Which statement made by a new graduate nurse about invasive mechanical ventilation techniques is incorrect and requires additional teaching?
1. "Assist control mode refers to the patient receiving a set total lung capacity (TLC) but the rate can be modified by the patient's own rate of breathing."
2. "Total control mode controls both the rate and volume that are preset and delivered without the machine responding to any of the patient's own breaths."
3. "Synchronized intermittent mandatory ventilation (SIMV) refers to the patient setting an independent rate but limited tidal volume based on the patient's own strength. A minimum rate is also used as a backup to prevent hypoventilation."
4. "Continuous positive airway pressure will increase the residual capacity and keep the alveoli open. Rate and volume are controlled by the patient. This is one step in the weaning process."
1
Rationale 1: It is the tidal volume that is set, not the total lung capacity. In addition, all ventilations, whether machine generated or spontaneous by the patient, will have the same tidal volume.
Rationale 2: This is a correct statement and does not require additional teaching.
Rationale 3: This is a correct statement and does not require additional teaching.
Rationale 4: This is a correct statement and does not require additional teaching.
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The nurse is preparing to insert a fetal oxygen saturation (FSpO2) monitoring device. Which statement indicates that further teaching is necessary? "This device will:
1. "Prevent my having to have a cesarean birth." 2. "Get a direct fetal heart rate tracing." 3. "Help labor by opening my cervix faster." 4. "Determine how my baby is tolerating labor."
The patient has shiny ulcerations on a red base over the medial calf of the right leg. There is quite a bit of fluid drainage. He takes anticoagulants because of recurrent deep vein thrombosis
He also reports a sedentary lifestyle. How would the nurse classify this chronic wound? a. Pressure ulcer b. Venous stasis ulcer c. Diabetic foot ulcer d. Arterial ulcer
A 2-year-old child has pushed paper into the ears and the caregiver asks what should be done. What should the nurse respond to the caregiver?
A) "Wait for a day or two to see if the child's ears seem irritated. If they do, bring her in." B) "Sterilize a pair of narrow tweezers. While someone else holds the child's head still, carefully insert the tweezers and remove the paper if there is any." C) "The child should be seen by a care provider. Don't put anything in her ear and bring her in right away." D) "Wash her ear out using warm water and an ear syringe then the paper will flush out with the water."
When assessing the infant and toddler, the nurse typically begins the assessment by including which of the following areas? (Select all that apply.)
A) Nutrition B) Growth and development C) Vision and hearing D) Information on perinatal illness E) Functional capacity