To improve the oxygenation of a client with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation, the nurse should place the client in which position?

Supine

Prone

Lateral side

Semi-Fowler's

Answer and Explanation

The Correct Answer is B

Choice A reason: The supine position is when a patient lies flat on their back. Although it is commonly used for many procedures and treatments, it is not the best position for improving oxygenation in clients with ARDS. Lying flat on the back can cause the lungs to become compressed, reducing the efficiency of gas exchange and potentially leading to further respiratory complications.

Choice B reason: The prone position, where the patient is lying face down, is the recommended position to improve oxygenation in clients with ARDS. Prone positioning helps to recruit more alveoli, improves ventilation-perfusion matching, and reduces the shunting of blood through non-ventilated areas of the lung. Studies have shown that placing patients in the prone position can significantly improve oxygenation and decrease mortality in ARDS patients.

Choice C reason: The lateral side position, where the patient lies on their side, can be used for patients with certain conditions or during recovery from some surgical procedures. However, it does not provide the same benefits for improving oxygenation in ARDS as the prone position does. Lateral positioning might help with comfort and prevent pressure sores, but it does not enhance lung function and gas exchange in the same way.

Choice D reason: The Semi-Fowler's position, where the patient's head and torso are elevated to a 30-45 degree angle, is useful for promoting respiratory comfort and reducing the risk of aspiration. While it can help improve ventilation and is beneficial for patients with respiratory distress, it does not offer the same degree of improvement in oxygenation for ARDS patients as the prone position.

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Correct Answer is C

Explanation

Choice A reason: Immediate return to hemodialysis is not typically the first line of treatment for these symptoms. Hemodialysis is a renal replacement therapy used when the kidneys are not functioning adequately. While it may be necessary in some cases, the symptoms described suggest an infection rather than complete kidney failure.

Choice B reason: Immediate removal of the transplanted kidney is a drastic measure and is not the first step in managing these symptoms. This action would be considered only if there is clear evidence of irreversible graft failure or severe complications that cannot be managed with other treatments.

Choice C reason: Antibiotic therapy is

The correct answer. The symptoms of oliguria (low urine output), elevated temperature, increased blood pressure, and signs of fluid retention suggest an infection, which is a common complication after kidney transplantation due to the immunosuppressive medications that lower the immune system's ability to fight infections. Treating the infection with antibiotics is crucial to prevent further complications and preserve the function of the transplanted kidney.

Choice D reason: Increased doses of immunosuppressive drugs are not appropriate in this situation. While immunosuppressive drugs are essential to prevent organ rejection, increasing their dosage in the presence of an infection could further compromise the immune system and exacerbate the infection. The priority is to address the infection first.

A. Administer the prescribed intravenous furosemide (Lasix). B. Ask the patient about an advanced directive C. Assess the client's respiratory status. D. Draw blood to assess the patient's serum electrolytes.

Correct Answer is C,D,A,B

Explanation

Choice A reason: Assessing the client's respiratory status is the top priority action. This ensures that any immediate issues with breathing or oxygenation are identified and managed promptly. Respiratory status can quickly deteriorate in patients with heart failure, and addressing this first can be life-saving.

Choice B reason: Drawing blood to assess the patient's serum electrolytes is important to determine any imbalances that need immediate correction. Electrolyte levels can affect heart function and overall stability, so understanding the patient's current status helps guide further treatment.

Choice C reason: Administering the prescribed intravenous furosemide (Lasix) is critical for managing fluid overload in heart failure. Furosemide helps reduce fluid retention and alleviate symptoms such as pulmonary edema, which can improve respiratory status and overall comfort.

Choice D reason: Asking the patient about an advanced directive is important for understanding their wishes and planning care accordingly. However, it is not an immediate priority compared to stabilizing the patient's respiratory status and addressing urgent medical needs.

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To improve the oxygenation of a client with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation, the nurse should place the client in which position?

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