Respiratory Failure Overview Quiz
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Questions and Answers

What primarily causes acute respiratory failure (ARF)?

  • Inadequate ventilation and/or oxygenation leading to ventilation-perfusion mismatch (correct)
  • Infection leading to increased respiratory rate
  • Excessive perfusion to the pulmonary capillary bed
  • Alveolar dilation and increased lung elasticity

    • Which condition can lead to oxygenation failure?

  • Pulmonary embolism (correct)
  • Cystic fibrosis
  • Chronic bronchitis
  • Pneumothorax

    • How do age-related changes in the lungs affect older adults in the context of respiratory failure?

  • Increased lung elasticity
  • Improved pulmonary reserve due to thicker alveoli
  • Decreased pulmonary reserves, leading to quicker decompensation (correct)
  • Enhanced respiratory muscle function

    • Which of the following symptoms is most likely to occur due to combined ventilatory and oxygenation failure?

    <p>Profound hypoxemia</p> Signup and view all the answers

    Which factor does NOT contribute to ventilatory failure?

    <p>Excessive pulmonary capillary perfusion</p> Signup and view all the answers

    What is a primary consequence of the systemic inflammatory response in ARDS?

    <p>Compression of terminal airways</p> Signup and view all the answers

    Which factor primarily leads to fluid accumulation in the alveoli during ARDS?

    <p>Increased permeability of the alveolar-capillary membrane</p> Signup and view all the answers

    What characterizes Severe Acute Respiratory Syndrome (SARS)?

    <p>Resulting from a viral infection of coronaviruses</p> Signup and view all the answers

    What effect does a reduction in surfactant have on the alveoli?

    <p>It leads to alveolar collapse or fluid filling.</p> Signup and view all the answers

    How is the SARS virus primarily transmitted?

    <p>Airborne droplets from sneezing or coughing</p> Signup and view all the answers

    Which condition can be classified as a cause of combined ventilatory and oxygenation failure?

    <p>Pneumonia</p> Signup and view all the answers

    What is a significant risk factor for developing acute respiratory distress syndrome (ARDS)?

    <p>History of smoking</p> Signup and view all the answers

    Which of the following conditions is associated with ventilatory failure?

    <p>Pneumothorax</p> Signup and view all the answers

    What inherent characteristic of patients with severe asthma could lead to oxygenation failure?

    <p>Low concentrations of oxygen in blood</p> Signup and view all the answers

    Which factor is NOT typically a risk for ventilatory failure?

    <p>High altitude exposure</p> Signup and view all the answers

    Which of the following is a common symptom of acute respiratory failure?

    <p>Dyspnea</p> Signup and view all the answers

    Which finding is typically associated with acute respiratory distress syndrome (ARDS)?

    <p>Reduced lung compliance</p> Signup and view all the answers

    What is a characteristic x-ray finding in a patient with ARDS?

    <p>Dense patchy bilateral pulmonary infiltrates</p> Signup and view all the answers

    Which symptom is indicative of severe hypoxemia even when 100% oxygen is administered?

    <p>Cyanosis</p> Signup and view all the answers

    Which of the following symptoms may indicate elevated carbon dioxide levels in the blood?

    <p>Confusion</p> Signup and view all the answers

    Which symptom is a common indication of severe COVID-19 illness?

    <p>Irregular heartbeat</p> Signup and view all the answers

    What serious complication may arise from severe COVID-19 illness?

    <p>Cyanosis</p> Signup and view all the answers

    Which of the following is NOT commonly associated with mild to moderate COVID-19 symptoms?

    <p>Unrelenting pressure in the chest</p> Signup and view all the answers

    What level of consciousness alteration might indicate severe COVID-19 progression?

    <p>Altered level of consciousness</p> Signup and view all the answers

    Which symptom may indicate the presence of acute respiratory distress syndrome (ARDS) in a COVID-19 patient?

    <p>Severe, unrelenting pressure in the chest</p> Signup and view all the answers

    What PaO2 level is commonly associated with hypoxemia in patients with respiratory failure?

