Reference Range: 1329545.
A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?

Decrease expiratory flow time.

Decrease expiratory pressure.

Increase rate of ventilation.

Increase ventilator tidal volume.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Decreasing expiratory flow time is not the appropriate intervention in this case. The client's pH and PaCO2 levels suggest respiratory acidosis, which indicates inadequate ventilation. Increasing expiratory flow time might exacerbate the acidosis by reducing ventilation.

Choice C rationale:

Increasing the rate of ventilation (respiratory rate) is a potential intervention to improve the client's acid-base balance. However, it should be done cautiously and under medical supervision to avoid respiratory alkalosis. It is not the first-line intervention in this scenario.

Choice D rationale:

Increasing the ventilator tidal volume may help improve ventilation, but it should also be done under medical guidance to prevent barotrauma. It is not the initial intervention to address the client's respiratory acidosis.

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Correct Answer is ["A","E"]

Explanation

The level of hypoxemia that the child may have experienced during the submersion depends on several factors, but the most important ones are:

The **temperature of water**: Cold water can induce a diving reﬂex, which lowers the heart rate and oxygen consumption, and may protect the brain from hypoxic injury. Cold water can also cause laryngospasm, which prevents water aspiration but also impairs gas exchange.
The **amount of time the child was submerged**: The longer the submersion, the more severe the hypoxemia and the higher the risk of brain damage and death. The survival rate decreases significantly after 5 minutes of submersion.

The other factors are less relevant or not directly related to the level of hypoxemia:

The **weight of the child**: This may aﬀect the buoyancy and the ability to ﬂoat or swim, but not the oxygen consumption or gas exchange during submersion.
The **oxygen concentration of the ambient air**: This may aﬀect the pre-submersion oxygen saturation, but not the rate of oxygen depletion or gas exchange during submersion.
The **witnessing of the fall into the pool**: This may aﬀect the time to rescue and resuscitation, but not the level of hypoxemia during submersion.

A. Encourage the client to exercise every day to eliminate bedtime wakefulness. B. Advise the client that lifestyle changes often take several weeks to be effective. C. Ask the client for a description of the exercise schedule that is being followed. D. Determine the amount of weight the client has lost since increasing activity.

Correct Answer is B

Explanation

Choice A rationale:

Encouraging the client to exercise every day to eliminate bedtime wakefulness is not appropriate advice in this scenario. It oversimplifies the issue and may not address the underlying causes of the client's sleep difficulties. Additionally, excessive exercise close to bedtime may actually interfere with sleep.

Choice C rationale:

Asking the client for a description of the exercise schedule being followed is a reasonable action. It allows the nurse to gather information about the client's exercise routine and assess whether it might be contributing to the sleep difficulties. However, this alone may not fully address the client's concerns.

Choice D rationale:

Determining the amount of weight the client has lost since increasing activity is relevant to the client's overall health and progress toward weight loss goals, but it does not directly address the issue of sleep difficulties. Weight loss and improved sleep may not always have a direct cause-and-effect relationship.

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Reference Range: 1329545.A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","E"]

Explanation

A client tells the nurse about beginning an exercise program a month ago to lose weight and improve sleep.The client states that it still takes at least two hours to fall asleep at night.Which action should the nurse implement?

Correct Answer is B

Explanation

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Reference Range: 1329545.
A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?