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- A nurse is caring for a client who presented to the emergency department with an acute asthma exacerbation. The respiratory rate is 36 breaths/min, and a pulse oximeter is 85% on room air with accessory muscle use to breathe. The nurse placed the client on oxygen 4 liters nasal cannula. The arterial blood gas (ABG) is as follows: pH: 7.28, PaCO2: 50 mm Hg, PaO2: 75 mm Hg, and HCO3: 26 mEq/L. Which of the following treatments is the nurse's highest priority? A) Administer bronchodilators B) Administer sodium bicarbonate Administer methylprednisolone (D) Perform a chest x-rayA 37-year-old male comes to the emergency room after having been stabbed above the left clavicle with an ice pick. The patient's main complaint is pain in the left side of the chest. Initial evaluation reveals a minute punctured wound superior to the left clavicle, just lateral to the sternocleidomastoid muscle. The vital signs are normal except for a moderately high respiratory rate. The chest radiograph shows the left lung to be collapsed to half its normal size and surrounded by air and blood. (This condition is known as hemopneumothorax, meaning blood and air in the thoracic cavity) 1. Explain how the air got inside the thoracic cavity (assuming it did not enter through the skin punctured wound.) 2. What is the name of the space where the air and blood are located? 3. What membranes contain the space?Sarah is a 69-year old female that presented to the emergency department with shortness of breath. Her past medical history includes heart failure and COPD. Her pulse oximetry on room air is 82%. You notify the provider, and he orders oxygen at 2 L via nasal cannula NC. Sarah’s chest x-ray reveals bilateral pneumonia. Her arterial blood gas result are below: pH: 7.30 PaCO2: 58 mm Hg PaO2: 78 mm Hg HCO3: 26 mEq/L Sarah is admitted to a general medical floor. You are the nurse assigned to Sarah. What potential problems can occur based on the above findings?
- Sarah is a 69-year old female that presented to the emergency department with shortness of breath. Her past medical history includes heart failure and COPD. Her pulse oximetry on room air is 82%. You notify the provider, and he orders oxygen at 2 L via nasal cannula NC. Sarah’s chest x-ray reveals bilateral pneumonia. Her arterial blood gas result are below: pH: 7.30 PaCO2: 58 mm Hg PaO2: 78 mm Hg HCO3: 26 mEq/L Sarah is admitted to a general medical floor. You are the nurse assigned to Sarah. How would you provide multidimensional care for Sarah?Sarah is a 69-year old female that presented to the emergency department with shortness of breath. Her past medical history includes heart failure and COPD. Her pulse oximetry on room air is 82%. You notify the provider, and he orders oxygen at 2 L via nasal cannula NC. Sarah’s chest x-ray reveals bilateral pneumonia. Her arterial blood gas result are below: pH: 7.30 PaCO2: 58 mm Hg PaO2: 78 mm Hg HCO3: 26 mEq/L Sarah is admitted to a general medical floor. You are the nurse assigned to Sarah. Describe the roles of other departments in Sarah’s treatment plan.The patient is on non- rebreather mask and the vital parameters are: Temperature- 37.7 degree centigrade Heart rate - 128 beats/ minute Respiratory rate - 25 breaths/ minute Blood pressure - 100/60 mmHg And saturation - 92% The initial survey reveals a patent airway with no evidence of current obstruction. Breathing is tachypneic and regular, with accessory muscle use indicating increased effort. Circulation characterized by tachycardia and mild hypotension. There are 1+ distal pulses bilaterally, and the skin is warm and dry. At the ER, an ECG reveals sinus tachycardia of 129, which resolves without any prior medical management. Sinus at 98 beats per minute. Using the ABC prioritization, identify the life threatening injuries of the patient. Why? A-airway B-Breathing C-circulation
- The patient is on non- rebreather mask and the vital parameters are: Temperature- 37.7 degree centigrade Heart rate - 128 beats/ minute Respiratory rate - 25 breaths/ minute Blood pressure - 100/60 mmHg And saturation - 92% The initial survey reveals a patent airway with no evidence of current obstruction. Breathing is tachypneic and regular, with accessory muscle use indicating increased effort. Circulation characterized by tachycardia and mild hypotension. There are 1+ distal pulses bilaterally, and the skin is warm and dry. At the ER, an ECG reveals sinus tachycardia of 129, which resolves without any prior medical management. Sinus at 98 beats per minute. Using the ABC, identify the life threatening injuries of the patient. Why?The nurse is assessing a newly intubated patient and detects normal breath sounds on the right side of the patient's chest and diminished, distant breath sounds on the left side of the chest. What likely cause for these clinical signs should the nurse suspect?A. inadequate mechanical ventilationB. Intubation in the right mainstream bronchusC. Left hemothoraxD. Right hemothorax