Respiratory Disorders Case Study 1 Kathleen Watson, a 57-year-old…
QuestionRespiratory Disorders Case Study 1 Kathleen Watson, a 57-year-old…Respiratory Disorders Case Study 1 Kathleen Watson, a 57-year-old female patient had surgery yesterday to remove four wisdom teeth. During her surgery, complications occurred with some hemorrhaging, and she aspirated food contents. She currently has oxygen at 2 L via nasal cannula.She has an IV of normal saline running at 75 ml/hr. Ms. Watson complains of pain 4/10 at this time. Her vital signs are: BP 128/74, HR 78, RR, 18, T 98.6, pulse ox 96%Upon returning to Ms. Watson’s room, the nurse notices that Ms. Watson appears to be breathing at a faster rate than earlier. The nurse decides to take vital signs again with the following results: BP 130/84, HR 88, RR 24, T 98.9, pulse ox 90%.After reporting concerns to the physician, the following tests are ordered. Match the test with the rationale.A. ABGs _____ 1. Determines the percentage of hemoglobin saturated with oxygenB. chest x-ray _____ 2. Evaluates the respiratory and metabolic acid-base balanceC. continuous pulse ox monitoring _____ 3. Evaluates the pulmonary system, specifically the lungs Results of the chest x-ray show fluid infiltration in both lung bases. The ABG results are pH 7.28, PaCO2 50, and HCO3 23. Interpret the ABG. Ms. Watson appears critically anxious, and the physician orders her oxygen increased to 6 L via face mask. The nurse is to monitor the patient closely and report a new set of vital signs in 1 hr. Those vital signs are BP 138/88, HR 104, RR 36, T 98.6, and pulse ox 88%. The physician diagnoses the patient with ARDS. What is acute respiratory distress syndrome?A rapidly progressing disease occurring in critically ill patientsA slowly progressing disease occurring in critically ill patientsA rapidly progressing disease occurring in post-operative patientsWhat signs and symptoms indicates ARDS in this patient? The physician transfers the patient to ICU.Which of the following can the ICU nurse anticipate will be ordered for Ms. Watson? Select all that apply and give a rationale for your answers.A. bronchoscopyB. mechanical ventilationC. suctioning PRND. sedatives, narcotics, neuromuscular blocking agentE. increase oxygen to 8 L via face maskF. PEEPG. increase IV fluidsWhat else can the nurse do to assist this patient? Select all that apply.A. Reposition the patient every 1-2 hoursB. Discourage coughingC. Communicate in a calm mannerD. Assess the patient’s nutritional needsWhat is the definition and purpose of positive end-expiratory pressure?A. pressure applied in the airways at the end of exhalation to keep alveoli openB. pressure applied in the airways at the end of inhalation to keep alveoli openC. pressure applied in the airways at the end of exhalation to increase surface tensionWhat 5 specific actions will the nurse do to prevent VAP? See Chart 21-11, page 530.1.2.3.4.5. What will the nurse do to prevent delirium? See Chart 21-13, page 533ABCDE Respiratory Disorders ABG Worksheet Use Chapter 13 from your textbook. Type of Acid-Base Balance/Treatment pH (high or low?)/signs and symptoms Causes Compensatory MechanismMetabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Use Chapter 13 from your textbook. Values for ABGs Normal Value Acid End of Value Range Base End of Value Range What organ has the most effect on this value? Value is respiratory or metabolic?pH PaCO2 HCO 3 – PaO2 Use Chapter 13 from your textbook and the Tic Tac Toe Method of ABG interpretation or the ROME Method of ABG interpretation videos. Pick the method that works best for you! Interpret values and indicate compensation. 1. pH 7.20CO2 78HCO 3 – 30 2. pH 7.26CO2 56HCO 3 – 24 3. pH 7.20CO2 25HCO 3 – 9 4. pH 7.32CO2 25HCO3 13 5. pH 7.48CO2 33HCO 3 – 24 6. .pH 7.56CO2 44HCO 3 – 38 7. pH 7.55CO2 20HCO 3 – 18 8. pH 7.48CO2 20HCO 3 – 16 9. pH 7.41CO2 26HCO3 17 10. pH 7.37CO2 33HCO3 17 11. pH 7.39CO2 48HCO3 28 Respiratory Disorders Chest Tubes ActivityLabel the chambers for the chest tube drainage systems, circle the correct system type, and answer the questions that follow. Wet or dry system? Wet or dry system? Which chamber fills with fluid from the patient and how should a nurse ensure accurate I/Os from this chamber? On a wet system, what controls the amount of suction applied to the patient? On a wet system, how do we know the appropriate amount of wall suction to use? Which chamber will show tidaling and what does this indicate? Intermittent bubbling in which chamber is appropriate under what conditions? Continuous bubbling in which chamber indicates an air leak? Tidaling and bubbling can stop in which chamber? What two things could this assessment indicate? Health ScienceScienceNursingMEDICAL SU NUR2301Share Question
