Pulmonary Embolism
What is the most common cause of a pulmonary embolism?
What are the veins of the legs or pelvis (DVT/VTE)?
This is the cardinal feature of ARDS.
What is refractory hypoxemia? (Hypoxemia that persists despite 100% oxygen.)
When a ventilator alarm sounds, the nurse should always do this before troubleshooting the ventilator.
What is assess the patient first?
A patient hospitalized with influenza should be placed on these transmission-based precautions.
What are droplet precautions?
The nurse observes a section of the chest moving inward during inspiration and outward during expiration. What is this finding called?
What is paradoxical chest wall movement?
These two laboratory tests are the top labs obtained when a PE is suspected.
What are D-dimer and ABGs?
Restlessness, irritability, agitation, confusion, tachycardia, and tachypnea are early signs of this problem in respiratory failure.
What is hypoxia/hypoxemia?
Secretions, a kinked tube, biting the ET tube, or the patient fighting the ventilator can trigger this type of alarm.
What is a high-pressure alarm?
Before administering the first dose of antibiotics to a patient with suspected pneumonia, the nurse should obtain this specimen.
What is a sputum culture?
A patient with a chest injury has absent breath sounds on the left and the trachea has shifted to the right. What complication should the nurse suspect?
What is a left-sided tension pneumothorax?
This is the first-line diagnostic test used to confirm a pulmonary embolism.
What is CT pulmonary angiography (CTPA)?
A patient with acute respiratory failure becomes increasingly restless, agitated, and confused. What should the nurse suspect?
What is worsening hypoxia?
A ventilator alarm sounds and the nurse discovers that the tubing has become disconnected from the patient. This type of alarm should be sounding.
What is a low-pressure alarm?
A patient with suspected active tuberculosis needs sputum testing. How should the nurse collect the specimens?
What are 3 consecutive daily morning sputum samples?
A patient with a pulmonary contusion may initially have few symptoms. Which respiratory assessment findings can develop as hemorrhage and edema worsen?
What are decreased breath sounds, crackles/wheezes, hypoxemia, and hemoptysis?
A patient with a PE is receiving IV heparin. Name the lab used to monitor therapy AND the antidote for excessive anticoagulation.
What are aPTT/PTT and protamine sulfate?
This ventilator setting prevents alveolar collapse and is commonly increased in ARDS, but high levels increase the risk of tension pneumothorax.
What is PEEP?
An intubated patient suddenly develops respiratory distress, decreased breath sounds on one side, and subcutaneous emphysema. What complication of mechanical ventilation should the nurse suspect?
What is a pneumothorax (barotrauma)?
A patient with severe throat pain has unilateral tonsillar swelling, a muffled voice, and drooling. The nurse then hears stridor. What is the nurse’s priority concern?
What is impending complete airway obstruction?
A patient with multiple rib fractures is taking shallow breaths because of severe pain. Why is adequate pain control a nursing priority?
What is to allow effective coughing and deep breathing?
A patient's ABG after a PE shows a low PaCO₂ and elevated pH. Which acid-base imbalance is occurring?
What is respiratory alkalosis?
An intubated patient with ARDS remains severely hypoxemic despite mechanical ventilation. Which positioning intervention can improve perfusion and gas exchange?
What is prone positioning?
An intubated patient requires suctioning. What should the nurse do immediately before suctioning the ET tube?
What is hyperoxygenate the patient?
A patient taking ethambutol for tuberculosis reports difficulty distinguishing red from green. What should the nurse do?
What is report/hold and notify the provider for suspected optic neuritis?
A patient with a hemothorax has a chest tube placed. Which amount of initial chest-tube blood loss may indicate the need for an open thoracotomy?
What is greater than 1,000 mL?