oxygenation questions

Question 1

when patient is on vent and alarms are going off what is your priority intervention?

Answer 1

assess your patient!!

Question 2

is patient is on BIPAP and continuing to decline what do we do?

Answer 2

get help, prepare for intubation

Question 3

patient has chest bruising, reports pain, low spo2, shallow breathing - what do you do?

Answer 3

give them pain meds , prepare for imaging

Question 4

what do we need to do before proning ?

Answer 4

• provider order
• get ABG
• get lots of help

(get ABG after proning to see if it worked)

Question 5

patient needs to be proned- what do we need to do first?

Answer 5

• get provider order
• get ABG before
• get lots of help

(get ABG after proning)

Question 6

partient just had a baby and is coughing up pink sputum- what sdo we do? what is wrong?

Answer 6

HOB, O2 on, turn off fluids, assess, call rapid

pulmonary edema

Question 7

patient has aptt of 70 on a heparin drip for pulmomary emboli- is this chill?

Answer 7

yes, check heparin algorithm

Question 8

patient with new trach and you notice small bubbles in his chest and neck that pop when you touch them. Whats wrong and what do we do?

Answer 8

subcutaneous emphysema

assess, call RR
–look for unilateral breath sounds b/c wondering if they have pneumo

Question 9

chest tube dislodges during transfer- what do we do?

Answer 9

cover 3 sides with sterile occlusive dressing

Question 10

patient with SUD has ARDS on ventilator support. with small amount of sedation and breathing out of sync with ventilator. They are maxed out on FiO2 and current spo2 is 89%

Answer 10

give more sedation!

Question 11

patient has CHF and pulm edema. They have 40 mg lasix and has 1L urine output in last 3 hours. what do we do?

Answer 11

its okay- assess lungs

Question 12

extubated patient and is on 5L, after 20 minutes you hear high pitched whistling sound in upper part of patient airway- whats happening what do we do?

Answer 12

stridor- get help!!

Question 13

what does a pneumo require?

Answer 13

a chest tube

Question 14

The nurse monitors a patient in the emergency department after chest tube placement for a pneumothorax. The nurse ismostconcerned if which assessment finding is observed?

-An air leak in the water-seal chamber
-400 mL of blood in the collection chamber
-Complaint of pain with each deep inspiration
-Subcutaneous emphysema at the insertion site

Answer 14

-400 mL of blood in the collection chamber

Question 15

A patient experiences a chest wall contusion as a result of being struck in the chest with a baseball bat. The emergency department nurse would bemostconcerned if which finding is observed during the initial assessment?

-Paradoxical chest movement
-Complaint of chest wall pain
-Heart rate of 110 beats/minute
-Large bruised area on the chest

Answer 15

• Paradoxical chest movement

- -> flail chest

Question 16

When assessing a patient who has just arrived after an automobile accident, the emergency department nurse notes tachycardia and absent breath sounds over the right lung. For which intervention will the nurse prepare the patient?

-Emergency pericardiocentesis
-Stabilization of the chest wall
-Bronchodilator administration
-Chest tube insertion

Answer 16

Chest tube insertion

Question 17

A patient with a possible pulmonary embolism (aka DVT) complains of chest pain and difficulty breathing. The nurse finds a heart rate of 142 beats/min, blood pressure of 100/60 mm Hg, and respirations of 42 breaths/min. Which action should the nurse takefirst?

-Administer anticoagulant drug therapy.
-Notify the patient’s health care provider.
-Prepare patient for a spiral computed tomography (CT).
-Elevate the head of the bed to a semi-Fowler’s position.

Answer 17

-Notify the patient’s health care provider.

Question 18

The nurse receives change-of-shift report on the following four patients. Which patient should the nurse assessfirst?

-A 53-yr-old patient with COPD who is on non-invasive positive airway pressure machine ( FiO2 of 40%)

-A 46-yr-old patient on bed rest who is complaining of sudden onset of shortness of breath

-A 77-yr-old patient on 2L NC with CHF who has been receiving 20mg Lasix daily (for four days) for pulmonary edema

-A 35-yr-old patient who was admitted with three broken ribs, is on a a PCA who has been napping for one hour

Answer 18

-A 46-yr-old patient on bed rest who is complaining of sudden onset of shortness of breath

Question 19

A patient is admitted to the emergency department with an open stab wound to the left chest. What action should the nurse take?

-Keep the head of the patient’s bed positioned flat.
-Cover the wound tightly with tape.
-Position the patient so that the left chest is dependent.
-Tape a nonporous dressing on three sides over the wound.

Answer 19

-Tape a nonporous dressing on three sides over the wound.

Question 20

The nurse provides discharge teaching for a patient who has two fractured ribs from an automobile accident. Which statement, if made by the patient, would indicate that teaching has been effective?

-“I am going to buy a rib binder to wear during the day.”
-“I can take shallow breaths to prevent my chest from hurting.”
-“I should plan on taking the pain pills only at bedtime so I can sleep.”
-“I will use the incentive spirometer every hour or two during the day.”

Answer 20

-“I will use the incentive spirometer every hour or two during the day.”

Question 21

After change-of-shift report, which patient should the nurse assessfirst?

-A 72-yr-old with cor pulmonale who has 4+ bilateral edema in his legs and feet
-A 28-yr-old with pneumonia and a temperature of 101° F (38.3° C)
-A 40-yr-old with a pleural effusion who is complaining of stabbing chest pain
-A 64-yr-old with lung cancer and tracheal deviation after subclavian catheter insertion

Answer 21

-A 64-yr-old with lung cancer and tracheal deviation after subclavian catheter insertion

–> tension pneumo