Question 2
Your client has just returned from surgery for removal of an abdominal tumor. The postoperative arterial blood gas values are pH 7.34 PaCO2 53 mmHg HCO3 25 mEq/L PaO2 70 mmHg SaO2 91%
The nurse should
- have the client breathe into a rebreather bag at a slow rate.
- prepare for intubation.
- encourage the client to cough productively and take deep breaths.
- obtain a medical order for the administration of sodium bicarbonate.
Question 3
On an intubated client which of the following interventions would potentially correct ABG results indicating respiratory acidosis?
- Sedate and paralyze the client
- Increase the rate and/or tidal volume
- Increase the PEEP
- Increase the FiO2 and/or PEEP
Question 4
Which arterial blood gas (ABG) report would the nurse expect in a client developing early ARDS?
- pH 7.34; PaCO2 25 mmHg; PaO2 80 mmHg; HCO3 19 mEq/L
- pH 7.50; PaCO2 28 mmHg; PaO2 58 mmHg; HCO3 24 mEq/L
- pH 7.34; PaCO2 60 mmHg; PaO2 68 mmHg; HCO3 30 mEq/L
- pH 7.50; PaCO2 28 mmHg; PaO2 100 mmHg; HCO3 24 mEq/L
Question 5
A client is admitted to ICU. Blood gases are pH 7.03; PCO2 37mmHg; HCO3 8 mEq/L. The medication most likely to be ordered to correct this acid-base imbalance is
- calcium carbonate.
- sodium bicarbonate.
- acetazolamide.
- carbonic acid.
Question 6
Your septic client is becoming restless and tachypneic. His arterial blood gases show pH 7.30; PaCO2 50 mmHg; HCO3 24 mEq/L; PaO2 76 mmHg; SaO2 90%. You would interpret these ABG findings as consistent with
- acute ventilatory failure.
- early acute respiratory distress syndrome.
- late acute respiratory distress syndrome.
- normal ABG results.
Question 7
The nurse is caring for a client who is being mechanically ventilated. What strategies have been shown to prevent ventilator-acquired pneumonia (VAP)?
- Routine prone positioning
- Changing ventilator circuit tubing every 72 hours
- Elevate head of bed 30 to 45 degrees if not contraindicated
- Administration of IV antibiotics routinely
Question 8
As the nurse caring for a ventilator-dependent client who is receiving vecuronium bromide, you assess the level of neuromuscular blockade using “Train-of Four” (TOF) peripheral nerve stimulation. When would you know you have the correct amount of the paralytic being delivered?
- The client displays three out of four twitch responses.
- The client displays zero twitch responses.
- The client displays one to two out of four twitch responses.
- The client can blink their eyes on command.
