Pulmonary care Quiz: Hypoxia, Asthma & Ppe

The priority nursing diagnosis in a patient with copious sputum and a weak cough would be "Ineffective airway clearance (actual) and potential for altered gas exchange." This is because the patient's weak cough and excessive sputum indicate a difficulty in clearing the airway, which can lead to ineffective breathing and potential complications such as altered gas exchange. It is important for the nurse to address this issue promptly to ensure proper oxygenation and prevent further respiratory complications.

Long-acting inhaled bronchodilators are known to be effective in reducing exacerbations, hospitalizations, and improving symptoms and health status in patients with respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). These medications provide long-lasting relief by relaxing the muscles in the airways, allowing for easier breathing. By reducing exacerbations and hospitalizations, they can significantly improve the overall quality of life for individuals with these conditions. Therefore, the statement "long-acting inhaled bronchodilators reduce exacerbations, hospitalizations, and improve symptoms and health status" is true.

Increased heart rate (HR) and increased respiratory rate (RR) are common physiological responses to pneumonia. Pneumonia is an infection that affects the lungs, causing inflammation and fluid buildup. As a result, the body tries to compensate by increasing the heart rate to pump more oxygen-rich blood to the affected areas. Additionally, the respiratory rate increases to facilitate faster breathing and oxygen exchange. Therefore, it is true that pneumonia can lead to increased HR and RR.

The correct answer is to place the patient in a position of comfort, increase oxygen to the highest level you have an order for, stay with the patient, and ask for the physician to be called. This is the priority of care because the patient is showing signs of respiratory distress, such as shallow and rapid breathing, low oxygen saturation, and paradoxical breathing pattern. Placing the patient in a position of comfort and increasing oxygen can help alleviate respiratory distress, while staying with the patient and calling the physician ensures that appropriate medical intervention can be provided.

A resident of a high-risk setting (prison/shelter) with an induration greater than 10mm after 48 hours is considered to have a positive skin test reaction for TB. This is because individuals in high-risk settings are more likely to be exposed to TB, and a larger induration size indicates a stronger immune response to the TB antigen, suggesting a higher likelihood of TB infection.

The normal value for PaO2 (partial pressure of oxygen in arterial blood) is typically between 75-100 mmHg. A value of 70 mmHg is slightly lower than the normal range, indicating a mild decrease in oxygen levels in the blood. Therefore, PaO2 of 70 is not a normal value.

The post-operative patient who has not been out of bed in the first 12-24 hours post op is most at risk for atelectasis. Atelectasis is the collapse or closure of the lung resulting in reduced or absent gas exchange. Post-operative patients who remain in bed for an extended period of time are more susceptible to atelectasis due to decreased lung expansion and decreased coughing and deep breathing. Early mobilization and ambulation are important in preventing atelectasis in post-operative patients.

A classic early clinical presentation of asthma is characterized by increased respirations and expiratory wheezing. This is because asthma is a chronic inflammatory disease of the airways that causes the airways to become narrow and inflamed, making it difficult for air to flow in and out of the lungs. This leads to increased effort in breathing and the production of wheezing sounds during expiration.

Airborne precautions are necessary when there is a risk of transmission of infectious agents through small particles suspended in the air. Intubation is a high-risk procedure that can generate aerosols, increasing the chances of spreading the virus. Therefore, in the patient with corona virus who is being intubated, airborne precautions are necessary to protect healthcare providers and prevent the spread of the virus to other patients and individuals in the vicinity.

The patient's ABG results show a pH of 7.32, a CO2 level of 50, and a bicarb level of 23. These values indicate an uncompensated respiratory acidemia, which means that there is an excess of carbon dioxide in the blood due to decreased breathing (hypoventilation). Therefore, it is important to assess the patient's breathing and determine the cause of this acute hypoventilation. This will help in identifying the underlying problem and providing appropriate treatment.

Prone positioning is a nursing measure used in the treatment of ARDS (and currently in corona virus) to increase oxygenation by improving V-Q ratio and decreasing shunt. By placing the patient in a prone position, the ventilation-perfusion (V-Q) ratio is improved, meaning that more oxygen can be delivered to the alveoli and more carbon dioxide can be eliminated. This helps to improve oxygenation and decrease the shunt, which is the portion of blood that bypasses the alveoli without participating in gas exchange.

The correct answer is the patient with AIDS with an induration of 5mm after 48 hours. This is because a positive TB test is indicated by an induration of 5mm or more after 48-72 hours. The other options do not mention any risk factors or conditions that would increase the likelihood of having TB.

The patient with the Flu would be on droplet precautions because the flu is primarily spread through respiratory droplets when an infected person coughs, sneezes, or talks. Droplet precautions are necessary to prevent the transmission of respiratory infections that are spread by droplets larger than 5 microns in size. This includes wearing a mask, practicing proper hand hygiene, and maintaining a safe distance from others. Patients with impaired immunity due to HIV infection, tuberculosis, and suspected measles would require different precautions based on the specific mode of transmission for each of these diseases.

Placing the patient on his right side with his head at 30 degrees would be the optimal position to improve oxygenation and V/Q matching in a patient with left upper and lower lobe pneumonia. This position helps to improve ventilation and perfusion in the affected lung areas by allowing gravity to assist with drainage and reducing the risk of aspiration. The right side position also helps to minimize compression of the left lung and facilitate better expansion of the right lung. Additionally, elevating the head at 30 degrees helps to reduce the risk of aspiration and improve lung function.

it is droplet.

Community-acquired pneumonia refers to pneumonia that is acquired outside of a healthcare setting, such as in the community or at home. It is typically diagnosed within 48 hours of hospital admission because if pneumonia is diagnosed after 48 hours of admission, it is considered to be a healthcare-associated pneumonia. This is an important distinction to make as the treatment and management of community-acquired pneumonia may differ from healthcare-associated pneumonia.

Hypoxia, or decreased oxygen at the tissues, can lead to compensatory mechanisms in the body. One of these mechanisms is an increased respiratory rate, as the body tries to take in more oxygen. Another mechanism is an increased heart rate, which helps to circulate the oxygenated blood more quickly. Additionally, increased blood pressure can occur as the body tries to maintain adequate blood flow to the tissues. Therefore, the correct answers are increased respiratory rate, increased heart rate, and increased blood pressure.

The correct answer is "This should be reviewed and considered at discharge." This is because the patient with COPD and acute pneumonia should receive their annual flu vaccine before they are discharged from the hospital. This is important because patients with COPD are at a higher risk of developing complications from the flu, and the vaccine can help prevent this. By reviewing and considering the flu vaccine at discharge, healthcare providers can ensure that the patient receives the vaccine in a timely manner to protect their health.

The most concerning assessment finding in a patient with asthma is decreasing breath sounds. This could indicate a worsening of the condition and potential airway obstruction. It is important to monitor breath sounds closely as they can provide important information about the patient's respiratory status. Increasing wheezing on auscultation, an increase in heart rate with bronchodilator treatments, and increasing oxygen requirements can also be concerning, but decreasing breath sounds should be the most concerning finding in this case.

Fever, tachypnea, and decreased PO intake can all increase the risk of fluid volume deficit in a patient with pneumonia. Fever causes increased sweating and evaporation, leading to fluid loss. Tachypnea, or rapid breathing, can result in increased respiratory water loss. Decreased PO intake, or reduced oral fluid intake, can lead to dehydration and fluid volume deficit. Cough and pain, however, do not directly contribute to fluid volume deficit in this context.