Author Question: The nurse is caring for a patient with idiopathic pulmonary arterial hypertension (IPAH) who is ... (Read 34 times)

rachel9 · **on:** Jun 25, 2018

The nurse is caring for a patient with idiopathic pulmonary arterial hypertension (IPAH) who is receiving epoprostenol (Flolan). Which assessment information requires the most immediate action by the nurse?

a. The oxygen saturation is 94.
b. The blood pressure is 98/56 mm Hg.
c. The patient's central IV line is disconnected.
d. The international normalized ratio (INR) is prolonged.

Question 2

The nurse notes that a patient has incisional pain, a poor cough effort, and scattered rhonchi after a thoracotomy. Which action should the nurse take first?

a. Assist the patient to sit upright in a chair.
b. Splint the patient's chest during coughing.
c. Medicate the patient with prescribed morphine.
d. Observe the patient use the incentive spirometer.

rleezy04 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: C
The half-life of this drug is 6 minutes, so the nurse will need to restart the infusion as soon as possible to prevent rapid clinical deterioration. The other data also indicate a need for ongoing monitoring or intervention, but the priority action is to reconnect the infusion.

Answer to Question 2

ANS: C
A major reason for atelectasis and poor airway clearance in patients after chest surgery is incisional pain (which increases with deep breathing and coughing). The first action by the nurse should be to medicate the patient to minimize incisional pain. The other actions are all appropriate ways to improve airway clearance but should be done after the morphine is given.