Respiratory Failure

Which of the following situations typically have a slow progression from optimal to impaired gas exchange? Select all that apply.

• Chronic Obstructive Pulmonary Disease (COPD)

• Acute Respiratory Distress Syndrome (ARDS)

• Pulmonary Embolism

• Pulmonary Fibrosis

Which of the following situations can lead to a very quick progression from optimal to impaired gas exchange? Select all that apply.

• Pneumonia

• Pulmonary Embolism

• Chronic Obstructive Pulmonary Disease (COPD) Exacerbation

• Asthma Attack

Organize these options into the right categories

Groups:

(a) Hypoxemic

,

(b) Hypercapnic

• Oxygenation failure

• Anatomic shunt

• PaO2 < 60 mmHg on 60% O2

• PaCO2 > 45mmHg and pH <7.35

• Ventilatory failure

• pulmonary embolism

• MVA / Multiple rib fractures

• Opioid overdose

• Intrapulmonary shunt

Match the following

• What does having a V/Q mismatch mean?

• For every one milliliter of air that we are breathing we have one milliliter of blood flow to the lungs

• Perfusion (Q)

• Blood movement to the alveoli

• What does having an ideal V/Q ratio mean

• Air movement to the alveoli

• Ventilation (V)

• 1:1

• What is an ideal V/Q ratio

• There is a lack of ventilation or a lack of perfusion or both

Lable the image with the correct V/Q ratio

a

b

c

1:1

0:1

1:0

A patient has a small change in mental status and is getting fatigued. What is your first nursing priority?

• Deliver 6L NC oxygen

• Put the patient in high Fowler's position

• Assess the patient's SpO2

• Get an ABG

After a change of shift, you are assigned to care for the following patients. Which patient should you see first?

• 57-year-old patient with COPD and a pulse oximetry reading from the previous shift of 90% saturation.

• 72-year-old patient with pneumonia who needs to be started on IV antibiotics.

• 51-year-old with asthma who reports shortness of breath after using a bronchodilator.

• 68-year-old patient on a ventilator for whom a sterile sputum specimen must be sent to the laboratory.

A patient has chronic obstructive pulmonary disease (COPD).  Which intervention for airway management should you delegate to the unlicensed assistive personnel (UAP)?

• Assisting the patient to sit up on the side of the bed.

• Teaching the patient to cough effectively.

• Auscultating breath sounds every 4 hours.

• Instructing the patient to cough effectively.

A patient with chronic obstructive pulmonary disease (COPD) arrives in the emergency department complaining of shortness of breath and dyspnea. Which assessment finding by the nurse is most important to report to the health care provider?

• The patient has bibasilar lung crackles.

• The patient is sitting in the tripod position.

• The patient’s respiratory rate has decreased from 30 to 10 breaths/min.

• The patient’s pulse oximetry indicates an O2 saturation of 91%.

The nurse is assigned a group of patients. Which patient would the nurse identify as being at increased risk for impaired gas exchange? A patient:

• who has been on anticoagulants for 10 days.

• with a heart rate of 100 beats/min and blood pressure of 100/60

• with a blood glucose of 350 mg/dL.

• with a hemoglobin of 8.5 g/dL