Pulmonatory Failure: A Case Study
1. It will be most important for the nurse to check pulse oximetry for which of these patients?
a. A patient with emphysema and a respiratory rate of 16
b. A patient with massive obesity who is refusing to get out of bed
c. A patient with pneumonia who has just been admitted to the unit
d. A patient who has just received morphine sulfate for postoperative pain
C
Rationale: Hypoxemia and hypoxemic respiratory failure are caused by disorders that interfere with the transfer of oxygen into the blood, such as pneumonia. The other listed disorders are more likely to cause problems with hypercapnia because of ventilatory failure.
Cognitive Level: Application Text Reference: pp. 1799-1800
Nursing Process: Assessment NCLEX: Physiological …show more content…
allow the patient to rest to help conserve energy.
b. arrange for a humidifier to be placed in the patient's room.
c. position the patient on the right side with the head of the bed elevated.
d. assist the patient with augmented coughing to remove respiratory secretions.
D
Rationale: The patient's assessment indicates that assisted coughing is needed to help remove secretions, which will improve PaCO2 and will also help to correct fatigue. If the patient is allowed to rest, the PaCO2 will increase. Humidification may help loosen secretions, but the weak cough effort will prevent the secretions from being cleared. The patient should be positioned with the good lung down to improve gas exchange.
Cognitive Level: Application Text Reference: p. 1809
Nursing Process: Planning NCLEX: Physiological Integrity
13. When the nurse is caring for an obese patient with left lower-lobe pneumonia, gas exchange will be best when the patient is positioned
a. on the left side.
b. on the right side.
c. in the high-Fowler's position.
d. in the tripod position.
B
Rationale: The patient should be positioned with the "good" lung in the dependent position to improve the match between ventilation and perfusion. The obese patient's abdomen will limit respiratory excursion when sitting in the high-Fowler's or tripod
a. A patient with emphysema and a respiratory rate of 16
b. A patient with massive obesity who is refusing to get out of bed
c. A patient with pneumonia who has just been admitted to the unit
d. A patient who has just received morphine sulfate for postoperative pain
C
Rationale: Hypoxemia and hypoxemic respiratory failure are caused by disorders that interfere with the transfer of oxygen into the blood, such as pneumonia. The other listed disorders are more likely to cause problems with hypercapnia because of ventilatory failure.
Cognitive Level: Application Text Reference: pp. 1799-1800
Nursing Process: Assessment NCLEX: Physiological …show more content…
allow the patient to rest to help conserve energy.
b. arrange for a humidifier to be placed in the patient's room.
c. position the patient on the right side with the head of the bed elevated.
d. assist the patient with augmented coughing to remove respiratory secretions.
D
Rationale: The patient's assessment indicates that assisted coughing is needed to help remove secretions, which will improve PaCO2 and will also help to correct fatigue. If the patient is allowed to rest, the PaCO2 will increase. Humidification may help loosen secretions, but the weak cough effort will prevent the secretions from being cleared. The patient should be positioned with the good lung down to improve gas exchange.
Cognitive Level: Application Text Reference: p. 1809
Nursing Process: Planning NCLEX: Physiological Integrity
13. When the nurse is caring for an obese patient with left lower-lobe pneumonia, gas exchange will be best when the patient is positioned
a. on the left side.
b. on the right side.
c. in the high-Fowler's position.
d. in the tripod position.
B
Rationale: The patient should be positioned with the "good" lung in the dependent position to improve the match between ventilation and perfusion. The obese patient's abdomen will limit respiratory excursion when sitting in the high-Fowler's or tripod