Author Question: The nurse is concerned that a patient with traumatic chest injures is developing respiratory ... (Read 98 times)

cabate

  • Hero Member
  • *****
  • Posts: 537
The nurse is concerned that a patient with traumatic chest injures is developing respiratory distress. What assessment findings led the nurse to come to this conclusion?
 
  Select all that apply.
 
  1. combative behavior
  2. absent breath sounds in left lower lobe
  3. pedal and popliteal pulses weak and irregular
  4. temperature raised 2 degrees over the last 4 hours
  5. oxygen saturation 86 on 40 oxygen face mask

Question 2

Emergency personnel are preparing to complete an on-the-scene rapid assessment of a victim of a motor vehicle crash. In which order should the victim's assessment be completed? Place the assessments in order of importance.
 
  1. assessment for obvious injuries
  2. Champion Revised Trauma Scoring System
  3. airway and breathing assessment
  4. circulation assessment
  5. level of consciousness and pupillary function



matt95

  • Sr. Member
  • ****
  • Posts: 317
Answer to Question 1

Correct Answer: 1, 2, 5

An early sign of an ineffective airway is a change in the patient's behavior. If the patient becomes combative, the nurse immediately assesses the effectiveness of the airway. Absent breath sounds can indicate airway obstruction. Oxygen saturation is a measurement of airway effectiveness. Oxygen flow should be adjusted to keep saturation level between 94 and 100. Changes in lower extremity pulses indicate an alteration in perfusion. Changes in body temperature indicate an infectious process.

Answer to Question 2

Correct Answer: 3, 4, 5, 1, 2

The airway and breathing assessment is completed first and the circulatory assessment second, following the principle of the ABCs. The airway must be patent to provide oxygen to the vital organs. The level of consciousness and pupillary function will indicate any head injury/spinal cord injury that must be immobilized before transport. The fourth step is to assess for obvious injuries. The Champion Revised Trauma Scoring System will indicate the patient's chance of survival based on the Glasgow Coma Scale, systolic blood pressure, and respiratory rate.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question


 

Did you know?

A cataract is a clouding of the eyes' natural lens. As we age, some clouding of the lens may occur. The first sign of a cataract is usually blurry vision. Although glasses and other visual aids may at first help a person with cataracts, surgery may become inevitable. Cataract surgery is very successful in restoring vision, and it is the most frequently performed surgery in the United States.

Did you know?

As of mid-2016, 18.2 million people were receiving advanced retroviral therapy (ART) worldwide. This represents between 43–50% of the 34–39.8 million people living with HIV.

Did you know?

The Centers for Disease Control and Prevention (CDC) was originally known as the Communicable Disease Center, which was formed to fight malaria. It was originally headquartered in Atlanta, Georgia, since the Southern states faced the worst threat from malaria.

Did you know?

Medications that are definitely not safe to take when breastfeeding include radioactive drugs, antimetabolites, some cancer (chemotherapy) agents, bromocriptine, ergotamine, methotrexate, and cyclosporine.

Did you know?

More than 4.4billion prescriptions were dispensed within the United States in 2016.

For a complete list of videos, visit our video library