SIMS: Hy Ball
Flutter valve to IPPB, be done q4h while awake. Upon entering the room, you notice that the mist is disappearing around the trach mask when the patient breathes in. Your instructor asks you which of the following could cause that to occur:
"There is excess condensation in the corrugated tubing." "The patient's inspiratory demand is exceeding the nebulizer system."
The doctor orders the following: bronchoscopy this p.m, cxr now and flutter valve q2h while awake. Your instructor gives you the order for the flutter valve. Which of the following would you suggest?
Call the physician and request the IPPB instead of flutter valve.
The instructor asks how you could minimize the desaturation problem next?
Decrease the amount of time that the catheter is in the airway
ABG: 7.34, PaCO2 33, HCO3 18, PaO2 80
Partially compensated metabolic acidosis
You have obtained the medical record of Mr. Ball. Which of the following would be appropriate to assess?
cbc, extremity radiograph, cervical spine radiograph, vital signs and bp, pelvic radiograph, current respiratory orders, abg results, bowel sounds, hx of present illness, breath sounds, cxr
Your instructor asks for suggestions for further assessment and management of Mr.Ball-- you would suggest the following:
ippb therapy, cxr, bronchoscopy,
The pulse oximeter alarm is sounding, it's displaying spo2 58%, what is causing the oximeter to alarm?
low perfusion state at probe site, probe movement, nail polish at probe site, intravascular dyes, exposure of probe to ambient light, disconnected probe
After reconnecting the probe, you begin the assessment. You would now assess:
skin color, medical hx from pt's father, palpation/percussion, pulse ox, breath sounds, sensorium, ecg monitor
You have completed the first IPPB treatment, Mr. Ball tolerated it well with no problems noted. Auscultation reveals bilateral crackles. You suggest to the instructor that the patient should be suctioned. What equipment would you need?
vacuum source with adjustable regulator, manual resuscitation bag with oxygen enrichment device, sterile suction catheter, stethoscope, collection bottle and connection tubing, sterile disposable gloves, ppe, oxygen flowmeter with connecting tubing
