PCC4 Exam 2 Questions With 100 % Correct Answers Verified
5 views 0 purchase
Course
PCC4
Institution
PCC4
What does the water-seal chamber do? - Answer-has 2 cm. of water, acts as a one-way
valve. Air enters from collection chamber and bubbles up. The water prevents backflow
of air into the patient from the system
what is the suction control chamber for - Answer-applies suction to the chest drainage...
PCC4 Exam 2 Questions With 100 %
Correct Answers Verified
What does the water-seal chamber do? - Answer-has 2 cm. of water, acts as a one-way
valve. Air enters from collection chamber and bubbles up. The water prevents backflow
of air into the patient from the system
what is the suction control chamber for - Answer-applies suction to the chest drainage
system. Water suction is vented to the atmosphere - turn up vaccuum until bubbling is
present
nursing assessments for chest tube - Answer-never put the drainage system above the
patient (back flow)
notify provider if >100 mL/hr
milking not stripping, do so gently
never clamp! - could cause tension pneumothorax
suspect leak if bubbling becomes continuous - briefly clamp between two spots to find
the leak
why is a tension pneumothorax a medical emergency - Answer-air enters the pleural
space but cannot escape. continued accumulation of air causes increasingly elevated
intrapleural pressures resulting in compression of lung, heart, and great vessels.
Emergent because it effects the cardiovascular system
you will see mediastinum shifts
treat with emergency needle decompression and chest tube
How do you decide the placement of chest tube - Answer-blood - lower (hemothorax)
air - upper
what does the collection chamber do on the drainage system - Answer-receives fluid
and air from the pleural space. the fluid stays here and air vents to the second
compartment
Blunt Trauma - Answer-chest is struck by an object; external injury may appear minor
but internally injuries are severe
can be caused by rib fractures, high velocity impact, compression
penetrating trauma - Answer-open injury in which a foreign body impales or passes
through
DO NOT REMOVE THE OBJECT
penumothorax - Answer-collection of air or gas in the pleural space causing the lung to
collapse
,normally negative pressure exists btw. visceral and parietal pleura
when air enters it causes paositive pressure
assess for site infection
assess for manifestations of re-accumulation - decreased or absent breath sounds
flail chest - Answer-paradoxical movement of chest after fracture of ribs
affected area moves in opposite direction with respect to the intact portion of the chest
palpation of abnormal respiratory movements, evaluation for crepitus near the rib
fractures, chest x-ray, ABGs
ventilator with controlled ventilation - you don't want them to initiate paradoxical breaths
What would be the P/F ratio for a patient with PaO2 80 and FIO2 of 0.9? - Answer-88 -
ARDS
what is the most common cause of ARDS - Answer-Sespsis
differentiate between early and late ARDS - Answer-early - minimal defining symptoms,
may have dyspnea, tachypnea, cough, restlessness. Lung sounds might be normal with
a few scattered crackles. ABGs mild respiratory alkalosis from hyperventilation. Chest x-
ray pretty normal until there is a 30% increase in fluid
Late - symptoms far worse because of fluids and decreased lung compliance.
respiratory distress is far more evident. Increased WOB. Mental status change.
Cyanosis. Scattered crackles and ronchi. White out chest x-ray. Hypoxemia despite
FIO2 increase. Hypercapnia, hypoventilation.
why is prone positioning good for ARDS - Answer-FIO2 doesn't need to be increased
by doing this you are recruiting more airways. If you prone a patient, the fluid filled
airways on your back drain by gravity and you have more alveoli available
How can PEEP reduce cardiac output - Answer-the additional intrathoracic pressures
can compromise venous return to the right side of the heart decreasing preload, CO,
and BP
Which signs and symptoms differentiate hypoxemic respiratory failure from hypercapnic
respiratory failure (select all that apply)
A. cyanosis
B. tachypnea
C. morning headache
D. Paradoxic breathing
E. use of pursed-lip breathing - Answer-A, B
The O2 delivery system chosen for the patient in acute respiratory failure should:
A. always be a low flow device such as a nasal cannula or face mask
B. administer continuous positve airway pressure ventilation to prevent CO2 narcosis
, C. correct the PaO2 to a normal level as quickly as possible using mechanical
ventilation
D. Maintain the PaO2 at greater than 60 at the lowest O2 concentration possible -
Answer-D
The most common early clinical manifestations of ARDS that the nurse may observe
are:
A. dyspnea and tachypnea
B. cyanosis and apprehension
C. hypotension and tachycardia
D. respiratory distress and frothy sputum - Answer-A
Maintenance of fluid balance in the patient with ARDS involves
A. hydration using colloids
B. administration of surfactant
C. fluid restriction and diuretics as necessary
D. keeping the hemoglobin levels above 9g/dL - Answer-C
Hypoxemic respiratory failure - Answer-oxygenation failure
PaO2 <60 SaO2 <90
shunt - right side to left side of heart without picking up oxygen
V/Q mismatch
associated - ARDS, pneumonia, pulmonary embolism, shock
Hypercapnic respiratory failure - Answer-ventilation failure
PCO2 >45
supply - gas flow in and out of lungs; demand - amount of ventilation needed to keep
PaCO2 in normal limits
ABGs indicate respiratory acidosis
associated - asthma, COPD, cystic fibrosis, flail chest, severe head injury (C3)
CO2 narcosis - Answer-if PaCO2 is high enough in blood; very pronounced CNS
symptoms - disorientation, decreased LOC, coma, increased ICP, seizures
increase rate and depth of respirations to blow off CO2, increase PEEP to increase gas
exchange within the alveoli
CO2 above 60 you're really worried - initiate seizure precautions
What are the effects of PEEP on ARDS - Answer-if you have positive pressure at the
END of expiration, maybe those alveoli stay open a bit longer and participate in gas
exchange
What are the effects of positive inspiratory pressure on ARDS - Answer-pressure
support; oxygen in with greater pressure, maybe you will get better diffusion
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller PatrickKaylian. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.69. You're not tied to anything after your purchase.
