week 1 Flashcards
If you have a patient that is hypoxic (blue) and is on O2 via NC how would you know
your interventions is effective
Cap refill normal, pink mucus membrane
This patient has an ETT tube (throat) and you’re about to ventilate them and suction them,. What are you going to do first?
Pre-oxygenate patient, wait 2 minutes
Patients trached with mechanical ventilation, how can you reduce pneumonia in those patients?
Give patient oral care: brush teeth with suction
ARDS patient using medication called vecuronium and is on ventilators, it can cause what?
Suppression of respiratory efforts, it lowers RR
What is the best position for a patient dealing with ARDS
Prone position
Dealing with 4 patients who are at risk for ards? (SATA)
History of Aspiration and lung trauma (chest injury), or systemic infection such as sepsis
Blood gasses (ABGS) what to use to see if a patient can come off a ventilator or getting correct ventilation. (SATA)
a. ABG
b. pH: determines if blood gas acidotic or alkalotic
c. CO2
d. HCO3
e. Uncompensated respiratory acidosis** (look at ABGs)
a. ABG
e. Uncompensated respiratory acidosis** (look at ABGs)
SATA: talking about Acute respiratory failure
All except nausea
Teaching a patient or family member for skill at home which indicates teaching is
effective
Caregiver can do skill independently and safely
A person is receiving a neuromuscular blocking agent, what should you have at your bedside when giving this medication?
Have ambu bag and oxygen at bedside, ett tubes at bedside
Patients with SPO2 below 90% what would you give them?
Give patient O2
If a patient has a trach, and you’re in PACU and assessing and their chest isn’t rising and falling and no breath sounds what does that mean?
The ETT needs to be replaced because it may be dislodged (in bronchus)
SATA: (3 answers) a person is on mechanical ventilation what interventions should you do to prevent complications?
a. Raise head of bed at least 30 degrees
b. Administer protonix (pantoprazole) for stress ulcers
c. ETT tube in mouth: move tube left to right every 12 hours
If you have a patient who has a bronchoscopy, what must return to ensure a patent airway?
a. Gag reflex
A patient who is experiencing possible respiratory failure which blood gas would indicate
that they are experiencing it?
a. High PaCO2
b. Sleepy (somnolent) and RR will drop
Patient with ards can develop emphysema if their mechanical vent and high PEEP
a. Statement
Patients with ards there are two O2s to determine if proning is effective with improving oxygenation. 2 questions
a. PaO2
b. SaO2
delegation : what can you delegate to an LVN with patient on mechanical ventilator? Choose one
a. RN will prone patient, monitor breath sounds, central venous pressure
b. RN can delegate to LVN to insert foley catheter
b. RN can delegate to LVN to insert foley catheter
Positive pressure ventilation with a patient with ARDS and a NG tube with what color in
drainage what does that mean?
Red, brown drainage indicate GI bleeding
How do you check a person’s oxygenation levels?
Pulse oximeter
81 year old lady with a broken hip what are we going to look at? 2 answers only
Check albumin levels (shows nutrition/protein) and weight loss
ABG results that are abnormal?
pH: 7.28
A person who has a positive and expiratory pressure peep (increased pressure) can cause what?
Can decline blood pressure: hypotension
If you find that your PEEP is worsening and at a level in regards to the water, what
means an emergency to call the doctor
If lung sounds are greater one side, call doctor immediately; it can be a pneumothorax
Guillain barre patient that is hyperventilating what ABG is gonna be increased?
High PaCO2
Hallmark manifestation of ARDS
Refractory Hypoxemia
A patient with an ETT with a cuff leak what are we going to hear?
a. Hissing sound
SATA (3 answers) Patient diagnosed with sepsis and on mechanical ventilator, which
criteria shows they are improving and starting to wean off ventilator
a. Hgb in normal range above 7.5
b. No systemic problems (no sepsis)
c. Initiate inspiratory efforts or breath in and breath out (weaned off ventilator)
When you are removing a copious amount of secretion from a patient trach what are you going to do first?
always administer 100% oxygen for over 2 minutes
