You are caring for a patient with past medical history of pulmonary fibrosis who is on a mechanical ventilator. You know that a patient with pulmonary fibrosis has stiff lungs. Which complication related to mechanical ventilation are you more worried about given the patient's history?
constipation
unplanned extubation
rapid respiratory rate
barotrauma
The Correct Answer is D
A. Constipation: Constipation is a potential side effect of immobility or opioid use but is not directly related to mechanical ventilation or stiff lungs. It is a lower-priority concern in this context.
B. Unplanned extubation: While always a concern in ventilated patients, it is not specifically linked to the patient’s underlying pulmonary fibrosis or stiff lungs. Standard precautions can mitigate this risk.
C. Rapid respiratory rate: The ventilator controls respiratory rate in mechanically ventilated patients, and while tachypnea may occur with distress, it is less of a direct risk compared with complications from stiff lung tissue.
D. Barotrauma: Pulmonary fibrosis causes decreased lung compliance, meaning the lungs are stiff and less able to expand. Mechanical ventilation in stiff lungs increases the risk of barotrauma, such as pneumothorax, because the high pressures needed to ventilate noncompliant lungs can damage alveoli.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Potassium: Frequent use of albuterol, a beta-2 agonist, can cause a shift of potassium from the blood into the cells, leading to hypokalemia. Low potassium can result in muscle weakness, arrhythmias, and other cardiac complications, making it an important lab to monitor in this patient.
B. Sodium: Albuterol does not typically affect sodium levels. Monitoring sodium is not a primary concern in the context of frequent bronchodilator use unless there are other comorbidities affecting electrolyte balance.
C. White blood cells: WBC count is not directly affected by albuterol use. It is usually monitored for infection or inflammatory processes rather than medication side effects.
D. BUN and Creatinine: Renal function markers such as BUN and creatinine are not directly influenced by short-acting bronchodilator therapy. Monitoring these labs is not necessary solely due to albuterol administration.
Correct Answer is A
Explanation
A. We can control amount of pressure going into lungs, decreasing risk of barotrauma: Pressure-control ventilation delivers breaths to a preset inspiratory pressure, limiting peak airway pressure. This reduces the risk of alveolar overdistension and barotrauma, making it particularly useful in patients with stiff or non-compliant lungs.
B. A patient will only need to be on the ventilator for a short period of time: The duration of mechanical ventilation depends on the patient’s underlying condition and recovery, not the mode itself. Pressure-control ventilation does not inherently shorten ventilation time.
C. The patient is more comfortable on this mode: Comfort may vary depending on sedation and ventilator settings. Pressure-control ventilation does not automatically make the patient more comfortable than other modes.
D. Patient is at lower risk of ventilator associated pneumonia: Ventilator-associated pneumonia risk is influenced by factors such as oral care, suctioning, and positioning, not by the choice of pressure-control ventilation mode.
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