A patient with respiratory failure has a respiratory rate of 6 breaths/min and an oxygen saturation (SpO2) of 78%. The patient is increasingly lethargic. Which intervention will the nurse anticipate?

Initiation of continuous positive pressure ventilation (CPAP)

Endotracheal intubation and positive pressure ventilation

Insertion of a mini-tracheostomy with frequent suctioning

Administration of 100% 02 by non-rebreather mask

Answer and Explanation

The Correct Answer is B

B. Endotracheal intubation and positive pressure ventilation are indicated in patients with severe respiratory failure who are unable to maintain adequate oxygenation and ventilation on their own. This intervention provides mechanical support to the patient's breathing by delivering positive pressure to the lungs via an endotracheal tube. Given the patient's respiratory rate of 6 breaths/min, low oxygen saturation (SpO2 of 78%), and increasing lethargy, endotracheal intubation and positive pressure ventilation are the most appropriate interventions to ensure adequate oxygenation and ventilation.

A. CPAP is a form of non-invasive positive pressure ventilation that helps keep the airways open and improves oxygenation. However, in a patient with severe respiratory failure and impending respiratory arrest, CPAP alone may not be sufficient to adequately support ventilation and oxygenation. CPAP is typically used in patients with milder forms of respiratory failure or as a step-down therapy from invasive mechanical ventilation.

C. Insertion of a mini-tracheostomy is not typically indicated in a patient with severe respiratory failure and impending respiratory arrest. While tracheostomy may be considered in certain cases for long-term ventilation or airway management, it is not the first-line intervention in an acute situation like this.

Additionally, frequent suctioning may not address the underlying cause of respiratory failure or improve oxygenation.

D. Administering 100% oxygen via a non-rebreather mask can help improve oxygenation temporarily. However, in a patient with severe respiratory failure and impending respiratory arrest, non-invasive oxygen therapy alone may not be sufficient to maintain adequate oxygenation and ventilation.

Endotracheal intubation and positive pressure ventilation are more definitive interventions to ensure adequate support for the patient's breathing.

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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.

A. Nitroglycerin B. Metoprolol C. Furosemide D. Epinephrine

Correct Answer is A

Explanation

A. Nitroglycerin is a vasodilator commonly used to reduce preload and afterload in critical care settings. By dilating blood vessels, nitroglycerin decreases systemic vascular resistance (afterload), which reduces the workload on the heart and improves cardiac output. It is often used to manage conditions such as acute heart failure, hypertensive emergencies, and acute coronary syndromes.

B. Metoprolol is a beta-blocker that primarily acts to reduce heart rate and myocardial contractility. While it can indirectly reduce afterload by lowering blood pressure, its primary mechanism of action is not targeted at afterload reduction. Metoprolol is commonly used in critical care for various indications, including hypertension, myocardial infarction, and heart failure, but it is not primarily used for afterload reduction.

C. Furosemide is a loop diuretic commonly used to manage volume overload and reduce preload in critical care settings. By promoting diuresis, furosemide decreases circulating blood volume, venous return, and preload, which indirectly reduces afterload. However, its primary mechanism of action is not targeted at afterload reduction but rather at reducing volume overload.

D. Epinephrine is a potent sympathomimetic agent that acts on alpha and beta-adrenergic receptors. While it can increase systemic vascular resistance (afterload) at higher doses due to its alpha-adrenergic effects, it is not commonly used for afterload reduction in critical care settings. Epinephrine is primarily used as a vasopressor to increase blood pressure and cardiac output in patients with shock or cardiac arrest.

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A patient with respiratory failure has a respiratory rate of 6 breaths/min and an oxygen saturation (SpO2) of 78%. The patient is increasingly lethargic. Which intervention will the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

Which of the following medications is commonly used for afterload reduction in critical care?

Correct Answer is A

Explanation

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