The nurse is caring for a 78-year-old patient who was ...

[kamilo84]

The nurse is caring for a 78-year-old patient who was hospitalized 2 days earlier with community-acquired pneumonia. Which assessment information is most important to communicate to the health care provider?
 
  a. Scattered crackles bilaterally in the posterior lung bases.
  b. Persistent cough that is productive of blood-tinged sputum.
  c. Temperature of 101.5 F (38.6 C) after 2 days of IV antibiotic therapy.
  d. Decreased oxygen saturation to 90 with 100 O2 by non-rebreather mask.

Question 2

A nurse is caring for a patient with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation using synchronized intermittent mandatory ventilation (SIMV).
 
  The settings include fraction of inspired oxygen (FIO2) 80, tidal volume 450, rate 16/minute, and positive end-expiratory pressure (PEEP) 5 cm. Which assessment finding is most important for the nurse to report to the health care provider?
  a. Oxygen saturation 99
  b. Respiratory rate 22 breaths/minute
  c. Crackles audible at lung bases
  d. Heart rate 106 beats/minute

[vseab]

Answer to Question 1

ANS: D
The patient's low SpO2 despite receiving a high fraction of inspired oxygen (FIO2) indicates the possibility of acute respiratory distress syndrome (ARDS). The patient's blood-tinged sputum and scattered crackles are not unusual in a patient with pneumonia, although they do require continued monitoring. The continued temperature elevation indicates a possible need to change antibiotics, but this is not as urgent a concern as the progression toward hypoxemia despite an increase in O2 flow rate.

Answer to Question 2

ANS: A
The FIO2 of 80 increases the risk for oxygen toxicity. Because the patient's O2 saturation is 99, a decrease in FIO2 is indicated to avoid toxicity. The other patient data would be typical for a patient with ARDS and would not need to be urgently reported to the health care provider.

[kamilo84]

Correct answers!

[vseab]

Great! Please up vote