NUR 4090 Exam 1 Questions With Complete Solutions
Acute Resp Failure NM Correct Answers -Assist with
intubation and maintain mechanical ventilation.
-Pts are in ICU.
-Assess respiratory status by monitoring the level of
responsiveness, abg, pulse ox and vitals
Acute Resp Failure S/S Correct Answers -impaired oxygenation
-restlessness
-fatigue
-headache
-dyspnea
-air hunger
-tachycardic
-inc BP.
As hypoxemia progresses confusion, lethargy, tachycardia,
tachypnea, central cyanosis, diaphoresis, respiratory arrest
Adjunct Modes: CPAP Correct Answers -Continuous Positive
Airway Pressure CPAP Positive pressure is continuous through
inspiratory and expiratory phase of breathing.
-Patient initiate breaths little help from vent. Patient can receive
the same therapy when not intubated, via mask.
Adjunct Modes: PEEP Correct Answers -PEEP: Pressure is
applied at the end of exhalation which prevents the alveolar sacs
from completely closing down with each exhalation; this
increases functional residual capacity and, makes it easier to
open again with the next inspiration. Use of it may help reduce
high levels of 02.
,Adjunct Modes: PSV Correct Answers Flow of pressure applied
at beginning of a spontaneous breath, which reduces the work of
breathing.
Antidotes Correct Answers Heparin: Protamine Sulfate
-Coumadin: Vit K
ARDS Correct Answers A rapid occuring (less than 72 hours
from precipitating event) progressive form of hypoxemic resp
failure which occurs in those who have sustained a severe
physiological insult pulmonary or non pulmonary in origin
ARDS management Correct Answers -ICU
-Supp o2
-intubation and mechanical vent
-Attempt to keep PaO2 > 60 with O2 sat at 90%
-PEEP: setting on vent to prevent alveoli from collapsing at end
of exhalation
-Monitor for O2 toxicity
ARDS medical management Correct Answers -find and correct
cause
-Proning: pt lies on abdomen for approx 16 hrs a day
-Heparin: prevent DVT and PE
-Vasopressor for hypotension
-Glucocorticoids reduce edema: methlyprednisone, salucotex,
prednisone
-ABX if indicated
-surfactant therapy
, ARDS mortality Correct Answers -mortality rate greater than
50%
-Most die from MODS and sepsis
-Those who survive need rehab (PT, OT, pulm therapy)
secondary to prolonged bed rest
ARDS Phase 1 Correct Answers Acute Exudative Phase
-Can last up to a week
-Injury to alveoli capillary endothelial and epithelial cells
-Proteinaceous flooding and dec gas exchange
-Fluid inactivates surfactant production
ARDS Phase 2 Correct Answers Proliferative Phase
-Lasts up to 3 weeks or longer
-Resolution of acute phase and initial repair or lung
-Pt may recover or move to next phase
ARDS Phase 3 Correct Answers Fibrotic Phase
-Normal lung tissue replaced by fibrotic tissue
-Leads to vascular occlusion and Pulmonary HTN
-Pt becomes vent dependent and death in common in this phase
ARDS S/S Correct Answers -Dyspnea and tachypnea (1st S/S)
-Inc resp distress
-Intercostal/ suprasternal retractions
-Acessory muscles
-Tripod postion
-Tachycardic
-O2 levels drop and later CO2
-Resp Alk
-Arteral hypoxemia that doesn't respond to supplemental oxygen
Acute Resp Failure NM Correct Answers -Assist with
intubation and maintain mechanical ventilation.
-Pts are in ICU.
-Assess respiratory status by monitoring the level of
responsiveness, abg, pulse ox and vitals
Acute Resp Failure S/S Correct Answers -impaired oxygenation
-restlessness
-fatigue
-headache
-dyspnea
-air hunger
-tachycardic
-inc BP.
As hypoxemia progresses confusion, lethargy, tachycardia,
tachypnea, central cyanosis, diaphoresis, respiratory arrest
Adjunct Modes: CPAP Correct Answers -Continuous Positive
Airway Pressure CPAP Positive pressure is continuous through
inspiratory and expiratory phase of breathing.
-Patient initiate breaths little help from vent. Patient can receive
the same therapy when not intubated, via mask.
Adjunct Modes: PEEP Correct Answers -PEEP: Pressure is
applied at the end of exhalation which prevents the alveolar sacs
from completely closing down with each exhalation; this
increases functional residual capacity and, makes it easier to
open again with the next inspiration. Use of it may help reduce
high levels of 02.
,Adjunct Modes: PSV Correct Answers Flow of pressure applied
at beginning of a spontaneous breath, which reduces the work of
breathing.
Antidotes Correct Answers Heparin: Protamine Sulfate
-Coumadin: Vit K
ARDS Correct Answers A rapid occuring (less than 72 hours
from precipitating event) progressive form of hypoxemic resp
failure which occurs in those who have sustained a severe
physiological insult pulmonary or non pulmonary in origin
ARDS management Correct Answers -ICU
-Supp o2
-intubation and mechanical vent
-Attempt to keep PaO2 > 60 with O2 sat at 90%
-PEEP: setting on vent to prevent alveoli from collapsing at end
of exhalation
-Monitor for O2 toxicity
ARDS medical management Correct Answers -find and correct
cause
-Proning: pt lies on abdomen for approx 16 hrs a day
-Heparin: prevent DVT and PE
-Vasopressor for hypotension
-Glucocorticoids reduce edema: methlyprednisone, salucotex,
prednisone
-ABX if indicated
-surfactant therapy
, ARDS mortality Correct Answers -mortality rate greater than
50%
-Most die from MODS and sepsis
-Those who survive need rehab (PT, OT, pulm therapy)
secondary to prolonged bed rest
ARDS Phase 1 Correct Answers Acute Exudative Phase
-Can last up to a week
-Injury to alveoli capillary endothelial and epithelial cells
-Proteinaceous flooding and dec gas exchange
-Fluid inactivates surfactant production
ARDS Phase 2 Correct Answers Proliferative Phase
-Lasts up to 3 weeks or longer
-Resolution of acute phase and initial repair or lung
-Pt may recover or move to next phase
ARDS Phase 3 Correct Answers Fibrotic Phase
-Normal lung tissue replaced by fibrotic tissue
-Leads to vascular occlusion and Pulmonary HTN
-Pt becomes vent dependent and death in common in this phase
ARDS S/S Correct Answers -Dyspnea and tachypnea (1st S/S)
-Inc resp distress
-Intercostal/ suprasternal retractions
-Acessory muscles
-Tripod postion
-Tachycardic
-O2 levels drop and later CO2
-Resp Alk
-Arteral hypoxemia that doesn't respond to supplemental oxygen