    <p>PaO2 less than 60 mm Hg</p> Signup and view all the answers

    Which laboratory test is specifically used to confirm and monitor ARDS?

    <p>Brain natriuretic peptide (BNP)</p> Signup and view all the answers

    In the context of respiratory failure, what combination of ABG results indicates combined ventilatory and oxygenation failure?

    <p>PaCO2 greater than 50 mm Hg and pH less than 7.35</p> Signup and view all the answers

    Which laboratory marker can indicate inflammation in a patient suspected of having SARS?

    <p>Lactate dehydrogenase</p> Signup and view all the answers

    What condition is indicated by a SaO2 level less than 90% in a patient being evaluated for respiratory failure?

    <p>Acute respiratory failure</p> Signup and view all the answers

    What is the preferred diagnostic test for SARS-CoV-2 infection?

    <p>Nucleic acid amplification test (NAAT)</p> Signup and view all the answers

    Which finding is NOT associated with a chest x-ray in patients with SARS?

    <p>Scattered ground glass opacities</p> Signup and view all the answers

    What does a positive result from a rapid antigen test indicate regarding SARS-CoV-2 infection likelihood?

    <p>High likelihood of infection</p> Signup and view all the answers

    Which of the following nursing actions is crucial after a chest x-ray?

    <p>Communicate the results to the appropriate personnel</p> Signup and view all the answers

    What is the primary characteristic of the nucleic acid amplification test (NAAT) for diagnosing SARS-CoV-2?

    <p>High sensitivity</p> Signup and view all the answers

    What is the typical range for pulmonary capillary wedge pressure in patients with ARDS?

    <p>4 to 12 mm Hg</p> Signup and view all the answers

    Which nursing action is essential during the placement of a central venous pressure catheter?

    <p>Monitor the ECG</p> Signup and view all the answers

    What is a key reason for continuous hemodynamic monitoring in patients with ARDS?

    <p>To manage fluid administration</p> Signup and view all the answers

    What method can be used to confirm the proper placement of a central venous catheter?

    <p>Chest x-ray confirmation</p> Signup and view all the answers

    Why is it important to have resuscitation medications and equipment readily available during hemodynamic monitoring?

    <p>To respond quickly to potential emergencies</p> Signup and view all the answers

    What is the primary reason for oxygenating a patient before suctioning their secretions?

    <p>To prevent further hypoxemia</p> Signup and view all the answers

    What is a common indicator that a patient may need suctioning?

    <p>Presence of coarse crackles over the trachea</p> Signup and view all the answers

    How can a nurse prevent aspiration during enteral feedings?

    <p>By elevating the head of the bed 30° to 45°</p> Signup and view all the answers

    What is an essential nursing action when using a mechanical ventilator?

    <p>Document ventilator settings according to facility protocol</p> Signup and view all the answers

    Which nursing intervention is critical when repositioning a patient on mechanical ventilation?

    <p>Immediately check for signs of hypoxemia</p> Signup and view all the answers

    What is the purpose of maintaining continuous ECG monitoring in a patient on mechanical ventilation?

    <p>To monitor for changes indicating increased hypoxemia</p> Signup and view all the answers

    Which measure should be taken to ensure safety when providing oral care for patients at risk of infection?

    <p>Wear protective clothing when appropriate</p> Signup and view all the answers

    What intervention can help provide emotional support to clients and their families during critical care?

    <p>Provide alternative communication means like dry erase boards</p> Signup and view all the answers

    What is a primary action of benzodiazepines in patient care?

    <p>Reduces anxiety and oxygen consumption</p> Signup and view all the answers

    Which nursing action is essential when administering propofol?

    <p>Ensure patient is intubated and ventilated</p> Signup and view all the answers

    Which patient condition is contraindicated for the use of propofol?

    <p>Hyperlipidemia</p> Signup and view all the answers

    What should be monitored closely in patients receiving benzodiazepines?

