The nurse, caring for a mechanically ventilated patient in the ICU, has ventilator orders written by the physician that include the following: mode–assist-control, FIO2 .60, rate 12, V•T 1,200 mL. The nurse should
1. carry out the orders as written.
2. request a change in mode.
3. request an increase in the respiratory rate.
4. request a decrease in the tidal volume.
4
Rationale: The nurse should contact the physician to request a reduction in tidal volume. Normal tidal volume should range from 7 to 9 mL/kg (approximately 600 to 800 mL in an adult). Therefore, the ordered tidal volume is at least 1 1/2 times normal, which could result in barotrauma. The mode, assist-control, is appropriate, as is the respiratory rate. Because of the risk of barotrauma, it is not a good idea to blindly carry out the orders as written.
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ANS:
A client is admitted with appendicitis and is awaiting surgery. The client states, "Now instead of pain in just one spot, the pain is kind of all over my abdomen." Which action by the nurse takes priority?
a. Assess the client's abdomen. b. Get a set of vital signs. c. Call the physician. d. Prepare the client for another x-ray.
After a mass transit disaster many injured patients are expected at the emergency room. The nurse expects victims to have which assessment findings?
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