A client with acute respiratory distress syndrome (ARDS) shows no improvement despite increases in concentration in oxygen administered. What intervention should the nurse attempt which may improve ventilation-perfusion matching?
Prone Position
Positioning supine with head elevated to 30-45 degrees
Infusion of Albumin
Transfusion of PRBC
The Correct Answer is A
A. Prone positioning involves turning the patient onto their abdomen to improve ventilation-perfusion matching by redistributing ventilation to the dorsal lung regions, where perfusion is typically better in ARDS patients.
B. Semi-recumbent positioning may be used to prevent aspiration and reduce the risk of VAP but is not as effective as prone positioning for improving V/Q matching.
C. Albumin infusion is not specific interventions for improving ventilation-perfusion matching in ARDS and should be considered based on other clinical indications.
D. Transfusion of packed red blood cells (PRBC) may be indicated in cases of severe anemia or hypoxemia due to inadequate oxygen-carrying capacity. However, it is not a primary intervention for improving ventilation-perfusion matching in ARDS
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
In respiratory acidosis, there is an accumulation of carbon dioxide (CO2) in the blood due to inadequate ventilation, leading to an increase in the partial pressure of arterial carbon dioxide (PaCO2) and a decrease in pH.
This is often caused by conditions that impair ventilation, such as airway obstruction, respiratory muscle weakness, lung diseases (e.g., chronic obstructive pulmonary disease, pneumonia), or central nervous system depression (e.g., drug overdose, head injury).
Management of respiratory acidosis include bronchodilators, sodium bicarbonate, adequate ventilation, and treatment of underlying causes.
Correct Answer is D
Explanation
D. Oral hygiene is crucial in reducing the risk of VAP as it helps to reduce the bacterial load in the oral cavity, which can be aspirated into the lower respiratory tract. Using a suction toothbrush to mechanically remove dental plaque and bacteria from the teeth and oral mucosa can help to prevent VAP.
A. Elevating the head of the bed to between 30 and 45 degrees (semi-recumbent position) is recommended to prevent aspiration of oral or gastric contents, which can contribute to the development of VAP. This position helps to promote drainage of secretions and reduces the risk of reflux.
B. While maintaining appropriate humidity levels in the ventilator tubing helps to prevent drying of the respiratory mucosa and promote secretion clearance, it does not directly reduce the risk of VAP. Other interventions are more directly related to VAP prevention.
C. Regular turning and repositioning of the client help to prevent pooling of secretions, improve ventilation-perfusion matching, and reduce the risk of pressure ulcers. Turning the client every 2 hours is often recommended to optimize lung expansion and secretion clearance, thereby reducing the risk of VAP.
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