A nurse is developing a plan of care for a patient on a ventilator, to prevent ventilator-associated pneumonia. The nurse recognizes that which of the following interventions should be included? Select all that apply.

Follow ventilator-weaning protocols.

Provide frequent mouth care.

Suction the patient every hour.

Place the patient in a prone position.

Refrain from suctioning the patient.

Answer and Explanation

Correct Answer : A,B,D

Choice A rationale
Following ventilator-weaning protocols is an important intervention to prevent ventilator-associated pneumonia. Weaning protocols help to reduce the duration of mechanical ventilation, which is a risk factor for developing ventilator-associated pneumonia.
Choice B rationale
Providing frequent mouth care is a key intervention in preventing ventilator-associated pneumonia. Good oral hygiene can help to reduce the amount of bacteria in the mouth that can potentially be aspirated into the lungs.
Choice C rationale
Suctioning the patient every hour is not typically recommended as a method to prevent ventilator-associated pneumonia. Over-suctioning can potentially damage the lung tissue and mucous membranes, and it can also increase the risk of introducing bacteria into the lungs.
Choice D rationale
Placing the patient in a prone position can help to improve oxygenation and reduce the risk of ventilator-associated pneumonia. The prone position can help to drain secretions from the lungs, reducing the risk of bacteria growth and infection.
Choice E rationale
Refraining from suctioning the patient is not a recommended intervention to prevent ventilator-associated pneumonia. Suctioning is necessary to remove secretions from the airway, which can help to prevent infection.

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Correct Answer is C

Explanation

Choice A rationale
A never event refers to a particularly shocking medical error (such as wrong-site surgery) that should never occur. A surgical site infection, while unfortunate, does not fall into this category.
Choice B rationale
A near miss refers to an event that could have had adverse consequences but did not, either by chance or timely intervention. In this case, the client did experience an adverse consequence (the infection), so this term does not apply.
Choice C rationale
An adverse event is an injury caused by medical management rather than the underlying disease. In this case, the surgical site infection that developed after the knee replacement surgery can be considered an adverse event.
Choice D rationale
A sentinel event is a specific type of unexpected occurrence involving death or serious physical or psychological injury. While serious, a surgical site infection requiring prolonged antibiotic therapy and wound care does not typically fall into this category.

A. pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L B. pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L C. pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L D. pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L .

Correct Answer is C

Explanation

Choice A rationale
A pH of 7.55, PaCO2 of 30 mm Hg, PaO2 of 80 mm Hg, and HCO3 of 24 mEq/L would indicate respiratory alkalosis, which is not typically associated with progressive COPD67.
Choice B rationale
A pH of 7.40, PaCO2 of 40 mm Hg, PaO2 of 94 mm Hg, and HCO3 of 22 mEq/L represent normal ABG values.
Choice C rationale
A pH of 7.30, PaCO2 of 60 mm Hg, PaO2 of 70 mm Hg, and HCO3 of 30 mEq/L are indicative of respiratory acidosis with metabolic compensation, which is commonly seen in patients with progressive COPD67.
Choice D rationale
A pH of 7.38, PaCO2 of 45 mm Hg, PaO2 of 88 mm Hg, and HCO3 of 26 mEq/L would indicate a slight respiratory acidosis, which is not typically associated with progressive COPD67.

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A nurse is developing a plan of care for a patient on a ventilator, to prevent ventilator-associated pneumonia. The nurse recognizes that which of the following interventions should be included? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A 65-year-old client with a history of diabetes mellitus was admitted to the hospital for a scheduled knee replacement surgery. During the postoperative period, the client developed a surgical site infection that required prolonged antibiotic therapy and wound care. This event is categorized as:

Correct Answer is C

Explanation

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Explanation

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In the context of developing a care plan for a patient on a ventilator to prevent ventilator-associated pneumonia, which interventions should be included? Select all that apply.

A nurse is developing a plan of care for a patient on a ventilator, to prevent ventilator-associated pneumonia. The nurse recognizes that which of the following interventions should be included? Select all that apply.