A pulmonary artery catheter is inserted to montior the pulonary artery wedge pressure(PAWP). An arterial line is inserted in the left radial artery for continuous blood pressure monitoring and an

Read the medical report, and answer the questions that follow:
January 6, 2020
A 55-year-old male client is admitted to the nursing unit with complaints of abdominal pain that is sharp and burning. T
January 6, 2020

A pulmonary artery catheter is inserted to montior the pulonary artery wedge pressure(PAWP). An arterial line is inserted in the left radial artery for continuous blood pressure monitoring and an

A pulmonary artery catheter is inserted to montior the pulonary artery wedge pressure(PAWP). An arterial line is inserted in the left radial artery for continuous blood pressure monitoring and an NG tube is inserted and connected to low intermittent suction. ASSESSMENT DATA Restless needs frequent reminding not to pull on the ET tube or NG Scattered crackles audible bilaterally tube Urine output over 2 hours is 50 mL of clear amber urine Bowel sounds slightly hypoactive audible in 4 quadrants Dressing dry, intact, Jackson-Pratt drain drainage unchanged. BP 100/46 mm Hg HR 124 beats/min PAWP 3mm Hg Respirations 24 breaths.min Temperature 102.1F Based on the data, which collaborative interventions will you anticipate for the client? Underline and provide rationale for the selections and rationales for NOT selecting an anwer Increase IV rate to 150 mL/hr Administer Lasix 40 mg IV . Administer norepinephrine (Levophed) infusion Give diltiazem (Cardizem) 15mg IV Infuse total parenteral nutrition at 70 mL/h Administer high-calorie entral feeding at 25 mL/h Obtain blood, sputum and urine specimens for culture The oxygen saturation remains at 90 %, the client is restless and needs frequent reminding not to pull at the ET tube. Which intervention to reduce anxiety and decrease the risk of accidental extubation will you try first? Underline and provide rationale for the selection Restrain hands with soft wrist restraints Administer neuromuscular blockade medications Have a family member stay at bedside to reassure the client Remind the client frequently that the tube is necessary to breathe. While observing a student who is precepting in the ICU and suctioning your client’s ET tube you suddenly intervene to stop the student. Which action by the student caused you to intervene? Underline and provide rationale for the selection FIO2 is increased to 100 % for 5-minutes before suctioning Uses an open-suction technique to perform suctioning Morphine 2 mg IV per prescription is administered Suction is applied to the catheter while insterting into the ET tube Which evidence-based intervention do you implement to prevent the client from developing ventilator-associated pneumonia? Underline and provide rationale for the selection Change the ventilator tubing and humidifier every 24-hours Avoid giving intermittent bolus enteral feedings Maintain the head of the bed elevated at least 30 degrees Use continuous pulse oximetry monitoring Due to staffing ratio to clients in the ICU, the supervisor sends an experienced LPN from the medical unit to assist you with the unstable client. All the interventions are listed in the care plan for the client. Which activities can you assign to the LPN? Underline and provide rationale for the selections and rationales for ones not choosen Provide oral care every 2 hours Place in a prone positon for 4 hours every shift Check residuals for enteral feedings every 4 hours Assess breath sounds every 4 hours Suction the ET tube as needed Educate the client and family about routine nursing care Check the PAWP every 2 hours Obtain arterial pressures from the arterial line every hour

 

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