Disorders
The hallmark of Acute Lung Failure. The main causes of this hallmark are alveolar hypoaventilation, V/Q mismatching, and intrapulmonary shunting.
What is hypoxemia?
A nurse is assessing a client following a bronchoscopy. Which of the followingfindings should the nurse report to the provider?
1. Blood-tinged sputum
2. Dry, nonproductive cough
3. Sore throat
4. Bronchospasms
What is bronchospasm?
Indicates that the patient is having difficulty maintaining the airway.
When generating solutions for a client in the ICU who has a SARS-CoV-2 infection that has progressed to ARDS, the nurse should plan to place the client in this position to promote ventilation.
What is the prone position?
A nurse is orienting a newly licensed nurse on the purpose of administering vecuronium to a client who has ARDS. Which of the following statement by the newly licensed nurse indicates understanding of the teaching?
1. "This medication is given to treat infection."
2. "This medication is given to facilitate ventilation."
3. "This medication is given to decrease inflammation."
4. "This medication is given to reduce anxiety."
What is "This medication is given to facilitate ventilation."
Vecuronium is a neuromuscular blocking agen given to facilitate ventilation and decrease oxygen consumption.
This procedure is initiated by positioning the patient with the neck flexed and head slightly extended in the "sniff" position. The oral cavity and pharynx are suctioned, and any dental devices are removed. The patient is preoxygenated and ventilated using the MRB and mask with 100% oxygen.
What is intubation?
A nurse is assessing a client following a gunshot wound to the chest. For which of the following findings should the nurse monitor to detect a pneumothorax? (Select all that apply.)
1. Tachypnea
2. Deviation of trachea
3. Bradycardia
4. Decreased use of accessory muscles
5. Pleuritic pain
What are tachypnea, deviation of the trachea, and pleuritic pain?
Tachypnea is the result respiratory distress caused by the injury
Deviation of the trachea is due to the increased tension in the chest
Pleuritic pain is due to inflammation of pleura of the lung caused by injury
Nail polish, inadequate peripheral circulation, hypothermia, a decreased hemoglobin level, and edema.
What can cause a low or inaccurate pulse oximetry reading?
Long-term immobility, oral contraceptive use and estrogen therapy, pregnancy, tobacco use, hypercoagulability, obesity, surgery, heart failure and chronic atrial fibrillation, long bone fractures.
What are the risk factors for the development of PE?
A nurse is assessing a client who states "I am anxious and unable to get enough air." Vital signs are HR 117/min, RR 38/min, T 101.2F, and BP 100/54. Which of the following nursing actions is the priority?
1. Notify the provider
2. Administer heparin via IV infusion
3. Administer oxygen therapy
4. Obtain a CT scan.
What is administer oxygen therapy?
Use the ABC approach to client care.
The system incorporates some type of device to collect and store oxygen between breaths. When the client's inspiratory flow exceeds the oxygen flow of the oxygen delivery system, the client is able to draw from the reservoir of oxygen to meet his or her inspiratory volume needs.
What is a reservoir system of oxygen delivery; simple face mask, partial rebreathing mask, and nonrebreathing mask.
Can result from mechanical ventilation in which rupture of the alveoli allows air to enter the interstitial space
What is barotrauma?
Can occur when a large amount of effusion is removed during a thoracentesis. Clinical presentations include severe coughing, chest discomfort, shortness, and hypoxia. If the edema is severe, shock and death may ensue.
What is re-expansion pulmonary edema.
A ventilator setting that can cause physiological responses such as increases in intrathoracic pressure, decreases in blood return to the heart, and decreased cardiac output and / or hypotension.
What is PEEP?
The anticholinergic agent used to inhibit bronchoconstriction and is more effective if administered with beta-2 agonists.
What is Atrovent?
1. Assess respiratory status
2. Apply sterile gauze to the insertion site
3. Obtain a chest x-ray
4. Place tape around the insertion site on 3 sides
What is apply steril gauze to the insertion site, place tape around the insertion site on 3 sides, assess respiratory status, and obtain a chest x-ray?
A life-threatening episode of airway obstruction that is often unresponsive to common treatment. It involves extreme wheezing, labored breathing, use of accessory muscles, distended neck veins, and creates a risk for cardiac and /or respiratory arrest.
What is status asthmaticus?
Should always be given fluids prior to and after this diagnostic procedure and the critical care nurse must monitor for AKI (especially those with dehydration, older, or pre-existing renal problems.
What is contrast-induced nephropathy and how do we prevent it
A procedure where surgical perforation of the chest wall and pleural space with a large-bore needle occur to obtain specimens for diagnostic evaluation, instill medication into the pleural space, and remove fluid (effusion) or air from the pleural space for therapeutic relief of plerual pressure.
What is a thoracentesis?
What are inhaled corticosteroids?
What is a venturi mask?
This disorder is characterised bynoncardiac pulmonary edema and disruption of the alveolar-capillary membrane as a result of injury to either the pulmonary vasculature or the airways. The disorder is categorized as direct or indirect, depending on the primary site of injury.
What is ARDS?
pH 7.33
PaCO2 37
HCO3 20 mEq/L
What is metabolic acidosis?
Dyspnea, bilateral noncardiogenic pulmonary edema, reduced lung compliance, diffuse patchy bilateral pulmonary infiltrates, severe hypoxemia despite administration of 100% oxygen.
What signs and symptoms are characteristic of ARDS?
Necessary for patients to assist with maintaining adequate ventilation. It can also be used to comfort the patient and decrease the work of breathing, particularly if the patient is fighting the ventilator.
What are sedatives?
The gradual withdrawal of the mechanical ventilator and the reestablishment of spontaneous breathing. This process should begin only after the original process for which ventilator support was required has been corrected and patient stability has been achieved.
What is weaning from the ventilator?
Readiness to wean: level of consciousness, physiologic and hemodynamically stability, adequacy of oxygenation and ventilation, spontaneous breathin capability, and respiratory rate and pattern.