Which of the following should be used when suctioning a mechanically ventilated patient? (Select all that apply.)
a. Three hyperoxygenation breaths (breaths at 100% FiO2)
b. Hyperinflation (breaths at 150% tidal volume)
c. Limit the number of passes to three.
d. Instill 5 to 10 mL of normal saline to facilitate secretion removal.
e. Use intermittent suction to avoid damaging tracheal tissue.
A, B, C
Hyperoxygenation, hyperinflation, and limiting the number of passes help avoid desaturation. There is no evidence to suggest that intermittent suction reduces damage, and saline instillation can actually increase the risk for infection.
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Which of these terms refers to electrically charged ions present in both intracellular and extracellular fluids?
a. electrolytes c. particles b. molecules d. solutes
A client is taking goserelin (Zoladex). What periodic assessment does the nurse plan for this client?
a. Weight and abdominal girth b. Pulmonary function tests c. Bone density testing d. Abdominal ultrasound
A nurse is assigned to six acutely ill patients. The nurse is very careful with administering all medications and treatments accurately and safely to all clients. Legally, which of the following should the nurse be most concerned with?
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