1. Exam One Review N464- Fall 2014

2. O (2 points) Discuss why patients with pulmonary disease are prone to atrial dysrhythmias.

3. O (2 points) Why does tachycardia sometimes lead to heart failure?

4. O (6 points) Based on your knowledge of clinical disorders, identify different clinical conditions that could cause problems with the following steps in gas exchange: O Ventilation O Diffusion O Perfusion (transportation)

5. O (4 points) Your patient has the following arterial blood gas results: pH- 7.28; PaO2- 52mm Hg; SaO2- 84%, PaCO2- 55 mm Hg; HCO3- 24 mEq/L. O What is your interpretation of these arterial blood gases? O What clinical condition or conditions could cause the patient to have these arterial blood gas results?

6. O (4 point) Your patient requires mechanical ventilation for treatment. The pressure alarm keeps going off for a few seconds at a time, even though you have just suctioned the patient. What nursing actions are warranted at this time?

7. O (4 points) What were the results of Mr. P’s first arterial blood gas analysis? What factors are contributing to these results? O pH= 7.30 O PaCO2= 40 mmHg O HCO3= 20 mEq/L O PaO2= 88 mm Hg O SaO2= 99%

8. O (2 points) What factor is contributing to Mr. P.’s worsening condition the day after hospital admission? O Progressive infiltrates

9. O (2 points) Interpret the arterial blood gases done the day after the arrest. O pH=7.35 O PaCO2= 50 mmHg O HCO3=26 mEq/L O PaO2= 58 mmHg O SaO2= 88%

10. O (4 points) Why did the physician change the ventilator settings after the second set of arterial blood gases? O O RR is increased to 16 breaths/minute O FiO2 is increased to.50 O PEEP is increased to 10 cm H2O

11. O (4 points) What must the nurse assess after the addition of the PEEP? Why is this especially important for Mr. P?

12. O (2 points) As the critical care nurse caring for Mr. W., what are your priorities at this point? On what ethical principles are these priorities based?

13. O (2 points) Suppose that you have strong religious beliefs about withdrawal of life support. If you were assigned to Mr. W., what actions should you take?

14. O (1 point) The nurse is caring for a critically ill patient with terminal cancer. The monitor alarms and shows ventricular tachycardia. The patient does not have a “do not resuscitate” order written on the chart. What is the appropriate nursing action? O O Contact the attending physician immediately to determine if CPR should be initiated. O Contact the family immediately to determine if they want CPR to be started. O Give emergency medications but withhold intubation. O Initiate CPR and call a code.

15. O (1 point) The nurse is caring for a critically ill patient on mechanical ventilation. The physician identifies the need for a bronchoscopy, which requires informed consent. If the physician were to obtain consent from the patient, the patient must be able to: O O be weaned from mechanical ventilation. O have knowledge and competence to make the decision. O nod his head that it is okay to proceed. O read and write in English