Exhibits
Based on the client's status at 1400, the nurse should plan to do which of the following? Select all that apply.
Increase the fractional concentration of Inspired oxygen
Change the ventilator settings to continuous positive airway pressure (CPAP)
Increase the respiratory rate
Continue weaning the ventilator as ordered
Decrease the tidal volume
Alert the provider of the blood gas values
Switch the ventilator to pressure control
Correct Answer : A,F,G
A. Increase the fractional concentration of Inspired oxygen: As the partial pressure of oxygen (PaO) has decreased to 64 mm Hg from 99 mm Hg, and the oxygen saturation may drop, it's necessary to increase the fraction of inspired oxygen (FiO2) to maintain adequate oxygenation.
B. Change the ventilator settings to continuous positive airway pressure (CPAP): CPAP is not typically used in patients who are intubated. CPAP is a non-invasive ventilation mode used for patients with respiratory distress who are breathing spontaneously. In this case, the patient is intubated and requires mechanical ventilation, so CPAP is not appropriate.
C. Increase the respiratory rate: While the respiratory rate has decreased from 15 to 13 breaths/minute, it's important to maintain a careful balance when adjusting ventilator settings. Increasing the respiratory rate may not be necessary at this point, especially if the patient is still oxygenating adequately. Moreover, the primary concern appears to be hypoxemia rather than hypoventilation.
D. Continue weaning the ventilator as ordered: While weaning the patient off the ventilator is a goal, it may not be appropriate at this time, especially with the worsening blood gas values
indicating respiratory insufficiency. Continuing the weaning process could potentially exacerbate respiratory failure.
E. Decrease the tidal volume: Decreasing the tidal volume could worsen ventilation-perfusion matching and exacerbate hypoxemia. This approach might be considered in certain cases of acute respiratory distress syndrome (ARDS) or in patients with severe lung injury, but it's not typically indicated in this scenario without further assessment.
F. Alert the provider of the blood gas values: The nurse should inform the provider about the changes in blood gas values, especially the decrease in PaO2 and the increase in PaCO2, which indicate worsening respiratory status and potential respiratory acidosis.
G. Switch the ventilator to pressure control: Given the deterioration in respiratory status with an increase in PaCO2 and decrease in PaO2, switching to pressure control ventilation may provide better control over the patient's ventilation and oxygenation, especially in cases of acute
respiratory failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Collaborating with a science teacher to prepare a health lesson may be beneficial for health education but does not directly address secondary prevention. Secondary prevention involves early detection and intervention to prevent the progression of disease or injury.
B. Initiating a hearing and vision screening program for first graders is an example of secondary prevention. This action aims to detect any hearing or vision problems early, allowing for timely intervention and management to prevent further complications or difficulties in learning and
development.
C. Preparing a presentation on how to prevent the spread of lice may be important for promoting hygiene and preventing infestations, but it falls more under the category of health education and primary prevention rather than secondary prevention.
D. Observing a person with type 1 diabetes mellitus self-administer a dose of insulin may be related to health education or management of a chronic condition, but it does not directly address secondary prevention for school-aged children.
Correct Answer is ["0.8"]
Explanation
- Convert the client's weight from pounds to kilograms (kg).
- Calculate the enoxaparin sodium dosage per day based on the client's weight and the prescribed dosage of 1.5 mg/kg/day.
- Divide the enoxaparin sodium dosage by the concentration of the medication in the prefilled syringe (120 mg/0.8 mL) to determine the volume to administer.
Step 1: Convert weight from pounds to kilograms
-
- Client's weight in kg = Client's weight in pounds / 2.2
-
- Client's weight in kg = 176 pounds / 2.2 = 80 kg
Step 2: Calculate enoxaparin sodium dosage per day
-
- Enoxaparin sodium dosage (mg/day) = Client's weight (kg) × Prescribed dosage (mg/kg/day)
- Enoxaparin sodium dosage (mg/day) = 80 kg × 1.5 mg/kg/day = 120 mg/day
Step 3: Determine the volume to administer
-
- Volume to administer (mL) = Enoxaparin sodium dosage (mg/day) / Medication concentration (mg/mL)
- Volume to administer (mL) = 120 mg/day / (120 mg/0.8 mL) = 0.8 mL
Therefore, the nurse should administer 0.8 mL of enoxaparin sodium to the client.
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