The nurse in the intensive care unit (ICU) is caring for a client ...

[09madisonrousseau09]

The nurse in the intensive care unit (ICU) is caring for a client diagnosed with acute respiratory distress syndrome (ARDS). Vital signs prior to endotracheal intubation: HR 108 bpm, RR 32 bpm, BP 88/58 mmHg, and oxygen saturation 82.
 
  The client is intubated and placed on mechanical ventilation with positive pressure ventilation. Which assessment finding indicates a further decrease of cardiac output secondary to positive pressure ventilation?
  A) Blood pressure 90/60 mmHg
  B) Urine output 25mL/hr
  C) Heart rate 110 bpm
  D) Oxygen saturation 90

Question 2

A client admitted with smoke inhalation injuries develops signs and symptoms of acute respiratory distress syndrome (ARDS). The nurse anticipates the healthcare provider will prescribe which course of action with regard to oxygen therapy?
 
  A) Oxygen via a nasal cannula
  B) Mechanical ventilation
  C) Oxygen via a facial mask
  D) Oxygen via a venturi mask

[sarahccccc]

Answer to Question 1

Answer: B

Decreased cardiac output is supported with by a decrease of urine output. Expected urine output is at least 30 mL/hr. This client's urine output is decreased; therefore this finding supports the diagnosis of decreased cardiac output. Although hypotension and tachycardia are indicative of a decreased cardiac output, this is not a change from the previous assessment and would not indicate a further decrease in cardiac output due to mechanical ventilation. The oxygen saturation level is within normal limits for this client and improving from the previous assessment.

Answer to Question 2

Answer: B

With ARDS, it is rarely possible to maintain adequate tissue oxygenation with oxygen therapy alone. With mechanical ventilation, the FiO2 (fraction of inspired oxygen-the percentage of oxygen administered) is set at the lowest possible level to maintain a PaO2 higher than 60 mmHg and oxygen saturation of approximately 90. It is important to remember that mechanical ventilation does not cure ARDS; it simply supports respiratory function while the underlying problem is identified and treated.

[09madisonrousseau09]

TYSM

[yeungji]

Excellent