Altered Ventilatory Function Flashcards
The patient has recently developed a productive cough and a fever of 40’C. A repeat chest x-ray shows infiltrates with consolidation in the right lower lobe after 48 hours in mechanical ventilator. Based on this specific patient scenario, this is known as what type of pneumonia?
a. Community-acquired pneumonia
b. Hospital-acquired pneumonia
c. Ventilator acquired pneumonia
d. Aspiration pneumonia
c. ventilator acquired pneumonia
The patient has just started treatment for pneumonia and is still experiencing hypoxemia. Which arterial blood gas readings below represent respiratory acidosis that is NOT compensated?
a. pH 7.55, PaCO 33, HCO3 19, PO2 85
b. pH 7.20, PaCO2 20, HCO3 20, PO2 85
c. pH 7.45, PaCO2 35, HCO3 22, PO2 85
d. pH 7.29, PaCO2 55, HCO3 23, PO2 85
d. pH 7.29, PaCO2 55, HCO3 23, PO2 85
You’re educating a patient with pneumonia on how to deep breathe by using an incentive spirometer. Which of the following is the correct way to use this device?
a. The patient inhales slowly from the device until no longer able, and then holds breath for 6 seconds and exhales.
b. The patient rapidly inhales 10 times from the device and then exhales for 6 seconds.
c. Encourage the patient to use it twice a day.
d. The patient exhales into the device rapidly and then coughs
a. The patient inhales slowly from the device until no longer able, and then holds breath for 6 seconds and exhales.
A patient is admitted with CAP. Sputum culture and sensitivity show that the patient is infected with a gram-positive bacterium. Culture and sensitivity are being done for the following reason EXCEPT:
a. To know what antibiotic will work best to treat the infection
b. To test what bacteria cause the infection
c. To know what antibiotic the bacteria is resistant
d. To know whether the bacteria is hospital or community acquired
d. To know whether the bacteria is hospital or community acquired
A patient is admitted with CAP. Sputum culture and sensitivity show that the patient is infected with a gram-positive bacterium. Culture and sensitivity are being done for the following reason EXCEPT:
a. To know what antibiotic will work best to treat the infection
b. To test what bacteria cause the infection
c. To know what antibiotic the bacteria is resistant
d. To know whether the bacteria is hospital or community acquired
d. To know whether the bacteria is hospital or community acquired
On your assessment, you note the findings of this patient with lower lobe pneumonia. Which of the following nursing interventions will promote lung expansion?
a. Keep head-of-the-bed less than 30 degrees at all times.
b. Pneumovax vaccine every 5 years.
c. Encourage incentive spirometer usage
d. Expectorate sputum
c. Encourage incentive spirometer usage
The patient is on a 100% non-rebreather mask. Which finding below is a HALLMARK sign and symptom that the patient is developing acute respiratory distress syndrome (ARDS)?
a. The patient’s PaO2 remains at 45 mmHg. b. The patient’s blood pressure is 180/96.
c. The patient is experiencing bradypnea.
d. The patient is tired and confused
d. The patient is tired and confused
A patient with respiratory distress syndrome (ARDS) is in the exudative phase. the patient’s lung cells that produce surfactant have become damaged. As the nurse you know this will lead to?
a. pulmonary edema
b. atelectasis
c. upper airway blockage
d. bronchoconstriction
b. atelectasis
A STAT chest x-ray is ordered. What finding on the chest x-ray is indicative of ARDS?
a. normal chest x-ray
b. infiltrates only on the upper lobes
c. enlargement of the heart with bilateral lower lobe infiltrates
d. white-out infiltrates bilaterally
d. white-out infiltrates bilaterally
Which patient below is at MOST risk for developing ARDS and has the worst prognosis?
a. A 52-year-old male patient with a pneumothorax.
b. A 30-year-old female with cystic fibrosis.
c. A 69-year-old female with sepsis caused by a gram-negative bacterial infection
d. A 48-year-old male being treated for diabetic ketoacidosis.
c. A 69-year-old female with sepsis caused by a gram-negative bacterial infection
As the nurse you know that acute respiratory distress syndrome (ARDS) can be caused by direct or indirect lung injury. Select below all the INDIRECT causes of ARDS:
a. Aspiration
b. Sepsis
c. Pneumonia
d. Pancreatitis
b. Sepsis
d. Pancreatitis
A patient is on mechanical ventilation with PEEP (positive end-expiratory pressure). Which finding below indicates the patient is developing a complication related to their therapy and requires immediate treatment?
a. PaCO2 38 mmHg
b. PaO2 80 mmHg
c. Blood pressure 70/45
d. HCO3 26 mmHg
c. Blood pressure 70/45
As the nurse you know that prone positioning can be beneficial for some patients with ARDS. Which findings below indicate this type of positioning was beneficial for this patient?
a. Improvement in lung sounds
b. Development of a V/Q mismatch
c. PaO2 from 86 mmHg to 75mmHg
d. Oxygen saturation from 86% to less than 80%
a. Improvement in lung sounds
To evaluate the effectiveness of prescribed therapies for a patient with ventilatory failure, which diagnostic test will be most useful to the nurse?
a. Pulmonary artery pressure monitoring
b. Chest x-rays
c. Pulse oximetry
d. Arterial blood gas (ABG) analysis
d. Arterial blood gas (ABG) analysis
The typical sign of type-1 respiratory failure is:
a. High PaO2, High PaCO2
b. Low PaO2, High PaCO2
c. Low PaO2, Normal PaCO2
d. Normal PaO2, High PaCO2
c. Low PaO2, Normal PaCO2
