NUR 254 TEST 3 Ch.2 - ARDS? Answer Sepsis ( & aspiration are the most...

NUR 254 TEST 3 Ch.2

• The nurse would carefully assess a pt with for the development of

ARDS?

Answer Sepsis ( & aspiration are the most likely to develop ARDS)

• A pt with ARDS are anxious all morning. They are now less responsive & difficult to

arouse.This is likely due to?

Answer Hypercapnia (hypercarbia) = increase in carbon dioxide in the bloodstream

• The nurse inspects the chest of a patient with ARDS and notices the musculature in between

the ribs "dipping in" with breathing. This would be accurately documented as?

Answer Intercostal retractions

• What is the reason a pt would receive Rocoronium or Succinylcholine?

Answer

• They are non-sedating, non-amnesic and non-analgesic drugs. Sometimes used in severe

ARDs pt who are mechanically ventilated and who need paralytic agents to prevent barotrauma and have better respirations with the vent.

**Typically found in Rapid Sequence Intubation (RSI) kits and used for initial intubation

• PEEP is increased from 5 to 10 for a pt w/ ARDS. What is a major pulmonary complication

the nurse should assess for related to this change?

Answer Barotrauma (such as pneumothorax)

• Which clinical manifestation is highly indicative of ARDS (as opposed to some other

complication)? 1 / 2

Answer

Refractory hypoxemia

• The nurse should implement which of the following interventions for a mechanically

ventilated pt?

Answer Explain all care activities

• What are the expected outcomes of mechanical ventilation for a pt w/ ARDS for the O2

saturation measurement & the PaO2 measurement?

Answer O2 sat >90% & PaO2 > 60mmHg

• The nurse is assessing a pt on a ventilator who started a "weaning trial" 30 min ago. Provide 3

assessment findings that indicate the trial is unsuccessful & needs to be stopped?

Answer Tachypnea

Tachycardia Labored breathing O2 saturation dropping Any other signs of increasing respiratory distress

• Shock is a SYNDROME resulting from a decrease in , that

causes inadequate resulting in ischemic organs/tissues that cannot carry out cellular metabolism?

Answer blood flow;oxygenation

• When monitoring for effectiveness of treatment, which value is often used to titrate

medications such as norepinepherine as it is an indicator of tissue perfusion?

Answer MAP

• What finding indicated progression from early to intermediate shock?
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