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A patient in acute respiratory failure is receiving ACV with a positive end-expiratory pressure (PEEP) of 10 cm H20. What sign alerts the nurse to undesirable effects of increased airway and thoracic pressure?

Nurse Oliver observes constant bubbling in the water-seal chamber of a closed chest drainage system. What should the nurse conclude? 

A female client with chest injury has suffered flail chest. A nurse assesses the client for which most distinctive sign of flail chest?

The RN is supervising a nursing student who will suction a patient on a mechanical ventilator. Which actions indicate that the student has a correct understanding of this procedure? Select all that apply.

A client with a tracheostomy is at increased risk for aspiration. Which nursing intervention(s) will reduce this risk? Select all that apply

Mr. G requires neuromuscular blockade to facilitate mechanical ventilation. Which is not a true statement when providing nursing care to paralyzed patients?

The nurse cares for a 78-year-old female admitted to the medical intensive care unit in respiratory distress. Nurses’ Notes   0900. Client was admitted to the ICU in respiratory distress after minimal response to high flow oxygen for a pulse oximeter reading of 83% in room air. Crackles heard bilaterally in lower lobes with diminished breath sounds in right middle lobe; S1S2 auscultated; bowel sounds positive in all 4 quadrants; skin warm dry and intact. VS T 99.8F(37.7C); HR 110; RR 30 bpm; B/P 168/90; pulse oximeter is 87% on 100% non-rebreather; pain-0/10. 0930. Client was intubated with #6 endotracheal tube and was placed on assist control mechanical ventilation, rate 14, Peep 5 mmHg, FIO2 60%. VS T 99.8F(37.7C); HR 110; RR 14; B/P 180/90; pulse oximeter is 96%. Client is restless. Laboratory Report Lab Results Reference range ABG pH 7.2 7.35-7.45 ABG P02 65 mm Hg 75-100 mm Hg ABG PC02 51 mm Hg 35-45 mmHg ABG HC03 28 mEq/L 22-26 mEq/L WBC 5,600 cells/mm3 4.5 – 10.5 x 103 cells/mm3 Platelets 250,000/ mm3 140,000 to 450,000/ mm3 Potassium(serum) 4.0 mEq/L 3.5 to 5 mEq/L Sodium (serum) 140 mEq/L 135 to 145 mEq/L Magnesium 1.5 mEq/L 1.5 to 2.1 mEq/L Lactate level 4.5 mEq/L 0.5 to 2.2 mEq/L Blood culture Gram negative cocci Negative Urine culture pending Negative Sputum culture pending Negative The client’s spouse enters the room and is able to visit for the first time. The​ client’s spouse asks the nurse what causes ARDS and is explaining direct injury ARDS vs Indirect Injury ARDS. Which etiology of direct injury to the lungs should the nurse include in the​ir education? 

What is a significant nursing intervention to reduce morbidity in the patient with rib fractures?

Choose one of the following questions to answer. Your answer should be a minimum of 3 paragraphs. However, you can use more space if needed. Support your writing with evidence.    Aaron Douglas, Aspects of Negro Life: From Slavery through Reconstruction, found in Debra J. Dewitte, Ralph M. Larrman, M. Kathryn Shields, Gateways to Art: Understanding the Visual Arts, (London: Thames & Hudson, 2023), 514. Artists sometimes use symbolism and elements of art, such as color, to create meaning within a work of art. What symbolism? What elements do you see being used here in this work to express his message? What is the message he is trying to convey? Artemisia Gentileschi, Judith Decapitating Holofernes, found in Debra J. Dewitte, Ralph M. Larrman, M. Kathryn Shields, Gateways to Art: Understanding the Visual Arts, (London: Thames & Hudson, 2023), 649. It is said that Artemisia Gentileschi uses identity and self-expression in her painting of Judith Decapitating Holofernes; what was she expressing? Is this painting metaphorical? How does she use compositional space to achieve this?   Andy Goldsworthy, Japanese Maple, found in Debra J. Dewitte, Ralph M. Larrman, M. Kathryn Shields, Gateways to Art: Understanding the Visual Arts, (London: Thames & Hudson, 2018), 525 . How does Andy Goldsworthy’s use of color, texture, time, space, and location influence his work? How is he using these components to express a specific theme? Are both the installation and the photograph considered an essential part of the finished artwork? Bull Leapers from Palace of Knossos, found in Debra J. Dewitte, Ralph M. Larrman, M. Kathryn Shields, Gateways to Art: Understanding the Visual Arts, (London: Thames & Hudson, 2023), 351. What can the Bull Leapers of Knossos tell us about the culture and society of the Minoans? What specific aspects of this fresco support your statements? Constantin Brancusi, Bird in Space, found in Debra J. Dewitte, Ralph M. Larrman, M. Kathryn Shields, Gateways to Art: Understanding the Visual Arts, (London: Thames & Hudson, 2023), 512. How does Constantin Brancusi’s Bird in Space push the boundaries of what is considered art? Is the title necessary to understand this piece?     Hon ‘ami Koetsu, Mount Fuji Tea Bowl, Sakai Collection, found in Debra J. Dewitte, Ralph M. Larrman, M. Kathryn Shields, Gateways to Art: Understanding the Visual Arts, (London: Thames & Hudson, 2023), 21. 6. How does this teabowl entitled Mount Fuji by Hon’ami Koetsu show how an artist might use beliefs and cultural practices to connect their audience to a greater sense of being?      

The nurse cares for a 78-year-old female admitted to the medical intensive care unit in respiratory distress. Nurses’ Notes   0900. Client was admitted to medical intensive care unit in respiratory distress after minimal response to high flow oxygen for a pulse oximeter reading of 83% in room air. Crackles heard bilaterally in lower lobes with diminished breath sounds in right middle lobe; S1S2 auscultated; bowel sounds positive in all 4 quadrants; skin warm dry and intact. Client temp 99.8F(37.7C); HR 110; RR 30 bpm; B/P 168/90; pulse oximeter is 87% on 100% non-rebreather; pain-0/10. 0930. Client intubated with #6 endotracheal tube place on assist control ventilation, respiratory rate 14, Peep 5 mmHg, FIO2 60%. Client temp 99.8F(37.7C); HR 110; RR 14; B/P 180/90; pulse oximeter is 96% on 60%. Client is restless. 1000. Chest-ray obtained. IV placed and midazolam given. EKG shows sinus tachycardia. VS T99.8F(37.7C); HR 100; RR 14; B/P 150/70; pulse oximeter 98%; FIO2-60%; drowsy/-1 sedation scale.  The nurse reassesses the client at 1000 and compares the findings to 0930. Based on the findings below Which of the following would indicate the patient’s condition has improved? Select all that apply.