Adult III Exam One (NUR 325) Illinois State University Fall
2024 Questions With Complete Solutions
Airway management Correct Answers -incorrect tube
placement is an emergency, secure help and bag patient
-maintain correct tube placement
-observe chest wall movement
-auscultate bilateral breath sounds
-maintain proper cuff inflation
-monitor ventilation: (PaCO2, PETCO2, rr and rhythm, use of
accessory muscles)
-maintain tube patency (do not routinely suction patient)
-prevent mucosal damage (limit suction pressures to
<120mmHg)
-aspiration precautions
ARDS assessment Correct Answers -Hx. direct or indirect
lung insult followed by resp. distress and decreased pO2, does
not respond to O2
-CNS changes: restlessness, personality changes, disorientation,
change in LOC
-dyspnea and tachypnea
-hyperventilation with normal breath sounds (initially)
-respiratory alkalosis and cough
-increased temp and pulse
-crackles, rhonchi, and bronchial breath sounds
-worsening chest x-ray progressing to white out or ground glass
-eventual severe hypoxemia and respiratory acidosis
,ARDS causes Correct Answers aspiration of gastric contents,
diffuse pneumonia, multisystem trauma, anaphylaxis, DIC,
sepsis, multiple transfusions, pancreatitis, etc
ARDs interventions Correct Answers -treat cause
-oxygenation and ventilation
-provide comfort and pain relief and sedation
-decrease O2 consumption
-positioning (prone) and continual lateral rotation therapy
-your goal is to increase ventilation
-fluid and electrolyte balance
-adequate nutrition
-psychosocial support
Categories of acute respiratory failure Correct Answers failure
of oxygenation, failure of ventilation, both
Causes of metabolic acidosis? Correct Answers -Gain of acids
or loss of base
gain of strong acid (DKA, lactic acidosis), lack of base (renal
failure, diarrhea, High K+ or high Cl-)
Causes of metabolic alkalosis? Correct Answers -gain of base
or loss of acid
Gain of base: excessive use of antacids, excess administration of
Na Bicarb
Loss of acids: vomiting, NG suctioning, Low K+ or low Cl-,
diuretics with loss of K+ or Cl-
Causes of respiratory acidosis? Correct Answers -breathe too
shallow, don't blow off CO2
, CNS depression, neuromuscular disorders, trauma(spine, brain,
chest wall), respiratory depression(COPD), altered diffusion
Causes of respiratory alkalosis? Correct Answers -breathe too
fast
anxiety, fear, pain, fever, head injury (central neurogenic),
hyperventilation, overventilation
Causes of respiratory failure Correct Answers Find out if it's
an oxygenation or ventilation problem
Asthma, pneumonia, PE, ARDS
Communication needs for someone on a ventilator Correct
Answers · Written communication
· Communication boards
· Lip reading laptop computers
· Text-to-speech devices
· Speech-enabling trach tubes
· Speaking valves
Complications of ARDs Correct Answers multiple organ
failure, renal failure, disseminated intravascular coagulation,
long-term pulmonary effects associated with high O2 and other
therapies
Complications of PPV Correct Answers o Barotrauma
o Pneumomediastinum
o Alveolar hypoventilation
o Ventilator associated pneumonia
