Critical Care HESI Final Exam Questions With Complete Solution

Critical Care HESI Final Exam Questions With Complete Solution Acute Respiratory Distress Syndrome (ARDS) - CORRECT ANSWERS -progressive disorder leading to acute respiratory failure -exchange of O2 for CO2 in the lungs is inadequate for O2 consumption and CO2 production within the body's cells ARDS: Characteristics - CORRECT ANSWERS -hypoxemia that persists even when 100% O2 is given -decreased pulmonary compliance -dyspnea -non-cardiac associated bilateral pulmonary edema -dense pulmonary infiltrates on radiography ARDS: HESI Hint - CORRECT ANSWERS -Unexpected, catastrophic pulmonary complication, with a mortality rate of 50% -More likely in mechanically ventilated clients with no hx of pulmonary disease ARDS: Prevention - CORRECT ANSWERS -Elevate HOB to at least 30 degrees -Assist with daily awakening (sedation vacation) -Comprehensive oral hygiene -Comprehensive mobilization program ARDS: Causes - CORRECT ANSWERS -Exacerbation of COPD -Pneumonia -TB -Contusion -Aspiration -Inhaled toxins -Emboli -Drug overdose -Fluid overload -Shock -Disseminated intravascular coagulation (DIC) ARDS: Nursing Assessment - CORRECT ANSWERS -Dyspnea, hyperapnea, crackles or rales, wheezing, or decreased breath sounds -Cyanosis, pallor, mottled skin -Increasing diminshed breath sounds Diffuse pulmonary infiltrates (white-out) -Verbalized anxiety, restlessness, confusion, and agitation -Hypoxemia: PO2 50 with FIO2 60 ARDS: Nursing Diagnosis - CORRECT ANSWERS -Imparied gas exchange -Risk for deficient fluid volume -Ineffective breathing pattern -Risk for injury -Risk for infection -Death anxiety -Alteration in tissue perfusion ARDS: Nursing Interventions - CORRECT ANSWERS -Position client for max lung expansion -Monitor client for signs of hypoxemia and O2 toxicity -Suction only when secretions are present -Monitor breath sounds for pneumothorax -Provide emotional support to decrease anxiety and allow ventilator to "work" the lungs Arterial Blood Gases (ABGs) - CORRECT ANSWERS Performed on arterial blood to determine levels of oxygen, carbon dioxide, and other gases present ABGs: Normal Values - CORRECT ANSWERS -pH: 7.35-7.45 -PaO2: 80-100 -PaCO2: 35-45 -HCO3: 21-28 -SpO2: 95-100% ABGs: HESI Hint - CORRECT ANSWERS -Before drawing ABGs from the radial artery, perform Allen's test to assess collateral circulation -Ensures collateral circulation to the hand if thrombosis of the radial artery should follow the puncture