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Respiratory Devices

Total questions: 10

Worksheet time: 20mins

Name
Class
Date
1.

Philly Mona is a 2 ppd smoker with a history of COPD who arrives to the ED with complaints of shortness of breath. He recently was on a steroid for a respiratory virus and states he has completed his medication regimen. His o2 sat on arrival is fluctuating between 87-89%. What respiratory device does Philly need?

a)

high flow nasal cannula

b)

simple mask

c)

nasal cannula

d)

no oxygen device

2.

Philly is now complaining that his nose is dry and itchy. He keeps pulling at the oxygen device you applied and removing it from his nose. What can you do to make Philly more comfortable and keep his respiratory device in his nose?

a)

Let Philly remove the device

b)

Get an order for a sitter to ensure Philly keeps it in his nose

c)

Yell at Philly to keep the device in his nose

d)

Apply a low flow bubbler for humidification

3.

Upon further workup, Philly was diagnosed with community acquired pneumonia. Philly has required oxygen titration throughout his time in the ED. He was transferred from the ED to 4 East for IV antibiotics and oxygen therapy. He is now on 6L and has an Spo2 of 86%. What intervention should you do for Philly?

a)

Titrate his nasal cannula o2 up to 8L

b)

Switch him to a high flow nasal cannula and titrate his o2 up to 8L

c)

Continue to monitor him

d)

Switch him to a simple mask and titrate his o2 up to 8L

4.

What else should you do for Philly when switching him over to a high flow nasal cannula?

a)

Switch the low flow bubbler to the high flow bubbler and fill with sterile water

b)

Make sure the low flow bubbler is full

c)


Switch the low flow bubbler to the high flow bubbler and fill with normal saline

d)

Hook up the sterile inhalation solution

5.

Alba Wheezy is being recovered in PACU after having a cholecystectomy. She has a history of ESRD, asthma, copd, and hyperlipidemia. The PACU nurse transfers Alba to 5 east. You are the receiving nurse. In report, you are told that Alba is drowsy but easily arousable and oriented, NSR, on 5L simple mask with an Spo2 of 99%, with minimal pain. What should you do for Alba Wheezy?

a)

apply a nasal cannula and titrate O2 down


b)

decrease the simple mask to 2L


c)

monitor Alba on room air


d)

remove the simple mask


6.

It's been 20 minutes since you changed out Alba’s respiratory device. She has been sleeping comfortably, but her Spo2 is 87% on 5L. What intervention can you try to help Alba?


a)

Apply humidification to her nasal cannula


b)

Call a MET


c)

Switch her to an oxymask


d)

increase her nasal cannula to 8L


7.

It is now night shift, and you go in to do your shift assessment on Alba. The Day shift nurse said she gave Alba 3 doses of pain medication post-surgery and after her last dose she has been resting well. Upon assessment you are having difficulty arousing Alba Wheezy. Her Spo2 is 81% on 6L via oxymask. What should you do?


a)

Call Rapid Response Nurse or MET


b)

Use adult emergency protocol to order an ABG


c)

Increase Oxygen to 15L


d)

Use adult emergency protocol to order a troponin


8.

The stat ABG drawn on Alba showed: pH- 7.25, Hco3- 19, Pao2- 65, PaCo2- 65. Subsequently she was placed on a Bipap for 2 hours. A repeat ABG was drawn after 2 hours and showed: pH- 7.30, Hco3- 20, Pao2- 69, PaCo2- 52. What is the best nursing intervention for Alba?


a)

Remove the Bipap and place on a high flow nasal cannula


b)

Remove the Bipap and place on a nasal cannula


c)

Remove the Bipap and place on an oxymask


d)

Continue the Bipap


9.

Flo Nasolot is a lung cancer patient that came into the ED with moderate respiratory distress. She is a DNR/DNI but has been continuing full cancer treatment.  Flo’s Spo2 is 74% on 15L oxymask and she has not been able to tolerate a Bipap. What should we do for Flo?


a)

Apply the high flow nasal interface


b)

Intubate Flo


c)

Encourage Flo to pursue comfort measures


d)

Apply the Bipap and put Flo in restraints so she can't pull it off


10.

Trey Kia is a chronic trach patient admitted to your floor for influenza A. Trey has been coughing up thick tan sputum throughout the day and is requiring 4L oxygen via trach collar. Trey's Spo2 decreases from 94% to 86% after a coughing fit. What are our priorities that we should we do for Trey?


a)

Hyperoxygenate Trey Kia


b)

Use a 14 Fr catheter to suction Trey to assist in clearing his secretions


c)

Call a Code Blue


d)

Call respiratory to let them know of changes to Trey