ECCO Caring for Patients with Pulmonary Disorders: Part 1 Post Test Questions With 100% Verified Solutions

ECCO Caring for Patients with Pulmonary Disorders: Part 1 Post Test Questions With 100% Verified Solutions In a patient with pulmonary embolism, which sequelae should the nurse anticipate? - ANSWER Pulmonary emboli disrupt gas exchange and oxygenation, and cause right heart strain. Which patient is most likely to have an indication for a non-rebreather mask? A patient: - ANSWER With carbon monoxide poisoning Mr. DeMontel is admitted after a thoracotomy. He has a chest tube drainage system to his left chest with orders for suction at -20 cm H2O. What is the priority nursing assessment? - ANSWER Verify that the chest tube connection is secured. Connection of the chest tube to the drainage system is essential for lung expansion. A nurse caring for a patient with ARDS on BiPAP observes rapid progression of dyspnea and tachypnea with RR between 37 and 41. What intervention should the nurse anticipate? - ANSWER Call emergency response team for intubation. A patient post-thoracotomy develops a right tension pneumothorax. Which sign or symptom should the nurse anticipate? - ANSWER Tachycardia A tension pneumothorax alters the return circulation to the heart, causing tachycardia. A patient with respiratory failure following cardiac surgery has crackles in bilateral posterior lower lobes and a temperature of 38.6C (101.5F), and is on 4 L/min NC. Which three interventions will promote normal respiratory function? - ANSWER Adequate oxygenation, effective coughing, positioning, anxiety reduction and bronchodilators optimize gas exchange and airway functioning. Which are nursing priorities for patient care before, during, or after thoracentesis? - ANSWER Wrong: Continually monitor vital signs and SpO2; Position patient sitting on or lying near edge of bed. Vital signs and SpO2 monitoring is continuous. Positioning occurs prior to the procedure. Attaching the tubing to the evacuation collection bottle occurs during the procedure. A patient is admitted with COPD exacerbation. ABGs are: pH 7.28, PaO2 60 mm Hg, PaCO2 76 mm Hg, HCO3^- 27 mEq/L, and SaO2 86% on FiO2 50% via air entrainment device. Which treatment would you anticipate next? - ANSWER NIPPV A patient is admitted with tachycardia, wheezing, and a nonproductive cough. Which treatment(s) should the nurse anticipate? - ANSWER Bronchodilators Mrs. Elinskas is admitted for acute CHF with sharp chest pain, diminished breath sounds, cough, and orthopnea Which intervention should the nurse anticipate? - ANSWER Administering of furosemide (Lasix) Which may affect pulse oximetry accuracy? - ANSWER The absence of peripheral circulation in cardiac arrest prevents accurate monitoring with pulse oximetry. A nurse checks that a patient can remove the NIPPV mask in the event of emesis. What are other nursing care priorities for patients using NIPPV? - ANSWER Check for dryness or irritation of eyes, nasal passages, and upper airway; Assess respiratory rate and depth, and changes in LOC; Examine skin for breakdown across nasal bridge or any pressure points. A patient with a hemothorax is admitted. Which intervention should the nurse anticipate? - ANSWER Attach chest tube drain to wall suction. Prepare for chest tube insertion. A patient with COPD on PEEP reports sudden chest pain. The nurse observes tracheal deviation, tachycardia, and shortness of breath. What other conditions should the nurse expect? - ANSWER Decreased chest excursion on one side; decreased partial pressure of O2 (PaO2) levels and increased partial pressure of CO2; and decreased oxygen saturation (SaO2) level are three other signs that indicate pneumothorax For which of these patients requiring oxygen therapy is an air entrainment system indicated? - ANSWER With air entrainment masks, the percentage of oxygen to be delivered is set. A patient has the following ABG results: pH 7.25, PaCO2 43, PaO2 80, SaO2 91%, and HCO3^- 18. What is the most likely underlying cause - ANSWER Low pH and low HCO3 indicate a metabolic cause of the acidosis. Following a chest x-ray, for which report should the nurse notify the provider? - ANSWER ETT is positioned in the right mainstem bronchus. A patient with pulmonary artery hypertension is receiving epoprostenol. Which intervention is indicated? - ANSWER Maintaining the continuous infusion rate for epoprosternol is critical. Epoprostenol is a life-sustaining drug, and interruption of the infusion can lead to serve rebound of symptoms and even death. A patient who underwent a pneumonectomy is admitted. For which complication should the nurse observe? - ANSWER Increased cough with frothy sputum A patient who underwent a thoracotomy is admitted. Which intervention is indicated? - ANSWER Maintain patency of chest drainage system. Which ABG test result requires that the provider be notified immediately? - CORRECT ANSWER A pH 7.2 is a critical value. Which patient in the immediate postoperative period should be given an NC? A patient requiring: - ANSWER FiO2 of 0.4 or less A patient with a history of COPD and pulmonary hypertension on conventional therapy develops worsening symptoms. Cardiac catheterization reveals elevated pulmonary vascular resistance and the PA pressure does not respond to calcium channel blockers or PDE-5 inhibitors. Which should the nurse initially anticipate? - ANSWER Epoprostenol (Floan) If the patient fails conventional therapies, other pharmacologic therapies specific to PAH include: prostacyclins, prostanoids, endothelin receptor antagonists (ERAs), phosphodiesterase (PDE) inhibitors, and guanylate cyclase simulator (GCS). For which complication should the nurse observe in a patient following bronchoscopy? - ANSWER Dysrhythmias Cardiac dysrhythmias may occur during or after a bronchoscopy. A patient with a hip fracture from a fall develops pleuritic chest pain, dyspnea, and dry cough. The patient's SPO2 is 90%. CTPA is positive for PE. The nurse should anticipate administration of which of the following? - ANSWER Unfractionated heparin