Four hours after mechanical ventilation is initiated for a patient with a suspected drug overdose, the patient's arterial blood gas (ABG) results include a pH of 7.50, Pa0 2 of 80 mm Hg. PaCO2 of 29 mmHg, and HCO3 of 23 mEq/L (23 mmo/L). The nurse will anticipate the need to:

decrease the respiratory rate.

Leave the ventilator at the current settings.

increase the tidal volume (VT).

Increase the F102

Answer and Explanation

The Correct Answer is A

The ABG results show a pH of 7.50, PaCO2 of 29 mmHg, and HCO3 of 23 mEq/L, indicating respiratory alkalosis. In respiratory alkalosis, there is a decrease in PaCO2 (hypocapnia), which can be caused by excessive ventilation.
To address the respiratory alkalosis, the nurse should decrease the respiratory rate. This would help reduce the amount of ventilation provided and allow the patient to retain more carbon dioxide (CO2), thereby increasing the PaCO2 levels and restoring acid-base balance.
B. Leaving the ventilator at the current settings in (option B) is incorrect because it may exacerbate respiratory alkalosis as it would maintain the same level of ventilation.
C. Increasing the tidal volume (VT) in (option C) is incorrect because it would not address the respiratory alkalosis. Tidal volume refers to the volume of air delivered with each breath, while the issue in this case is excessive ventilation leading to hypocapnia.
D. Increasing the FiO2 (fraction of inspired oxygen) in (option D) is incorrect because it is not indicated based on the given ABG results. The oxygenation (PaO2) level is within normal limits (80 mmHg), suggesting adequate oxygenation.
It is important to consult with the healthcare provider or respiratory therapist for further guidance on adjusting the ventilator settings based on the patient's condition and response to therapy.

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Correct Answer is ["A","B","C","D"]

Explanation

These conditions can lead to fluid loss, either through increased gastrointestinal output (diarrhea, vomiting, lower GI bleeding) or accumulation of air in the pleural space (tension pneumothorax), resulting in a decrease in blood volume and subsequent hypovolemic shock.
E. Diabetes insipidus in (option E) is incorrect because it is not directly associated with hypovolemic shock. Diabetes insipidus is a condition characterized by excessive thirst and the production of large volumes of dilute urine due to insufficient production or response to antidiuretic hormone (ADH). While diabetes insipidus can lead to dehydration and potential hypovolemia, it is not a direct cause of hypovolemic shock.
F. Valvular stenosis in (option F) is incorrect because it is a condition characterized by the narrowing or obstruction of one or more heart valves. While it can cause problems with cardiac output and circulation, it is not specifically related to hypovolemic shock, which is caused by a decrease in blood volume.
Therefore, the conditions that can cause hypovolemic shock include diarrhea, vomiting, lower GI bleeding, and tension pneumothorax.

A. Draw an arterial blood gas (ABG). B. Start insulin drip to maintain blood glucose at 150 mg/dl or lower. C. Give a normal saline bolus IV of 30mL/kg. D. Titrate norepinephrine (Levophed) to keep MAP greater than 65 mm Hg.

Correct Answer is C

Explanation

Septic shock is characterized by inadequate tissue perfusion and hypotension, which can lead to organ dysfunction and failure. The administration of intravenous fluids, such as a normal saline bolus, is the initial priority in the management of septic shock to restore intravascular volume and improve perfusion.
A. Draw an arterial blood gas (ABG) in (option A) is incorrect because: ABG may be ordered to assess the patient's acid-base status and oxygenation, but addressing hypotension and restoring perfusion through fluid administration takes priority.
B. Start insulin drip to maintain blood glucose at 150 mg/dl or lower in (option B) is incorrect because: Hyperglycaemia is commonly observed in critically ill patients, including those with septic shock. While controlling blood glucose is important, it is not the immediate priority compared to addressing hypotension and restoring intravascular volume.
D. Titrate norepinephrine (Levophed) to keep mean arterial pressure (MAP) greater than 65 mm Hg in (option D) is incorrect because: Norepinephrine is a vasopressor medication used to increase blood pressure and perfusion in septic shock. While it may be necessary for the management of septic shock, fluid resuscitation should be initiated first to optimize intravascular volume before starting vasopressors.
Therefore, the first order that the nurse should accomplish in this scenario is to give a normal saline bolus IV of 30 mL/kg to address the hypotension and restore intravascular volume.

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Four hours after mechanical ventilation is initiated for a patient with a suspected drug overdose, the patient's arterial blood gas (ABG) results include a pH of 7.50, Pa0 2 of 80 mm Hg. PaCO2 of 29 mmHg, and HCO3 of 23 mEq/L (23 mmo/L). The nurse will anticipate the need to:

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Naxlex Comprehensive Predictor Exams

Which conditions can cause hypovolemic shock? Select all that apply.

Correct Answer is ["A","B","C","D"]

Explanation

A 48-year-old female patient with septic shock presents with a BP of 70/46, pulse 136, respirations 32, temperature 104.0° F, and blood glucose of 246 mg/dl. The following have been ordered. Which order will the nurse accomplish first?

Correct Answer is C

Explanation

Which of the following clinical manifestations of Disseminated intravascular coagulation (DIC)?

A 32-year-old male patient sustains 78% TBSA burn and is currently admitted to the burn unit. Which sequential order would the nurse arrange the events involved in burn shock following a patient's exposure to burns?

A 40-year-old female patient with massive trauma and possible spinal cord injury is admitted to the emergency department (ED). The nurse suspects that the patient may be experiencing neurogenic shock in addition to hypovolemic shock, based on which one of the following?

The patient weighing 147 pounds with septic shock has a BP of 70/46 mm Hg, pulse 136, respirations 30, temperature 104° F, and blood glucose 391 mg/dL. Which intervention red by the health care provider should the nurse implement first?

Which of the following findings is most consistent with disseminated intravascular coagulation (DIC)?

A 31-year-old male patient with burn injuries is admitted to the burn unit. Which priority does the nurse anticipate within the first 24 hours?

Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)