Respiratory Care Modality

Arterial blood gases should be obtained how often after initiating continuous mechanical ventilation?

20 minutes

the nurse is caring for a client in the ICU who required emergent endotracheal intubation with mechanical ventilation. the nurse receives an order to obtain ABGs after the procedure. the nurse recognizes that ABgs should be obtained how long after mechanical ventilation is initiated?

20 minutes

Which is a correct endotracheal tube cuff pressure

22 mm Hg

A nurse provides care for a client receiving oxygen from a nonrebreather mask. Which nursing intervention has the highest priority?

Assessing the client's respiratory status, orientation and skin color

An adult client with cystic fibrosis is admitted to an acute care facility with an acute respiratory infection. Ordered respiratory treatment includes CPT. When should the nurse perform this procedure.

At bedtime

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

Auscultating the lungs for bilateral breath sounds

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 should:

Continues assessing the client's respiratory status frequently

The nurse is preparing to perform CPT on a client. Which statement by the client tells the nurse that the procedure is contraindicated.

I just finished eating my lunch, I'm ready for my CPT now.

Which finding would indicate a decrease in pressure with mechanical ventilation?

Increase in compliance

A client with COPD is incubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at this client's bedside?

Manual resuscitation bag

For a client who has a chest tube connected to a closed water-seal drainage system, the nurse should include which action in the care plan?

Measuring and documenting the drainage in the collection chamber

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

Negative pressure ventilator

The nurse is admitting a patient with COPD. The decrease of what substance in the blood gas analysis would indicate to the nurse that the patient is experiencing hypoxemia?

PaO2

A client is receiving supplemental oxygen. When determining the Effectiveness of Oxygen Therapy, which arterial blood gas value is most important?

Partial pressure of arterial oxygen

The nurse is preparing to perform tracheostomy care for a client with a newly inserted tracheostomy tube. Which action, if performed by the nurse, indicates the need for further review of the procedure?

Places clean tracheostomy ties then removes soiled ties after the new ties are in place

In general, chest drainage tubes are not indicated for a client undergoing which procedure?

Pneumoectomy

The client is postoperative for total larygnectomy and has recovered from anesthesia. The clients respiratory are 32 breaths/minute, blood pressure is 102/58 and pulse rate is 104 bpm. Pulse ox is 90%. The client is receiving humidifier oxygen. To aid in the client's respiratory status, the nurse places the client in which of the following positions.

Semi-Fowler's

The nurse suctions a patient through the endotracheal tube for 20 seconds and observes dysrhythmias on the monitor. What does the nurse determine is occurring with the patient?

The patient is hypoxic from suctioning

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 patient with COPD requires oxygen administration. What method of delivery does the nurse know would be best for this patient?

Venturi mask

The nurse is preparing to assist the health care provider to remove a client's chest tube. Which instruction will the nurse correctly give to the client?

When the tube is being removed, take a deep breath, exhale and bear down.

Which is a potential complication of a low pressure in endotracheal tube cuff

aspiration pneumonia

Which ventilator mode provides full ventilatory support by delivering a prest tidal volume and respiratory rate

assist control

Which is an adverse reaction that would require the process of weaning from a ventilator to be terminated?

blood pressure increase of 20 mm Hg

The nurse is transporting a patient with chest tubes to a treatment room. The chest tube becomes disconnected and falls between the bed rail. What is the priority action by the nurse?

cut the contaminated tip of the tube and insert a sterile connector and reattach

After undergoing a left thoracotomy, a client has a chest tube in place. When caring for this client the nurse must:

encourage coughing and deep breathing

a client is covering from thoracic surgery needed to perform a right lower lobectomy. which of the following is the most likely postoperative nursing intervention

encourage coughing to mobilize secretions

The nurse should monitor a client receiving mechanical ventilation for which of the following complications

gastrointestinal hemorrhage

a patient has been receiving 100% oxygen therapy by way of a nonrebreather mask for several days. now the patient complains of tingling in the fingers and SOB, is extremely restless and describes a pain beneath the breastbone. what should the nurse suspect?

