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When planning care for a patient on a mechanical ventilator, the nurse understands that the application of positive end-expiratory pressure (PEEP) to the ventilator settings has which therapeutic effect?

The nurse on the medical-surgical unit is caring for a 69-year-old male client with pain and swelling of the right lower extremity. Nurses’ Notes   Day 1. 0930 Admission note: Client admitted from the Emergency Department via stretcher and transferred to bed. Client is alert and oriented. Saline lock IV in the R antecubital vein patent. Right lower extremity noted to have 2+ pedal edema, pain 8/10 in right calf. Warmth noted to right calf. Positive Homan’s sign to R lower extremity noted. Client has positive motion and sensation to right lower extremity. Right pedal pulse weak, palpable. R lower extremity elevated on 2 pillows. VS: BP 145/82, HR 96, RR 16, Temp 36.7C (98F). Client ordered to be on complete bedrest. Client made aware. 1010: Radiology called results of right leg ultrasound: Positive for deep vein thrombosis of the right posterior tibial vein. Provider made aware. New orders pending. 1030: Patient begins to experience SOB, anxiety, O2 Sat 83%, RR 38, HR 108, BP 149/88, patient seems to be apprehensive and anxious Which of the following actions should the nurse anticipate including in the patient’s plan of care? Select all that apply

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?