A patient is suffering from hypoxemia, dysrhythmias, bronchospasm during suctioning. Identify what methods you would use to assess the patient's status during suctioning and describe what precautions should be taken to prevent each of the hazards mentioned.
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1) A patient is suffering from hypoxemia, dysrhythmias, bronchospasm during suctioning. Identify what methods you would use to assess the patient's status during suctioning and describe what precautions should be taken to prevent each of the hazards mentioned.
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- Scenario: Maria Reyes, 67 years old, is seen at a health clinic with rapid short breaths accompanied by blood-streaked sputum, pleuritic chest pain, fever, and recurrent chills. The following questions will assist the nursing student in the assessment of this client suspected for pneumonia. 1.) What should the nurse note or observe when counting respirations? 2.)How is tactile fremitus assessed? 3.) Describe the method for checking diaphragmatic axcursion. 4.) Describe the pattern of percussion to the anterior and posterior thorax. 5.) What is the characteristic tone when percussing normal lung tissue? 6.) Describe the different techniques in voice auscultation.At 11 p.m., a patient is admitted to the Emergency Department (ED) with a respiratory rate of 44 breaths/minute and SaO2 85%. They are anxious with audible wheezes. The patient is immediately given nebulised Salbutamol follow by oxygen via face mask and Hydrocortisone intravenously (i.v) Explain the reason for intravenous (JV) Hydrocortisone. . Provide two (2) nursing interventions with rationales to improve airway clearance and/or improve breathing patternpatient starts to complain that they are finding it difficult to breathe after insertion of nasogastric. They are displaying more effort required for work of breathing (WOB), diaphoresis, cyanosis and some confusion. Explain your nursing management and what assessments you need to perform. (rationale included)
- A nurse is administering a blood transfusion for a patient following surgery. During the transfusion, the patient dis-plays signs of dyspnea, dry cough, and pulmonary edema. What would be the nurse’s priority actions related to thesesymptoms?a. Slow or stop the infusion; monitor vital signs, notify thephysician, place the patient in upright position with feetdependent.b. Stop the transfusion immediately and keep the vein openwith normal saline, notify the physician stat, administerantihistamine parenterally as needed.c. Stop the transfusion immediately and keep the veinopen with normal saline, notify the physician, andtreat symptoms.d. Stop the infusion immediately, obtain a culture of thepatient’s blood, monitor vital signs, notify the physician,administer antibiotics stat.A patient admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/ minute via nasal prongs. The patient’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD), because of these history findings ,the Nurse closely monitors the oxygen flow and the patient's respiratory status Explain the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD) Which complication may arise if the patient receives a high oxygen concentration? List two (2) nursing Interventions with rationales for this patient mark for each nursing intervention 2 marks for each rationaleA nurse is caring for a client who presented to the emergency department with an acute asthma exacerbation. The respiratory rate is 36 breaths/min, and a pulse oximeter is 85% on room air with accessory muscle use to breathe. The nurse placed the client on oxygen 4 liters nasal cannula. The arterial blood gas (ABG) is as follows: pH: 7.28, PaCO2: 50 mm Hg, PaO2: 75 mm Hg, and HCO3: 26 mEq/L. Which of the following treatments is the nurse's highest priority? A) Administer bronchodilators B) Administer sodium bicarbonate Administer methylprednisolone (D) Perform a chest x-ray
- The nurse is teaching a patient about the inhaler Advair (salmeterol/fluticasone). Which statements by the patient indicate a correct understanding of this medication? Select all that apply.a) “I will rinse my mouth with water after each dose.”b) “I need to use this inhaler whenever I feel short of breath, but not less than 4 hours between doses.”c) “This medication is taken twice a day, every 12 hours.”d) “I can take this inhaler if I get short of breath while exercising.”e) “I will call my doctor if I notice white patches inside my mouthFor each of the following Patient Profiles, determine the most appropriate triage category (red, yellow, green, or black), and why. patient profiles: 1. C/O severe abdominal pain/Arm Lac - conscious - respirations : 16/min - radial pulse : present 2. asthma attack: audible wheezing - tells you his having an asthma attack - respirations : 28/min - radial pulse : present 3. pinned by beam now removed, no feelings in legs - tells you she can't feel her legs - respirations : 18/min - radial pulse : present 4. no obvious injuries - does not respond to commands - respirations : 16/min - radial pulse : present 5. multiple lacerations from glass - tells you he is going to throw up - respirations : 26/min - radial pulse : rapid and threadyFor each of the following Patient Profiles, determine the most appropriate triage category (red, yellow, green, or black), and why. patient profiles: 1. severe right leg pain - tells you his legs hurt - respirations : 26/min - radial pulse : present 2. patient pinned under large bench - moans weakly when you talk to her - respirations : 36/min - radial pulse : absent 3. chest pain, dyspnea, cardiac history - tells you shes having trouble in breathing - respirations : 18/min - radial pulse : present 4. dislocated shoulder-bleeding - tells you his shoulder hurt - respirations : 26/min - radial pulse : present 5. cyanotic -unconscious - respirations : begins breathing when you open the airway - radial pulse : present
- Scenario Description: Juan Ferguson 50-year-old man with long-term emphysema who has become dyspneic and has been brought to the Emergency Department by paramedics and now is admitted to your floor for admission. He arrives alert and anxious, wheezing and still dyspneic. An IV has been started. Oxygen is started. What is my client’s primary and possible secondary diagnosis? What signs and symptoms would I expect to see with primary and secondary diagnosis? What do I need to assess? What is my top three priority assessments for this client? (Airway, breathing, circulation) What is my focused assessment for this patient and any nursing interventions I may need? What are the signs/symptoms that my client may exhibit if their condition is worsening? Give one or two reasons you would want to contact the healthcare provider?Scenario 1: Mr. Pickwick has obstructive sleep apnea, and the doctor has ordered him to be placed on BiPAP at the following settings: mode, S/T; rate, 12 breaths/minute; IPAP = 12 cm H2O; EPAP = 6 cm H2O. You enter his room, identify yourself, and explain everything to him. You also perform a complete assessment. After applying BiPAP, you note a drop in blood pressure and oxygen saturation. 1) What would you recommend to Mr. Pickwick for infection control in the home?Scenario 1: Mr. Pickwick has obstructive sleep apnea, and the doctor has ordered him to be placed on BiPAP at the following settings: mode, S/T; rate, 12 breaths/minute; IPAP = 12 cm H2O; EPAP = 6 cm H2O. You enter his room, identify yourself, and explain everything to him. You also perform a complete assessment. After applying BiPAP, you note a drop in blood pressure and oxygen saturation. What are possible causes of the drop in blood pressure and Spo2 and what changes or modifications would you recommend?