NUR 425 Exam 3 | Latest Update | 2024/2025 | Graded A+

NUR 425 Exam 3 | Latest Update | 2024/2025 | Graded A+ CPAP (Continuous Positive Airway Pressure) -FiO2 and PEEP only settings -This is used to only keep alveoli open -Pt. makes own tidal volume and takes their own breath PS (Pressure Support) mode -No set RR -Supports with pressure setting when it senses the pt. starting to take a breath -This is only meant for someone with a normal respiratory rate and good respiratory drive. AC (Assist Control) -Set RR -Set Vt with every breath -Pt. can take additional breaths, and that breath is supported with same programmed tidal volume SIMV (Synchronized Intermittent Mandatory Ventilation)-Set RR -Set Vt with every breath -Pt. can take breath, but there is no support with Vt, so the volume of spontaneous breaths varies A 36 year old female has suffered a TBI and currently has an external ventricular drain (EVD) open to drain. Her ICP has been trending 18mmHg for the past 10 minutes. Her mother is at the bedside talking to her. These are her Vital signs: HR: 117 MAP: 82 RR: 29 T: 39 C Come up with a list of at least 7 appropriate nursing actions for this patient. List these in order of most importance. 1. MORE FOCUSED NEURO ASSESSMENT These others are not in order: -Administer antipyretic -Assess pain -Assess anxiety level -Assess where the transducer is -Assess CSF drainage for infection -Make sure patient's neck is not bent -Assess for bubbles in the tubing -Assess for CSF leak -Assess for kinks in tubing and obstructions -Possibly ask mom to leave or ask them to be quiet -Assess insertion site for signs of infection -Decrease environmental stimuli, make sure she's comfortable A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L. What does this mean? A. Respiratory Alkalosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Alkalosis, Partially Compensated A (The primary disorder is acute respiratory alkalosis (low CO2) due to the pain and anxiety causing her to hyperventilate. There has not been time for metabolic compensation.) A nurse is caring for a client admitted with confusion and lethargy. The clients was found at home unresponsive with an empty bottle of aspirin lying next to her bed. VS reveal BP 104/72, HR 116 with regular rhythm, and respiratory rate 42/min and deep. Which of the following arterial blood gas findings should the nurse expect? a. ph 7.68 PaO2 96 mmHg PaCO2 38 mmHg HCO3 28 mEq/L b. pH 7.48 PaO2 100 mmHg PaCO2 28 mmHg HCO3 23 mEq/L c. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 18 mEq/L d. pH 7.58 PaO2 96 mmHg PaCO2 38 mmHg