10 to 20 mmHg. (risk for barotruama)
Nursing care for pnuemothorax - CORRECT ANSWER✅✅• O2 therapy & Monitor respiratory status
• Heart, lung sounds and VS every 4 hours
• Document ventilator settings if on vent
• Position high Fowler's if possible (90 degrees)
• Monitor chest tube drainage
• Provide emotional support
• Administer medications
• Monitor for infection
• Monitor pain
• I and O
• Referral services- home health, resp. services (portable O2)
, Chest tube - CORRECT ANSWER✅✅~ Monitor the client's vital signs, LOC, their ability to breathe on
their own, and lung sounds.
~ Observe for signs of infection such as redness, swelling, or drainage from the insertion site. Also, look
for indications of hemolysis (RBC breakdown), such as increased heart rate or low blood pressure.
~ Fluid intake and output including how much fluid comes out through the tube. Bright red drainage in
an old tube can indicate a problem. Over 100 mL an hour is excessive.
~ Promote mobility with range-of-motion exercise.
~ DVT prophylaxis
~ Never clamp, strip, or milk the tube.
~ Water seal chamber has tidaling, think about how the ocean has tides.
~ Occlusive dressing and bottle of sterile water at bedside.
~ Premedicate before removal
Mechanical ventilation - CORRECT ANSWER✅✅~ Asses LOC, VS, lung sounds, pulse ox, and ABGs
~ Suction oral & tracheal secretions as needed only and avoid suctioning before ABGs
~ Reposition ET tube Q24hrs
~ Monitor closely skin breakdown, Turn Q2
~ Strict infection control
~ Frequent oral care - chlorohexidine Q2 (prevent VAP)
~ Sedation holidays
~ Manual resuscitation (ambu) & re-intubation equip @ bedside
~ Prone positioning may be beneficial when dependent lung areas are the most damaged.
~ Start nutrition as early as possible
High pressure alarm = HIGH blockage
Low pressure = LEAK
Intervene if O2 sats are dropping with mechanical ventilation. - CORRECT ANSWER✅✅Auscultate to
assess lung sounds.
Communication and support for a mechanically ventilated patient. - CORRECT ANSWER✅✅Assess the
patient's understanding and initiate a form of communication. This decreases anxiety and allows the
patient to make their needs known.
A communication board is a good choice.
Risk factors for ARDs - CORRECT ANSWER✅✅~ Sepsis
~ Aspiration
~ Oxygen toxicity
~ Severe pancreatitis
~ Pneumonia
~ Near drowning events
~ Trauma
Usually major systemic inflammation
Manifestations of ARDs - CORRECT ANSWER✅✅• Severe Dyspnea
• Non cardiogenic pulmonary edema (lung sounds- crackles)
• Tachypnea/use of accessory muscles
• Reduced lung compliance
• Dense patchy bilateral pulmonary infiltrates "white out"
• Severe hypoxemia despite administration of 100% oxygen
(refractory hypoxemia)
Fast onset - air hunger and crackles are earliest signs
Low PaO2 and initially low PaCO2 due to hyperventilation (alkalosis) that changes to high PaCO2 with
fatigue. pH will drop as *RESPIRATORY ACIDOSIS* develops.
,Nursing care of ARDs - CORRECT ANSWER✅✅~ Observe and document hypoxemic neurological status
~ Maintain a patent airway
~ Re-position the patient often and observe for hypotension, increased secretions, and elevated temp
(signs of deterioration)
• Assess the patient's respiratory status
• Implement strategies
Positioning and turning schedule
Oral care
Skin care
Range of motion of extremities
DVT prophylaxis
Administer corticosteroids and antibiotics
Mechanical ventilation may be necessary with a high PEEP 10 to 20 mmHg. (risk for barotruama)
Nursing care for pnuemothorax - CORRECT ANSWER✅✅• O2 therapy & Monitor respiratory status
• Heart, lung sounds and VS every 4 hours
• Document ventilator settings if on vent
• Position high Fowler's if possible (90 degrees)
• Monitor chest tube drainage
• Provide emotional support
• Administer medications
• Monitor for infection
• Monitor pain
• I and O
• Referral services- home health, resp. services (portable O2)
, Chest tube - CORRECT ANSWER✅✅~ Monitor the client's vital signs, LOC, their ability to breathe on
their own, and lung sounds.
~ Observe for signs of infection such as redness, swelling, or drainage from the insertion site. Also, look
for indications of hemolysis (RBC breakdown), such as increased heart rate or low blood pressure.
~ Fluid intake and output including how much fluid comes out through the tube. Bright red drainage in
an old tube can indicate a problem. Over 100 mL an hour is excessive.
~ Promote mobility with range-of-motion exercise.
~ DVT prophylaxis
~ Never clamp, strip, or milk the tube.
~ Water seal chamber has tidaling, think about how the ocean has tides.
~ Occlusive dressing and bottle of sterile water at bedside.
~ Premedicate before removal
Mechanical ventilation - CORRECT ANSWER✅✅~ Asses LOC, VS, lung sounds, pulse ox, and ABGs
~ Suction oral & tracheal secretions as needed only and avoid suctioning before ABGs
~ Reposition ET tube Q24hrs
~ Monitor closely skin breakdown, Turn Q2
~ Strict infection control
~ Frequent oral care - chlorohexidine Q2 (prevent VAP)
~ Sedation holidays
~ Manual resuscitation (ambu) & re-intubation equip @ bedside
~ Prone positioning may be beneficial when dependent lung areas are the most damaged.
~ Start nutrition as early as possible
High pressure alarm = HIGH blockage
Low pressure = LEAK
Intervene if O2 sats are dropping with mechanical ventilation. - CORRECT ANSWER✅✅Auscultate to
assess lung sounds.