    <p>Respirations and SaO2</p> Signup and view all the answers

    What is a critical nursing action when administering sedation to a patient on mechanical ventilation?

    <p>Continuously monitor ECG and blood pressure</p> Signup and view all the answers

    What is a key action to be taken when discontinuing corticosteroids in hospitalized clients?

    <p>Discontinue the medication gradually to prevent withdrawal.</p> Signup and view all the answers

    Which of the following medications is recommended for pain management in hospitalized patients?

    <p>Morphine sulfate</p> Signup and view all the answers

    Why is it important to monitor glucose and electrolytes in patients receiving corticosteroids?

    <p>Corticosteroids can lead to adrenal suppression.</p> Signup and view all the answers

    What is the significance of having naloxone available for patients using opioid analgesics?

    <p>To reverse the effects of respiratory depression.</p> Signup and view all the answers

    Which statement best describes client education regarding the use of corticosteroids?

    <p>Always take oral doses with food to minimize stomach irritation.</p> Signup and view all the answers

    What is a crucial nursing action when administering neuromuscular blocking agents?

    <p>Ensure clients are intubated and ventilated.</p> Signup and view all the answers

    What must be available to reverse the effects of neuromuscular blocking agents?

    <p>Neostigmine and atropine.</p> Signup and view all the answers

    Which of the following correctly describes a side effect of neuromuscular blocking agents?

    <p>They can leave clients awake and frightened.</p> Signup and view all the answers

    What should be done to ensure client safety when administering neuromuscular blocking agents?

    <p>Explain all procedures to the client.</p> Signup and view all the answers

    Which statement about neuromuscular blocking agents is true?

    <p>They help to decrease oxygen consumption.</p> Signup and view all the answers

    What nursing action should be performed prior to administering the first dose of an antibiotic?

    <p>Culture the sputum prior to administration of the first dose.</p> Signup and view all the answers

    What is the recommended method for administering IV doses of vancomycin to avoid red man syndrome?

    <p>Give IV doses slowly over at least 60 minutes.</p> Signup and view all the answers

    Which of the following statements regarding client education for oral antibiotic doses is accurate?

    <p>Finish the prescribed dose even if symptoms improve.</p> Signup and view all the answers

    Which aspect is essential to monitor in patients receiving vancomycin therapy?

    <p>Coagulopathy and renal function.</p> Signup and view all the answers

    What should a nurse avoid when administering antibiotics?

    <p>Giving multiple medications simultaneously.</p> Signup and view all the answers

    What is the main action of Remdesivir in treating SARS-CoV-2 infection?

    <p>Slows replication of the virus</p> Signup and view all the answers

    Which of the following nursing actions is NOT required before initiating Remdesivir therapy?

    <p>Monitor for hyperkalemia</p> Signup and view all the answers

    What should a nurse monitor for as a potential adverse effect of Remdesivir?

    <p>Hypersensitivity reaction</p> Signup and view all the answers

    While administering Remdesivir, which parameter is crucial for assessing renal function?

    <p>Glomerular filtration rate (GFR)</p> Signup and view all the answers

    Which adverse gastrointestinal effects should a nurse monitor for during treatment with Remdesivir?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the primary action of antirheumatics like Baricitinib and Tocilizumab in the context of SARS-CoV-2 infection?

    <p>Inhibit inflammatory processes associated with the infection</p> Signup and view all the answers

    Which nursing action is crucial when monitoring a patient receiving antirheumatics?

    <p>Monitor for hypersensitivity reactions</p> Signup and view all the answers

    What laboratory test should be obtained before initiating therapy with antirheumatics like Baricitinib?

    <p>CBC with differential</p> Signup and view all the answers

    Why is it important to monitor liver and kidney function in patients receiving antirheumatics for SARS-CoV-2?

    <p>These medications can affect renal and hepatic metabolism</p> Signup and view all the answers

    What potential complication should a nurse specifically monitor for in patients receiving antirheumatics?

