AH Chp 21 Prep U

When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for which of the following time periods?

10-15 sec

A client with a respiratory condition is receiving oxygen therapy. While assessing the client's PaO2, the nurse knows that the therapy has been effective based on which of the following readings?

80-100 mm Hg

A nurse observes constant bubbling in the water-seal chamber of a closed chest drainage system. What should the nurse conclude?

The system has an air leak.

A client on long-term mechanical ventilation becomes very frustrated when he tries to communicate. Which intervention should the nurse perform to assist the client? a. ask client to write, use pic board, or spell words b. ask family member to translate c. notify HCP d. tell pt not to worry

a. ask client to write, use pic board, or spell words

A nurse is assigned to care for a client with a tracheostomy tube. How can the nurse communicate with this client? a. By providing a trachostomy plug to use for verbal communication b. suction pt c. by supplying a magic slate or a similiar device

c. by supplying a magic slate or a similiar device

A nurse prepares to perform postural drainage. How should the nurse ascertain the best position to facilitate clearing the lungs?

auscultation

A client suffers acute respiratory distress syndrome as a consequence of shock. The client's condition deteriorates rapidly, and endotracheal (ET) intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm? a. Kinking of the ventilator tubing b. A change in the oxygen concentration without resetting the oxygen level alarm c. disconnected ventilator tube

a. Kinking of the ventilator tubing

A client is recovering from thoracic surgery needed to perform a right lower lobectomy. Which of the following is the most likely postoperative nursing intervention? a. encourage coughing b. make sure thoracotomy tube is linked to open chest drainage c. restrict fluid intake d. move pt onto their side

a. encourage coughing pt should be in semifowlers position

After lobectomy for lung cancer, a client receives a chest tube connected to a disposable chest drainage system. The nurse observes that the drainage system is functioning correctly when she notes tidal movements or fluctuations in which compartment of the system as the client breathes? a. air leak chamber b. water seal chamber c. drainage tubing d. collecting chamber

b. water seal chamber Fluctuations in the water-seal compartment are called tidal movements and indicate normal function of the system

A home health nurse is visiting a home care client with advanced lung cancer. Upon assessing the client, the nurse discovers wheezing, bradycardia, and a respiratory rate of 10 breaths/minute. These signs are associated with which condition? a. delirium b. semiconsciousness c. hypoxia

c. hypoxia