A3 EX 2 Chapter 21: Respiratory Care Modalities PREP U

Which type of ventilator has a preset volume of air to be delivered with each inspiration? Pressure-cycled Negative-pressure Volume-controlled Time-cycled

Volume-controlled the volume of air to be delivered with each inspiration is preset. Negative-pressure ventilators exert a negative pressure on the external chest

pursed lip breathing

"Inhale through your nose." "Slowly count to 3." "Exhale slowly through pursed lips." "Slowly count to 7."

A client has been placed on a ventilator, and the spouse begins to cry during the initial visit. What is the best therapeutic statement for the nurse to communicate? "The ventilator gives breaths every timed interval for breathing." "Tell me what you are feeling." "People on the ventilator do not feel pain." "I know this is stressful, but it is the best treatment

"Tell me what you are feeling."

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? 45 mm Hg 58 mm Hg 84 mm Hg 120 mm Hg

84 mm Hg 60 to 95 mm Hg.

Venturi mask

A face mask and reservoir bag device that delivers specific concentrations of oxygen by mixing oxygen with inhaled air. low levels of supplemental oxygen

A client is on a ventilator. Alarms are sounding, indicating an increase in peak airway pressure. The nurse assesses first for Higher than normal endotracheal cuff pressure A cut or slice in the tubing from the ventilator A kink in the ventilator tubing Malfunction of the alarm button

A kink in the ventilator tubing

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? Histotoxic hypoxia Anemic hypoxia Circulatory hypoxia Hypoxemic hypoxia

Circulatory hypoxia Circulatory hypoxia results from inadequate capillary circulation and may be caused by decreased cardiac output, local vascular obstruction, low-flow states such as shock, or cardiac arrest.

A client is diagnosed with mild obstructive sleep apnea after having a sleep study performed. What treatment modality will be the most effective for this client? Bi-level positive airway pressure (BiPAP) Surgery to remove the tonsils and adenoids Medications to assist the patient with sleep at night Continuous positive airway pressure (CPAP)

Continuous positive airway pressure (CPAP) CPAP provides positive pressure to the airways throughout the respiratory cycle. Although it can be used as an adjunct to mechanical ventilation with a cuffed endotracheal tube or tracheostomy tube to open the alveoli, it is also used with a leak-proof mask to keep alveoli open, thereby preventing respiratory failure

A client with chronic obstructive pulmonary disease (COPD) is intubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at this client's bedside? Water-seal chest drainage set-up Tracheostomy cleaning kit Manual resuscitation bag Oxygen analyzer

Manual resuscitation bag

A client who is undergoing thoracic surgery has a nursing diagnosis of "Impaired gas exchange related to lung impairment and surgery" on the nursing care plan. Which of the following nursing interventions would be appropriately aligned with this nursing diagnosis? Select all that apply. Monitor and record hourly intake and output. Request order for patient-controlled analgesia pump Encourage deep breathing exercises. Monitor pulmonary status as directed and needed. Regularly assess the client's vital signs every 2 to 4 hours.

Monitor pulmonary status as directed and needed. Regularly assess the client's vital signs every 2 to 4 hours. Encourage deep breathing exercises.

The nurse is teaching the client in respiratory distress ways to prolong exhalation to improve respiratory status. The nurse tells the client to Initially inhale through the mouth. Purse the lips when exhaling air from the lungs. Hold the breath for 5 seconds and then exhale. Sit in an upright position only.

Purse the lips when exhaling air from the lungs.

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 Tracheal cuff pressure set at 30 mm Hg A scheduled time for deflation of the tracheal cuff Cool air humidified through the tube

Symmetry of the client's chest expansion Immediately after intubation, the nurse should check for symmetry of chest expansion. This is one finding that indicates successful endotracheal placement. The tracheal cuff pressure is set between 15 and 20 mm Hg

pressure cycle ventilation

it delivers a flow of air (inspiration) until it reaches a preset pressure, and then cycles off, and expiration occurs passively

When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for how long? no longer than 5 seconds no longer than 10 seconds no longer than 20 seconds no longer than 30 seconds

no longer than 10 seconds

Time cycled ventilators

push air into the lungs until a preset time has elapsed

Signs and symptoms of oxygen toxicitiy

substernal discomfort, paresthesias, dyspnea, restlessness, fatigue, malaise, progressive respiratory difficulty, refractory hypoxemia, alveolar atelectasis, and alveolar infiltrates evident on chest x-ray

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 bedside? An Ambu bag A set of hemostats An incentive spirometer A bottle of sterile water

A bottle of sterile water It is essential that the nurse ensure that a bottle of sterile water is readily available at the client's bedside. If the chest tube and drainage system become disconnected, air can enter the pleural space, producing a pneumothorax. To prevent the development of a pneumothorax, a temporary water seal can be established by immersing the open end of the chest tube in a bottle of sterile water

A nurse is teaching a client about using an incentive spirometer. Which statement by the nurse is correct? "Before you do the exercise, I'll give you pain medication if you need it." "You need to start using the incentive spirometer 2 days after surgery." "Don't use the incentive spirometer more than 5 times every hour." "Breathe in and out quickly."

