Exam 9: Ventilatory Assistance

One of the early signs of hypoxemia on the nervous system is

A patient's ventilator settings are adjusted to treat hypoxemia.The fraction of inspired oxygen is increased from 0.6 to 0.7,and the positive end-expiratory pressure is increased from 10 to 15 cm H₂O.Shortly after these adjustments,the nurse notes that the patient's blood pressure drops from 120/76 mm Hg to 90/60 mm Hg.What is the most likely cause of this decrease in blood pressure?

The nurse is caring for a patient with an endotracheal tube.The nurse understands that endotracheal suctioning is needed to facilitate removal of secretions and that the procedure

Select all of the factors that may predispose the patient to respiratory acidosis.(Select all that apply.)

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery.Four hours after admission to the surgical intensive care unit at 4 PM,the patient has stable vital signs and normal arterial blood gases (ABGs),and is placed on a T-piece for ventilatory weaning.The following information pertains to the 1900 assessment. Assessments and Vital Signs Nursing Action Restless Performs complete assessment Increased to 110 beats/min Suctions patient for pink, frothy secretions Respirations 36 breaths/min Obtains prescriptions from provider for ABGs, electrolyte levels, and portable chest x-ray Blood pressure 156/98 Sinus tachycardia 10/ Elevated pulmonary artery pressure Loud crackles throughout New : pH: 7.28 :46 22/ :58 saturation: 88\% What action by the nurse is best?

A patient is admitted to the progressive care unit with a diagnosis of community-acquired pneumonia.The patient has a history of chronic obstructive pulmonary disease and diabetes.A set of arterial blood gases obtained on admission without supplemental oxygen shows pH 7.35; PaCO₂ 55 mm Hg; bicarbonate 30 mEq/L; PaO₂ 65 mm Hg.These blood gases reflect:

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery.Four hours after admission to the surgical intensive care unit at 4 PM,the patient has stable vital signs and normal arterial blood gases (ABGs),and is placed on a T-piece for ventilatory weaning.The following information pertains to the 1900 assessment. Assessments and Vital Signs Nursing Action Restless Performs complete assessment Increased to 110 beats/min Suctions patient for pink, frothy secretions Respirations 36 breaths/min Obtains prescriptions from provider for ABGs, electrolyte levels, and portable chest x-ray Blood pressure 156/98 Sinus tachycardia 10/ Elevated pulmonary artery pressure Loud crackles throughout New : pH: 7.28 :46 22/ :58 saturation: 88\% What interdisciplinary staff member does the nurse notify to assist in the care of this patient while preparing to give this patient diuretics?

A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min.His spontaneous respirations are 12 breaths/min.He receives a dose of morphine sulfate,and his spontaneous respirations decrease to 4 breaths/min.Which acid-base disturbance will likely occur?

A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min.His spontaneous respirations are 12 breaths/min.He receives a dose of morphine sulfate,and his respirations decrease to 4 breaths/min.What adjustments may need to be made to the patient's ventilator settings?

A patient's endotracheal tube is not secured tightly.The respiratory care practitioner assists the nurse in taping the tube.After the tube is retaped,the nurse auscultates the patient's lungs and notes that the breath sounds over the left lung fields are absent.The nurse suspects that

The nurse is caring for a mechanically ventilated patient and notes the high pressure alarm sounding.The nurse cannot quickly identify the cause of the alarm and notes the patient's oxygen saturation is decreasing and heart rate and respiratory rate are increasing.The nurse's priority action is to

Oxygen saturation (SaO₂)represents

The nurse is assisting with endotracheal intubation of the patient and recognizes that the procedure will be done in what order: _______________,_______________,_______________,_______________,_______________? A)assess balloon on endotracheal tube for symmetry and leaks B)assess lung fields for bilateral expansion C)inflate balloon of endotracheal tube D)insert endotracheal tube with laryngoscope and blade E)suction oropharynx

The nurse is caring for a mechanically ventilated patient.The providers are considering performing a tracheostomy because the patient is having difficulty weaning from mechanical ventilation.Related to tracheostomy,the nurse understands which of the following?

The nurse is caring for a mechanically ventilated patient and responds to a high inspiratory pressure alarm.Recognizing possible causes for the alarm,the nurse assesses for which of the following? (Select all that apply.)

The primary mode of action of neuromuscular blocking agents is

The nurse is caring for a mechanically ventilated patient and is charting outside the patient's room when the ventilator alarm sounds.What is the priority order for the nurse to complete these actions: _______________,_______________,_______________,_______________? A)check quickly for possible causes of the alarm that can be fixed B)after troubleshooting, connect back to mechanical ventilator and reassess patient C)go to patient's bedside D)manually ventilate the patient while getting a respiratory therapist

The nurse is assisting with endotracheal intubation and understands that correct placement of the endotracheal tube in the trachea would be identified by which of the following? (Select all that apply.)

A patient's status worsens and needs mechanical ventilation.The pulmonologist wants the patient to receive 10 breaths/min from the ventilator but wants to encourage the patient to breathe spontaneously between the mechanical breaths at his own tidal volume.This mode of ventilation is called

The amount of effort needed to maintain a given level of ventilation is termed