Nursing Care and Respiratory Conditions

A nurse is caring for a patient who is postoperative and receiving oxygen via a face mask at 10 L/min. The nurse notes that the patient is experiencing dry mucous membranes and thick secretions. Which of the following actions should the nurse take?

• Increase the oxygen flow rate.

• Switch the patient to a nasal cannula.

• Provide a humidifier for the oxygen therapy.

• Administer an antitussive medication.

A nurse is caring for a patient who has been on a ventilator for 3 days. The patient’s arterial blood gas results show a pH of 7.35, PaCO2 of 50 mmHg, PaO2 of 80 mmHg, and HCO3 of 24 mEq/L. What should the nurse interpret these findings to indicate?

• Respiratory acidosis with adequate oxygenation.

• Respiratory alkalosis with inadequate oxygenation.

• Metabolic acidosis with inadequate ventilation.

• Normal acid-base balance and adequate oxygenation.

A nurse is assessing a patient with pneumonia. The nurse notes that the patient's respiratory rate is 28 breaths per minute, the patient is using accessory muscles to breathe, and the oxygen saturation is 90%. Which action should the nurse take first?

• Reposition the patient to a semi-Fowler's position.

• Encourage the patient to cough and deep breathe.

• Administer supplemental oxygen as prescribed.

• Perform a sputum culture to identify the pathogen.

A patient with asthma is admitted to the emergency department with shortness of breath, wheezing, and a decreased oxygen saturation level of 88%. Which intervention will the nurse implement as a priority intervention?

• Administer a dose of a bronchodilator as ordered.

• Perform a complete respiratory assessment.

• Place the patient in a high-Fowler’s position.

• Prepare for possible intubation.

A nurse is caring for a patient who is in respiratory failure and is being mechanically ventilated. The nurse is reviewing the patient’s ventilator settings. Which of the following settings should the nurse monitor closely to prevent further complications of respiratory failure?

• Tidal volume

• Respiratory rate

• Fraction of inspired oxygen (FiO2)

• Positive end-expiratory pressure (PEEP)

A patient with respiratory failure is receiving non-invasive positive pressure ventilation (NIPPV) for assistance with breathing. Which of the following interventions is most important for the nurse to include in the plan of care?

• Ensure the patient is comfortable and well-positioned in bed.

• Assess the patient’s respiratory rate and oxygen saturation every 8 hours.

• Provide oral suctioning every 4 hours to maintain airway clearance.

• Assess the patient’s skin under the mask for pressure ulcers.

A nurse is caring for a patient with respiratory failure and mechanical ventilation. The patient is being weaned from the ventilator, and the nurse notes that the patient’s respiratory rate is 32 breaths per minute with a PaCO2 of 48 mmHg. Which of the following actions should the nurse take?

• Continue the weaning process, as the patient is progressing.

• Assess the patient for signs of respiratory distress and notify the healthcare provider.

• Increase the ventilator settings to higher pressure support.

• Provide oxygen therapy and monitor the patient’s pulse oximetry.

A patient in respiratory failure is receiving non-invasive positive pressure ventilation (NIPPV) via a BiPAP machine. The nurse notes that the patient’s oxygen saturation is decreasing despite the intervention. What is the most appropriate action the nurse should take?

• Increase the pressure support on the BiPAP machine.

• Increase the oxygen flow rate via the BiPAP machine.

• Switch to invasive mechanical ventilation.

• Administer a bronchodilator and reassess the patient.

A nurse is caring for a patient who is receiving mechanical ventilation. The nurse is assessing the patient's ventilator settings and notices that the patient's tidal volume is set to 400 mL. The nurse recognizes that which of the following factors should be considered when setting tidal volume for mechanical ventilation?

• The patient’s weight and lung compliance

• The patient’s age and respiratory rate

• The patient’s baseline oxygen saturation level

• The patient's blood pressure and heart rate

A nurse is monitoring a patient with acute respiratory failure who is receiving mechanical ventilation. Which of the following is the most important nursing intervention to prevent ventilator-associated pneumonia (VAP)?

• Administer antibiotics as prescribed.

• Elevate the head of the bed to 30 to 45 degrees.

• Sedate the patient to ensure adequate rest.

• Wean the patient off the ventilator as quickly as possible.