A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?
Impaired carbon dioxide elimination due to shunting
Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch
Hypoxemia due to dead space
Decreased pulmonary compliance due to stiffness
The Correct Answer is D
A. ARDS is characterized by severe hypoxemia due to shunting, but it typically impairs oxygenation rather than carbon dioxide elimination. The primary issue is the inability to oxygenate blood, not the elimination of carbon dioxide.
B. In ARDS, pulmonary arterial pressure often increases due to pulmonary hypertension caused by widespread inflammation and hypoxemia, not decreased pressure. V/Q mismatch contributes to hypoxemia but does not directly cause decreased pulmonary arterial pressure.
C. While hypoxemia is a hallmark of ARDS, it is primarily due to shunting (where blood passes through unventilated areas of the lung) rather than dead space, which is more associated with conditions like pulmonary embolism.
D. ARDS involves decreased pulmonary compliance due to the stiffness of the lungs, which results from diffuse alveolar damage and the formation of hyaline membranes. This stiffness makes it difficult for the lungs to expand, leading to reduced oxygenation and severe hypoxemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Provide mouth care: Mouth care is important for overall comfort and hygiene but is not the first step in preparing for chest percussion, vibration, and postural drainage. The priority is to prepare the client for the procedures that will aid in clearing lung secretions.
B. Cup hands and tap on the client's chest repeatedly: This action is part of chest percussion and should be performed after positioning the client correctly. Percussion should be done on the appropriate lung areas based on the positioning.
C. Auscultate lung fields: Auscultation of lung fields is essential for assessing lung sounds and determining the effectiveness of therapy. However, it should be done after positioning the client to ensure that the correct areas are being treated and assessed.
D. Position the client so that the lung area to be drained is above the client's trachea: Proper positioning is crucial for effective postural drainage, as it allows gravity to assist in moving secretions from the lung areas to the central airways. This should be done before performing chest percussion or vibration.
Correct Answer is B
Explanation
A. Hyperventilate the client with 100% oxygen before suctioning the airway: Hyperventilation before suctioning is a method to prevent hypoxia, not to thin secretions. It does not affect the viscosity of secretions.
B. Provide humidified oxygen: Humidified oxygen helps to moisten the airways, which can thin secretions, making them easier to clear. This is an appropriate intervention for managing tenacious secretions in a client with a tracheostomy.
C. Perform chest physiotherapy prior to suctioning: Chest physiotherapy helps mobilize secretions but does not thin them. While useful in clearing airways, it is not a direct method for thinning secretions.
D. Prelubricate the suction catheter tip with sterile saline when suctioning the airway: Prelubricating the suction catheter is done to reduce friction and trauma during suctioning but does not impact the thickness of the secretions.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.