The nurse on duty in the emergency department when a patient with severe respiratory distress is brought in. The patient appears cyanotic, with labored breathing and a respiratory rate of 35 breaths per minute. Initial assessment reveals decreased breath sounds on the left side. What immediate actions should taken?
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The nurse on duty in the emergency department when a patient with severe respiratory distress is brought in. The patient appears cyanotic, with labored breathing and a respiratory rate of 35 breaths per minute. Initial assessment reveals decreased breath sounds on the left side. What immediate actions should taken?
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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-rayTo evaluate the effectiveness of mechanical ventilation for a patient with respiratory failure, which diagnostic will be most useful to the nurse? 1. A chest x-ray 2. Oxygen saturation 3. Arterial blood gas analysis 4. Central venous pressureWhich of the following would the nurse expect to see in client experiencing hypoventilation? increased oxygenation in the alveoli increased carbon dioxide in the bloodstream decreased hemoglobin in the bloodstream decreased carbon dioxide in the alveoli
- A patient admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/ minute via nasal prongs. The patient’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD), because of these history findings ,the Nurse closely monitors the oxygen flow and the patient's respiratory status Explain the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD) Which complication may arise if the patient receives a high oxygen concentration? List two (2) nursing Interventions with rationales for this patient mark for each nursing intervention 2 marks for each rationaleThe 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 hemothoraxAt 11 p.m., a patient is admitted to the Emergency Department (ED) with a respiratory rate of 44 breaths/minute and SaO2 85%. They are anxious with audible wheezes. The patient is immediately given nebulised Salbutamol follow by oxygen via face mask and Hydrocortisone intravenously (i.v) Explain the reason for intravenous (JV) Hydrocortisone. . Provide two (2) nursing interventions with rationales to improve airway clearance and/or improve breathing pattern
- Kenneth Bronson is a 27-year-old male who was just admitted to the Medical Unit from the Emergency Department. He presented to the Emergency Department two hours ago with chest tightness, difficulty breathing, a productive cough for a week, and fever. Chest x-ray revealed right lower lobe pneumonia. IV was started of normal saline at 75 mL per hour. He is receiving oxygen at 2 L/min per nasal cannula. SpO2on room air was 90%, which increased to 95% with supplemental oxygen. He had a temp of 102.6°F and was given acetaminophen 1,000 mg in the Emergency Department. The pharmacy just delivered the antibiotics to be given. Would you do anything different for a patient experiencing respiratory distress? Would you do anything differently if Kenneth had told you he had been using e-cigarettes? How would the RN collaborate with the hospital pharmacist to prevent anaphylaxis? What evidence-based interventions would you perform on Kenneth?Case History: Andy, age 3, passed NBHS, but has had a history of severe allergies, eustachian tube dysfunction and otitis media. He had one set of PE tubes placed at 18 months of age. The PE tubes extruded (came out) about 4 months ago. Since a severe upper respiratory infection approximately 2 months ago, Andy's mother has noticed that he appears even more congested than usual. He is breathing almost exclusively through his mouth and snores at night. He appears to be ignoring much of the time and often says, "What?" His speech has become "slushier" or "mushier." He also seems to be reverting to "baby talk" at times. Group Member #1 - Audiological findings: Otoscopy = bulging tympanic membranes with yellow fluid visible behind the TM Tympanometry = Type B right; Type B left %3D -10 -10 LIJ 10 10 30 30 40 40 50 50 60 60 70 70 80 80 90 90 100 100 110 110 120 120 130 130 0.125 0.25 0.5 1 Frequency-kHz. Group Member #2 – Effect of the hearing loss: What challenges / difficulties is this…John Michael Jones was seen by Dr. Peters who has seen the patient previously in this office. History: Mr. Jones has been having a fever and shortness of breath the last two days. He is not on any present medications but has been taking an over the counter Nyquil, but this has not been working. Physical Examination: Dr. Peters listens to Mr. Jones chest and hears nothing of real concern. Dr. Peters tells Mr. Jones that he doesn't believe the patient has bronchitis but just the flu. Dr Peters documented he spent 12 minutes with the patient. Plan: Drink a lot of fluid, rest and return if it worsens. What is the correct E/M code for this scenario
- Daniela is a CST working the day shift. She is scheduled to be the first scrub on a procedure in which a laser will be used to ablate abnormal laryngeal tissue and is preparing the room. What specific safety issues should Daniela consider in preparing for this case? What policies and procedures should be in place to ensure the patient’s safety? What are the possible concerns regarding the anesthetic used in this case?The patient states, "I have gas after I eat spicy foods." The patient complains of what ? after eating spicy foodsThe following questions will assist the nursing student in the assessment of a client suspected for pneumonia. 1.) What should the nurse note or observe when counting respirations? 2.)How is tactile fremitus assessed? 3.) Describe the method for checking diaphragmatic axcursion. 4.) Describe the pattern of percussion to the anterior and posterior thorax. 5.) What is the characteristic tone when percussing normal lung tissue? 6.) Describe the different techniques in voice auscultation.