"Before you do the exercise, I'll give you pain medication if you need it."

An adult client with cystic fibrosis is admitted to an acute care facility with an acute respiratory infection. Ordered respiratory treatment includes chest physiotherapy. When should the nurse perform this procedure? When bronchospasms occur When secretions have mobilized At bedtime Immediately before a meal

At bedtime The nurse should perform chest physiotherapy at bedtime to reduce secretions in the client's lungs during the night.

The nurse is caring for a client following a thoracotomy. Which finding requires immediate intervention by the nurse? Heart rate, 112 bpm Chest tube drainage, 190 mL/hr Pain of 5 on a 1-to-10 scale Moderate amounts of colorless sputum

Chest tube drainage, 190 mL/hr he nurse should monitor and document the amount and character of drainage every 2 hours. The nurse must notify the primary provider if drainage is ≥150 mL/hr.

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 client's respiratory status frequently Consults with the physician about removing the client from the ventilator Changes the setting on the ventilator to increase breaths to 14 per minute Contacts the respiratory therapy department to report the ventilator is malfunctioning

Continues assessing the client's respiratory status frequently

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. Encourage the patient to try to stop coughing during and after using the spirometer. Inform the patient that using the spirometer is not necessary if the patient is experiencing pain. Have the patient lie in a supine position during the use of the spirometer.

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

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? Encouragement of coughing Incentive spirometry Use of a cooling blanket Endotracheal suctioning

Endotracheal suctioning

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. Use aerosol sprays to deodorize the client's environment after postural drainage. Administer bronchodilators and mucolytic agents following the sequence. Perform this measure with the client once a day.

Instruct the client to remain in each position of the postural drainage sequence for 10 to 15 minutes. Postural drainage is usually performed two to four times daily, before meals (to prevent nausea, vomiting, and aspiration) and at bedtime. Prescribed bronchodilators, water, or saline may be nebulized and inhaled before postural drainage to dilate the bronchioles, reduce bronchospasm, decrease the thickness of mucus and sputum, and combat edema of the bronchial walls. The nurse instructs the client to remain in each position for 10 to 15 minutes and to breathe in slowly through the nose and out slowly through pursed lips to help keep the airways open so that secretions can drain while in each position

Which oxygen administration device has the advantage of providing a high oxygen concentration? Catheter Venturi mask Nonrebreathing mask Face tent

Nonrebreathing mask provides high oxygen concentration, but it usually fits poorly. However, if the nonrebreathing mask fits the client snugly and both side exhalation ports have one-way valves, it is possible for the client to receive 100% oxygen, making the nonrebreathing mask a high-flow oxygen system.

A client has been receiving 100% oxygen therapy by way of a nonrebreather mask for several days. Now the client complains of tingling in the fingers and shortness of breath, is extremely restless, and describes a pain beneath the breastbone. What should the nurse suspect? Oxygen-induced atelectasis Oxygen toxicity Hypoxia Oxygen-induced hypoventilation

Oxygen toxicity Oxygen toxicity may occur when too high a concentration of oxygen (greater than 50%) is administered for an extended period

The nurse is caring for a client with an endotracheal tube (ET). Which nursing intervention is contraindicated? Routinely deflating the cuff Ensuring that humidified oxygen is always introduced through the tube Deflating the cuff before removing the tube Checking the cuff pressure every 6 to 8 hours

Routinely deflating the cuff

A client with myasthenia gravis is receiving continuous mechanical ventilation. When the high-pressure alarm on the ventilator sounds, what should the nurse do? Check for an apical pulse. Increase the oxygen percentage. Suction the client's artificial airway. Ventilate the client with a handheld mechanical ventilator.

Suction the client's artificial airway.

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 having a stress reaction. The patient is hypoxic from suctioning. The patient is having a myocardial infarction. The patient is in a hypermetabolic state.

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 client has a pneumothorax. The system has an air leak. The system is functioning normally. The chest tube is obstructed.

The system has an air leak.

A client who must begin oxygen therapy asks the nurse why this treatment is necessary? What would the nurse identify as the goals of oxygen therapy? Select all that apply. To provide adequate transport of oxygen in the blood To provide visual feedback to encourage the client to inhale slowly and deeply To clear respiratory secretions To decrease the work of breathing To reduce stress on the myocardium

To provide adequate transport of oxygen in the blood To decrease the work of breathing To reduce stress on the myocardium

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? Suction control chamber Water-seal chamber Collection chamber Air-leak chamber

Water-seal chamber