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How should the nurse interprets these blood gas values? 2 3
- A. Compensated metabolic alkalosis
- B. Normal values
- C. Uncompensated respiratory acidosis
- D. Uncompensated respiratory alkalosis
Correct Answer: C
Rationale: The correct interpretation is uncompensated respiratory acidosis (Choice C) based on the values. Step 1: Evaluate pH - pH is <7.35, indicating acidosis. Step 2: Determine PaCO2 - PaCO2 is >45 mmHg, indicating respiratory cause. Step 3: Check HCO3- - HCO3- is within normal range, indicating uncompensated state. Choices A, B, and D are incorrect because they do not align with the given blood gas values.
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The nurse is caring for a patient with acute respiratory dist ress syndrome who is hypoxemic despite mechanical ventilation. The primary care provider (PCP) orders a nontraditional ventilator mode as part of treatment. Despite sedation and aabnirba.lcgoems/tieas,t the patient remains restless and appears to be in discomfort. The nurse informs the PCP of this assessment and anticipates what order?
- A. Continuous lateral rotation therapy
- B. Guided imagery
- C. Neuromuscular blockade
- D. Prone positioning
Correct Answer: C
Rationale: The correct answer is C: Neuromuscular blockade.
1. Neuromuscular blockade helps to achieve optimal ventilator synchrony by reducing patient-ventilator asynchrony and improving oxygenation in patients with acute respiratory distress syndrome (ARDS).
2. Despite sedation, the patient's restlessness and discomfort suggest inadequate ventilator synchrony, which can be addressed by neuromuscular blockade.
3. Continuous lateral rotation therapy (A) and prone positioning (D) are interventions for improving ventilation and oxygenation in ARDS but do not directly address patient-ventilator synchrony.
4. Guided imagery (B) is a non-pharmacological technique for relaxation and pain management, which may not address the underlying issue of ventilator synchrony in this case.
Which is likely the most common recollection from a patie nt who required endotracheal intubation and mechanical ventilation?
- A. Difficulty communicating
- B. Inability to get comfortable
- C. Pain
- D. Sleep disruption
Correct Answer: A
Rationale: The correct answer is A: Difficulty communicating. When a patient undergoes endotracheal intubation and mechanical ventilation, they are unable to speak normally. This leads to frustration and anxiety due to the inability to communicate effectively with healthcare providers and loved ones. The lack of communication can also impact their emotional well-being. Choices B, C, and D are less likely as the most common recollection because patients might not remember feeling uncomfortable, experiencing pain, or having sleep disruption during sedation and ventilation. Additionally, the inability to communicate is a primary concern for patients in this situation.
The patient’s significant other is terrified by the prospect o f removing life-sustaining treatments from the patient and asks why anyone would do that. What explanation should the nurse provide?
- A. “It is to save you money so you won’t have such a large financial burden.”
- B. “It will preserve limited resources for the hospital so oatbhirebr.c pomat/tieesnt ts may benefit from them.”
- C. “It is to discontinue treatments that are not helping and may be very uncomfortable.”
- D. “We have done all we can for your wife and any more treatment would be futile.”
Correct Answer: C
Rationale: The correct answer is C because it explains that the decision to remove life-sustaining treatments is based on the fact that these treatments are not helping the patient and may actually be causing discomfort. This rationale aligns with the principle of beneficence, which emphasizes doing good and avoiding harm to the patient. It also respects the patient's autonomy by prioritizing their well-being and quality of life.
Choice A is incorrect as it focuses on financial reasons rather than the patient's best interest. Choice B is incorrect because it prioritizes hospital resources over individual patient care. Choice D is incorrect as it lacks clarity and may come across as insensitive to the significant other's concerns.
The nurse is caring for a mechanically ventilated patient an d responds to a high inspiratory pressure alarm. Recognizing possible causes for the alarma, btihrbe.c nomu/rtesset assesses for which of the following? (Select all that apply.)
- A. Coughing or attempting to talk
- B. Disconnection from the ventilator
- C. Kinks in the ventilator tubing
- D. Need for suctioning
Correct Answer: B
Rationale: The correct answer is B: Disconnection from the ventilator. This is the correct choice because a high inspiratory pressure alarm can indicate a disconnection, leading to inadequate ventilation and increased pressure in the circuit. This can be a life-threatening situation that requires immediate attention.
Explanation of why other choices are incorrect:
A: Coughing or attempting to talk - While coughing or talking may affect the patient's ability to ventilate properly, it is not directly related to the high inspiratory pressure alarm.
C: Kinks in the ventilator tubing - Kinks in the tubing may cause increased resistance to airflow, but they are more likely to trigger a low pressure alarm rather than a high inspiratory pressure alarm.
D: Need for suctioning - Suctioning may be necessary for airway clearance, but it is not directly related to the high inspiratory pressure alarm.
Which of the following is (are) official journal(s) of the A merican Association of Critical-Care Nurses? (Select all that apply.)
- A. American Journal of Critical Care
- B. Critical Care Clinics of North America
- C. Critical Care Nurse
- D. Critical Care Nursing Quarterly
Correct Answer: A
Rationale: Step-by-step rationale:
1. The American Association of Critical-Care Nurses (AACN) publishes the American Journal of Critical Care (AJCC).
2. The AJCC is a peer-reviewed journal that covers critical care nursing practice, research, and education.
3. The content in AJCC aligns with AACN's mission and standards for critical care nursing.
4. Hence, AJCC is an official journal of AACN.
Summary of other choices:
- B: Critical Care Clinics of North America - Not an official journal of AACN.
- C: Critical Care Nurse - Not an official journal of AACN.
- D: Critical Care Nursing Quarterly - Not an official journal of AACN.