MedSurg Chapter 21 Respiratory Care Modalities

Which of the following ranges of water pressure identifies the amount of pressure within the endotracheal tube cuff that is believed to prevent both injury and aspiration?

15-20

Which of the following is a correct endotracheal tube cuff pressure?

17mmhg

Arterial blood gases should be obtained at which timeframe following the initiation of continuous mechanical ventilation?

20 min

The nurse should monitor and document the amount and character of drainage every 2 hours. The nurse will notify the primary provider if drainage is _____ or greater.

50 mL/hr

A nurse is caring for a client who has a tracheostomy and temperature of 103° F (39.4° C). Which intervention will most likely lower the client's arterial blood oxygen saturation?

ET suctioning

The nurse has instructed a patient on how to perform pursed-lip breathing. The nurse recognizes the purpose of this type of breathing is to accomplish which of the following?

Improve oxygen transport, induce a slow, deep breathing pattern, and assist the patient to control breathing

n general, chest drainage tubes are not indicated for a patient undergoing which of the following procedures?

Pneumonectomy

A client is prescribed postural drainage because secretions are accumulating in the upper lobes of the lungs. The nurse instructs the client to:

Take prescribed albuterol (Ventolin) before performing postural drainage.

Hyperbaric oxygen therapy increases the blood's capacity to carry and deliver oxygen to compromised tissues. This therapy may be used for a client with:

a compromised skin graft

client has a sucking stab wound to the chest. Which action should the nurse take first?

apply a dressing and tape down 3 sides

Which of the following is a potential complication of a low pressure in the endotracheal tube (ET) cuff?

aspiration pneumonia

Which of the following ventilator modes provides full ventilatory support by delivering a present tidal volume and respiratory rate?

assist control

For a client with an endotracheal (ET) tube, which nursing action is the most important?

auscultate lungs for bilateral breath sounds

The nurse is caring for a patient in the ICU who is receiving mechanical ventilation. Which of the following nursing measures are implemented in an effort to reduce the patient's risk of developing ventilator-associated pneumonia (VAP)?

cleaning the pts mouth with chlorhexidine daily

A client is on a positive-pressure ventilator with a synchronized intermittent mandatory ventilation (SIMV) setting. The ventilator is set for 8 breaths per minute. The client is taking 6 breaths per minute independently. The nurse

continues assessing the pt respiratory status frequently

The nurse is caring for a patient with an endotracheal tube (ET). Which of the following nursing interventions is contraindicated?

deflating the cuff prior to removal

A client is postoperative and prescribed an incentive spirometer (IS). The nurse instructs the client to:

expect coughing when using the IS properly

A nurse is attempting to wean a client after 2 days on the mechanical ventilator. The client has an endotracheal tube present with the cuff inflated to 15 mm Hg. The nurse has suctioned the client with return of small amounts of thin white mucus. Lung sounds are clear. Oxygen saturation levels are 91%. What is the priority nursing diagnosis for this client?

impaired gas exchange related to ventilator settings adjusted

Which of the following would indicate a decrease in pressure with mechanical ventilation?

increase in compliance

The nurse is assisting a client with postural drainage. Which of the following demonstrates correct implementation of this technique?

instruct the client to remain in each position of the postural drainage sequence for 10 to 15 minutes

Which ventilator mode provides a combination of mechanically assisted breaths and spontaneous breaths?

intermittent mandatory ventilation

A young male client has muscular dystrophy. His PaO2 is 42 mm Hg with a FiO2 of 80%. Which of the following treatments would be least invasive and most appropriate for this client?

neg pressure ventilator This client needs ventilatory support. His PaO2 is low despite receiving a high dose of oxygen. The iron lung or drinker respiratory tank is an example of a negative-pressure ventilator. This type of ventilator is used mainly with chronic respiratory failure associated with neurological disorders, such as muscular dystrophy. It does not require intubation of the client. The most common ventilator is the positive-pressure ventilator, but this involves intubation with an endotracheal tube or tracheostomy. CPAP is used for obstructive sleep apnea. Bi-PAP is used for those with severe COPD or sleep apnea who require ventilatory assistance at night.

Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?

non re breather mask

In general, chest drainage tubes are not used for the patient undergoing

pneumonectomy

The nurse is caring for a patient who is scheduled for a lobectomy. Following the procedure, the nurse will plan care based on which of the following?

pt will return with 2 chest tubes

A nurse is caring for a client who has a tracheostomy tube and who is undergoing mechanical ventilation. The nurse can help prevent tracheal dilation, a complication of tracheostomy tube placement, by:

using the minimal-leak technique with cuff pressure less than 25 cm H2O. To prevent tracheal dilation, a minimal-leak technique should be used and the pressure should be kept at less than 25 cm H2O. Suctioning is vital but won't prevent tracheal dilation. Use of a cuffed tube alone won't prevent tracheal dilation. The tracheostomy shouldn't be plugged to prevent tracheal dilation. This technique is used when weaning the client from tracheal support.

Fluctuations in the ______ are called tidal movements and indicate normal function of the system as the pressure in the tubing changes with the client's respiration

water-seal compartment