oxygen toxicity

The nurse is teaching the client in respiratory distress ways to prolong exhalation to improve respiratory status. the nurse tells the client to

purse the lips when exhaling air from lungs

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

take prescribed albuterol before performing postural drainage

Which is the most reliable and accurate method for delivering precise concentrations of oxygen through noninvasive means

venturi mask

Which type of ventilator has a preset volume of air to be delivered with each inspiration?

volume cycled

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?

water-seal chamber

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

Auscultation

A client with pneumonia develops respiratory failure and has partial pressure of arterial oxygen of 55 mm Hg. He's placed on mechanical ventilation with a fraction of inspired oxygen of 0.9. The nursing goal should be to reduce the FIO2 to no greater than:

0.5

A client who must begin oxygen therapy ask the nurse why this treatment is necessary? What would the nurse identify as the goals of oxygen therapy? Select all that apply.

1. Provide adequate transport of oxygen in the blood 2. To decrease the work of breathing 3. To reduce the stress on the myocardium

The Nurse is teaching a postoperative client who had a coronary artery bypass graft about using the incentive spirometer. The nurse instructs the client to perform the exercise in the following order:

1. Sit in an upright position 2. Place the mouthpiece of spirometer in the mouth 3. Breathe air in through the mouth 4. Hold breath for about 3 seconds Exhale air slowly through the mouth

The nurse is using an in line suction kit to suction a patient who is intubated and on a mechanical ventilator. what benefits does incline suction have for the patient.

1. decreases hypoxemia 2. decreases patient anxiety 3. sustains positive end expiatory pressure PEEP

which of the following are indicators that a client is ready to be weaned from a ventilator. select all that apply

1. vital capacity of 13 ml/kg 2. Tidal volume of 8.5 m;/kg 3. PaO2 of 64 mmHg

When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for how long?

10-15 seconds

Which range of water pressure within the endotracheal tube cuff is believe to prevent both injury and aspiration?

15-20 mm Hg

A client has a tracheostomy but doesn't require continuous mechanical ventilation. When weaning the client from tracheostomy tube, the nurse initially should plug opening in the tube for:

5 to 20 minutes

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?

84 mm Hg

A client is on a ventilator. Alarms are sounding, indicating an increase in peak airway pressure. The nurse assesses first for:

A kink in the ventilator tubing

The nurse is caring for a client following a wedge resection. While the nurse is assessing the client's chest tube drainage system, constant bubbling is noted in the water seal chamber. This finding indicates which problem?

Air Leak

Which is a potential complication of a low pressure in the endotracheal tube cuff

Aspiration pneumonia

A client in the intensive care unit has a tracheostomy with humidified oxygen being instilled through it. The client is expectorating thick yellow mucus through the tracheostomy tube frequently. The nurse:

Assesses the client's tracheostomy and lung sounds every 15 minutes

A new ICU nurse is observed by her preceptor entering a patient's room to suction the tracheostomy after performing the task 15 minutes before. What should the preceptor educate the new nurse to do to ensure that the patient needs to be suctioned?

Auscultate the lung for adventitious sounds

The nurse is caring for a client being weaned from a mechanical ventilator. Which findings would require the weaning process to be terminated?

Blood pressure increase of 20 mm hg from baseline

The nurse assesses a patient with a heart rate of 42 and a blood pressure of 70/46. What type of hypoxia does the nurse determine this patient is displaying?

Circulatory hypoxia

The nurse hears the patient's ventilator alarm sound and attempts to find the cause. What is the priority action of the nurse when the cause of the alarm is not able to be determined?

Disconnect the patient from the ventilator and manually ventilate the patient with a manual resuscitation bag until the problem is resolved

The nurse is assisting a physician with an endotracheal intubation for a client in respiratory failure. It is most important for the nurse to assess for:

Symmetry of the client's chest expansion

A nurse is planning care for a client after a tracheostomy. One of the client's goals is to overcome verbal communication impairment. Which intervention should the nurse include in the care plan?

