A patient develops increasing dyspnea and hypoxemia 2 days after ...

[nmorano1]

A patient develops increasing dyspnea and hypoxemia 2 days after heart surgery. To determine whether the patient has acute respiratory distress syndrome (ARDS) or pulmonary edema caused by heart failure, the nurse will plan to assist with
 
  a. obtaining a ventilation-perfusion scan.
  b. drawing blood for arterial blood gases.
  c. insertion of a pulmonary artery catheter.
  d. positioning the patient for a chest x-ray.

Question 2

A nurse is caring for an obese patient with right lower lobe pneumonia. Which position will be best to improve gas exchange?
 
  a. On the left side
  b. On the right side
  c. In the tripod position
  d. In the high-Fowler's position

[potomatos]

Answer to Question 1

ANS: C
Pulmonary artery wedge pressures are normal in the patient with ARDS because the fluid in the alveoli is caused by increased permeability of the alveolar-capillary membrane rather than by the backup of fluid from the lungs (as occurs in cardiogenic pulmonary edema). The other tests will not help in differentiating cardiogenic from noncardiogenic pulmonary edema.

Answer to Question 2

ANS: A
The patient should be positioned with the good lung in the dependent position to improve the match between ventilation and perfusion. The obese patient's abdomen will limit respiratory excursion when sitting in the high-Fowler's or tripod positions.

[nmorano1]

Excellent

[kishoreddi]

Gracias!