Mechanical Ventilation Practice Questions

Mechanical Ventilation Practice Questions 5.0 (1 review) Terms in this set (24) Science MedicineNursing Save The nurse is caring for a client who is intubated for mechanical ventilation.Which intervention(s) will the nurse implement to reduce the client's risk of injury? Select all that apply.-Position with head above the stomach level.-Provide oral hygiene.-Assess for a cuff leak.-Reduce pulling on ventilator tubing.-Monitor cuff pressure every 8 hours.-Position with head above the stomach level.-Provide oral hygiene.-Assess for a cuff leak.-Reduce pulling on ventilator tubing.-Monitor cuff pressure every 8 hours

Explanation:

Maintaining the endotracheal or tracheostomy tube is an essential part of airway management. Oral hygiene is provided frequently because the oral cavity is a primary source of lung contamination in the client who is intubated. Assessing for a leak from the cuff of the endotracheal tube needs to be done at the same time as providing other respiratory care. Ventilator tubing should be positioned so that there is minimal pulling or distortion of the tube in the trachea which reduces the risk of trauma to the trachea. Cuff pressure is monitored every 8 hours to maintain the pressure at 20 to 25 mm Hg. The head of the bed should be higher than the stomach to reduce the risk of aspiration.

The nurse is using an in-line suction kit to suction a patient who is intubated and on a mechanical ventilator. What benefits does inline suction have for the patient? (Select all that apply.) -Prevents aspiration -Decreases hypoxemia -Sustains positive end expiratory pressure (PEEP) -Increases oxygen consumption -Decreases patient anxiety -Decreases hypoxemia -Sustains positive end expiratory pressure (PEEP) -Decreases patient anxiety

Explanation:

An in-line suction device allows the patient to be suctioned without being disconnected from the ventilator circuit. In-line suctioning (also called closed suctioning) decreases hypoxemia, sustains PEEP, and can decrease patient anxiety associated with suctioning (Sole et al., 2013).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?Select all that apply.-Pulse oximeter -Tracheostomy cleaning kit -Hemostat -Water-seal chest drainage set-up -Manual resuscitation bag -Pulse oximeter -Manual resuscitation bag

Explanation:

The client with COPD depends on mechanical ventilation for adequate tissue oxygenation. The nurse must keep a manual resuscitation bag at the bedside to ventilate and oxygenate the client in case the mechanical ventilator malfunctions. The nurse needs to keep an oxygen analyzer (pulse oximeter) on hand to evaluate the effectiveness of ventilation. Because the client doesn't have chest tubes or a tracheostomy, keeping a water-seal chest drainage set-up or a tracheostomy cleaning kit or hemostat at the bedside isn't necessary.

The nurse should monitor a client receiving mechanical ventilation for which of the following complications?-Increased cardiac output -Pulmonary emboli -Gastrointestinal hemorrhage -Immunosuppression -Gastrointestinal hemorrhage

Explanation:

Gastrointestinal hemorrhage occurs in approximately 25% of clients receiving prolonged mechanical ventilation. Other possible complications include incorrect ventilation, oxygen toxicity, fluid imbalance, decreased cardiac output, pneumothorax, infection, and atelectasis.Immunosuppression and pulmonary emboli are not direct consequences of mechanical ventilation.A young male client has muscular dystrophy. His PaO2 is 42 mm Hg with a FiO2 of 80%. Which of the following treatments would be least invasive and most appropriate for this client?-Continuous positive airway pressure

(CPAP)

-Negative-pressure ventilator -Bilevel positive airway pressure (Bi- PAP) -Positive-pressure ventilator -Negative–pressure ventilator

Explanation:

This client needs ventilatory support. His PaO2 is low despite receiving a high dose of oxygen. The iron lung or drinker respiratory tank is an example of a negative–pressure ventilator. This type of ventilator is used mainly with chronic respiratory failure associated with neurological disorders, such as muscular dystrophy. It does not require intubation of the client. The most common ventilator is the positive–pressure ventilator, but this involves intubation with an endotracheal tube or tracheostomy. CPAP is used for obstructive sleep apnea. Bi–PAP is used for those with severe COPD or sleep apnea who require ventilatory assistance at night.

A mechanically ventilated client is receiving a combination of atracurium and the opioid analgesic morphine. The nurse monitors the client for which potential complication?-Venous thromboemboli -Pneumothorax -Cor pulmonale -Pulmonary hypertension -Venous thromboemboli

Explanation:

Neuromuscular blockers predispose the client to venous thromboemboli (VTE), muscle atrophy, foot drop, peptic ulcer disease, and skin breakdown.Nursing assessment is essential to minimize the complications related to neuromuscular blockade.The client may have discomfort or pain but be unable to communicate these sensations.The health care provider has prescribed continuous positive airway pressure (CPAP) with the delivery of a client's high-flow oxygen therapy. The client asks the nurse what the benefit of CPAP is.What would be the nurse's best response?-CPAP allows for the elimination of bacterial growth in oxygen delivery systems.-CPAP allows for greater humidification of the oxygen that is given.-CPAP allows a lower percentage of oxygen to be used with a similar effect.-CPAP allows a higher percentage of oxygen to be safely used.-CPAP allows a lower percentage of oxygen to be used with a similar effect.

Explanation:

Prevention of oxygen toxicity is achieved by using oxygen only as prescribed. Often, positive end- expiratory pressure (PEEP) or CPAP is used with oxygen therapy to reverse or prevent microatelectasis, thus allowing a lower percentage of oxygen to be used. Oxygen is moistened by passing through a humidification system. Changing the tubing on the oxygen therapy equipment is the best technique for controlling bacterial growth.