Encourage the client's communication attempts by allowing him to time to select or write words.

A patient is being educated in the use of incentive spirometry prior to having a surgical procedure. What should the nurse be sure to include in the education?

Encourage the patient to take approximately 10 breaths per hour, while awake.

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

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

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 postural drainage sequence for 10-15 minutes

A client suffers acute respiratory distress syndrome as a consequence of shock. The client's condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are intimated. When the high pressure alarm on the mechanical ventilator sounds, the nurse starts to check for the cause. Which condition triggers for high pressure alarm?

Kinking of the ventilator tubing

A client in acute respiratory distress is brought to the emergency department. After endotracheal intubation and initiation of mechanical ventilation, the client is transferred to the intensive care unit. Before suctioning the ET tube, the nurse hyperventilates and hyperoxygenates the client. What is the rationale for these interventions?

They help prevent cardiac arrhythmias

Which oxygen administration device has the advantage of providing a high oxygen concentration?

Non-rebreathing mask

A client with end-stage COPD requires bi-level positive airway pressure (BiPAP). While caring for the client, the nurse determines the bilateral wrist restraints are required to prevent compromised care. Which client care outcome is associated with restraint use in the client who requires BiPAP?

The client will maintain adequate oxygenation

Which type of ventilator has a preset volume of air to be delivered with each inspiration?

Volume controlled

the nurse is assigned to care for a client with a chest tube. the nurse should ensure that which item is kept at the client's bed side

a bottle of sterile water

A patient with emphysema informs the nurse "the surgeon will be removing 30% of my lung so that I will not be so short of breath and will have an improved quality of life" What surgery does the nurse understand the surgeon will perform?

a lung volume reduction

a patient is to receive an oxygen concentration of 70%. what is the best way for the nurse to deliver this concentration

a partial rebreathing mask

a nurse provides care for a client receiving oxygen from a nonrebreather mask. which nursing intervention has the highest priority?

assessing the client's respiratory status, orientation and skin color

the nurse is caring for a client in the ICU is receiving mechanical ventilation. which nursing measure is implemented in an effort to reduce the client's risk of developing ventilator-associated pneumonia

cleaning the client's mouth with chlorhexidine daily

A patient is diagnosed with mild obstructive sleep apnea after having a sleep study performed. What treatment modality will be most effective for this patient?

continuous positive airway pressure

A client with supraglottic cancer undergoes a partial laryngectomy. Postoperatively, a cuffed tracheostomy tube is in place. When removing secretions that pool above the cuff, the nurse should instruct the client to:

cough as the cuff is being deflated

Positive end-expiratory pressure therapy has which effect on the heart?

reduced cardiac output

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

hypoxia

A nurse is caring for a patient after a throacotomy for a lung mass. which nursing diagnosis should be the first priority

impaired gas exchange

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. oyxgen saturation levels are 91%. what is the priority nursing diagnosis for this client?

impaired gas exchange related to ventilator setting adjustments

The nurse is educating a patient with COPD about the technique for performing pursed lip breathing. What does the nurse inform the patient is the importance of using this technique?

it prolongs exhalation

The nurse is caring for a client who is schedule for a lobectomy. Following the procedure, the nurse will plan care based on the client

returning to the nursing unity with two chest tubes

The nurse is caring for a client with an endotracheal tube. Which nursing intervention is contraindicated?

routinely deflating the cuff

A nurse is weaning a client from mechanical ventialtion. Which assessment finding indicates the weaning process should be stopped.

runs of ventricular tachycardia

A client undergoes a tracheostomy after a many failed attempts at weaning him from a mechanical ventilator. Two days after tracheostomy, while the client is being waened, the nurse detects a mild air leak in the tracheostomy tube cuff. what should the nurse do first?

suction the client, withdraw residual air from the cuff and reinflate it

A client has been placed on a ventilator and the spouse is visiting for the first time. the spouse begins to cry. the best statement by the nurse is

tell me what you are feeling