A patient with respiratory failure has a respiratory rate of 6 ...

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A patient with respiratory failure has a respiratory rate of 6 breaths/minute and an oxygen saturation (SpO2) of 88. The patient is increasingly lethargic. Which intervention will the nurse anticipate?
 
  a. Administration of 100 oxygen by non-rebreather mask
  b. Endotracheal intubation and positive pressure ventilation
  c. Insertion of a mini-tracheostomy with frequent suctioning
  d. Initiation of continuous positive pressure ventilation (CPAP)

Question 2

While caring for a patient who has been admitted with a pulmonary embolism, the nurse notes a change in the patient's oxygen saturation (SpO2) from 94 to 88. Which action should the nurse take next?
 
  a. Increase the oxygen flow rate.
  b. Suction the patient's oropharynx.
  c. Instruct the patient to cough and deep breathe.
  d. Help the patient to sit in a more upright position.

[potomatos]

Answer to Question 1

ANS: B
The patient's lethargy, low respiratory rate, and SpO2 indicate the need for mechanical ventilation with ventilator-controlled respiratory rate. Administration of high flow oxygen will not be helpful because the patient's respiratory rate is so low. Insertion of a mini-tracheostomy will facilitate removal of secretions, but it will not improve the patient's respiratory rate or oxygenation. CPAP requires that the patient initiate an adequate respiratory rate to allow adequate gas exchange.

Answer to Question 2

ANS: A
Increasing oxygen flow rate will usually improve oxygen saturation in patients with ventilation-perfusion mismatch, as occurs with pulmonary embolism. Because the problem is with perfusion, actions that improve ventilation, such as deep breathing and coughing, sitting upright, and suctioning, are not likely to improve oxygenation.

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Thank you

[potomatos]

No problemo