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

Answer and Explanation

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

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Correct Answer is C

Explanation

C. Respiratory acidosis- The pH is acidic, and the PaCO2 is elevated, indicating respiratory acidosis. The client's hypoventilation (respiratory rate of 7/min) is causing retention of carbon dioxide, leading to respiratory acidosis.
A. Metabolic alkalosis- The ABG values do not support a diagnosis of metabolic alkalosis. The pH is acidic, and the base excess is negative, indicating a mild metabolic acidosis.
B. Respiratory alkalosis- The ABG values do not support a diagnosis of respiratory alkalosis. The pH is acidic, and the PaCO2 is elevated, indicating respiratory acidosis rather than alkalosis.
D. Metabolic acidosis- While there is evidence of a mild metabolic acidosis indicated by the negative base excess, the primary disturbance in this case is respiratory acidosis, as evidenced by the low pH and elevated PaCO2.

A. Flushing B. Vomiting C. Dyspnea D. Bradycardia

Correct Answer is C

Explanation

C Dyspnea, or difficulty breathing, is a classic symptom of circulatory overload. When the circulatory system is overloaded with excess fluid, it can lead to pulmonary congestion and impaired gas exchange, resulting in dyspnea. Patients experiencing circulatory overload may exhibit signs such as shortness of breath, increased respiratory rate, and crackles on lung auscultation.

A Flushing, or the sudden reddening of the skin, is not typically associated with circulatory overload. Instead, it can be a symptom of various conditions such as fever, allergic reactions, or hormonal changes. While circulatory overload may lead to fluid retention and increased blood volume, flushing is not a characteristic symptom.

B Vomiting is also not a typical symptom of circulatory overload. Vomiting can be caused by various factors such as anesthesia, pain medications, or postoperative ileus. While fluid overload can result in gastrointestinal symptoms like nausea and abdominal discomfort, vomiting is not a specific indicator of circulatory overload.

D Bradycardia, or a slow heart rate, is not typically associated with circulatory overload. Instead, it can be caused by factors such as medications (e.g., opioids, beta-blockers), vagal stimulation, or underlying cardiac conditions. In circulatory overload, the body's compensatory response is often tachycardia (increased heart rate) rather than bradycardia.

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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?

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Naxlex Comprehensive Predictor Exams

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