    <p>Manifestations of arterial and deep vein thrombosis</p> Signup and view all the answers

    What is the primary action of anticoagulants like dalteparin and enoxaparin?

    <p>Inhibit blood coagulation</p> Signup and view all the answers

    Which nursing action is crucial before initiating therapy with anticoagulants?

    <p>Obtain CBC with differential and absolute neutrophil count</p> Signup and view all the answers

    What should a nurse monitor for in a patient receiving anticoagulants?

    <p>Hypersensitivity reactions</p> Signup and view all the answers

    What is an appropriate nursing assessment related to the administration of anticoagulants?

    <p>Check injection site for bruising and inflammation</p> Signup and view all the answers

    Which guidelines should be referred to for immunizations regarding SARS-CoV-2?

    <p>Centers for Disease Control and Prevention (CDC)</p> Signup and view all the answers

    What is one of the primary roles of a respiratory therapist during mechanical ventilation?

    <p>Manage the ventilator and adjust settings.</p> Signup and view all the answers

    Which of the following actions is NOT crucial when confirming the placement of an endotracheal tube post-intubation?

    <p>Checking the client's nutritional intake.</p> Signup and view all the answers

    What is the purpose of PEEP during mechanical ventilation?

    <p>To keep alveoli expanded during expiration.</p> Signup and view all the answers

    What should a nurse monitor when caring for a patient with an endotracheal tube concerning the tube's cuff?

    <p>Cuff pressure to maintain between 20 to 30 cm.H2O.</p> Signup and view all the answers

    Which equipment should always be readily available during the intubation procedure?

    <p>A manual resuscitation bag and face mask.</p> Signup and view all the answers

    What is the primary benefit of using a kinetic bed for patients?

    <p>To reduce atelectasis and improve ventilation</p> Signup and view all the answers

    Which nursing action should be taken if a client experiences distress during rotation on a kinetic bed?

    <p>Stop the rotation</p> Signup and view all the answers

    What is a critical monitoring parameter during kinetic therapy?

    <p>Breath sounds</p> Signup and view all the answers

    How should rotational therapy be initiated for a patient?

    <p>Start slowly and gradually increase rotation</p> Signup and view all the answers

    What should be provided alongside kinetic therapy to prevent skin breakdown?

    <p>Routine skin care</p> Signup and view all the answers

    What complication can arise from long-term intubation?

    <p>Damage to trachea and vocal cords</p> Signup and view all the answers

    How often should the positioning of an endotracheal tube be checked?

    <p>Every 1 to 2 hours</p> Signup and view all the answers

    What is the recommended cuff pressure to maintain for an endotracheal tube?

    <p>20 to 30 cm H2O</p> Signup and view all the answers

    Which nursing action should be performed when a client is moved or turned who has an endotracheal tube?

    <p>Monitor lung sounds and chest movement</p> Signup and view all the answers

    What is a potential reason for needing a tracheostomy in ventilated patients?

    <p>Long-term ventilation requirements</p> Signup and view all the answers

    What is a potential complication of long-term intubation?

    <p>Damage to trachea and vocal cords</p> Signup and view all the answers

    When checking the cuff pressure of an endotracheal tube, what is the appropriate range to maintain?

    <p>20 to 30 cm H2O</p> Signup and view all the answers

    What action can help prevent infection in patients with an endotracheal tube?

    <p>Using sterile suctioning techniques</p> Signup and view all the answers

    What should a nurse assess every time a client with an endotracheal tube is moved?

    <p>Lung sounds and oxygen saturation</p> Signup and view all the answers

    Which of the following actions is important to secure the position of an endotracheal tube?

    <p>Documenting the level of the tube</p> Signup and view all the answers

    What is a primary cause of acute respiratory failure (ARF)?

    <p>Inadequate ventilation due to lung disease</p> Signup and view all the answers

    Which condition is a likely consequence of a systemic inflammatory response in ARDS?

    <p>Fluid accumulation in the alveoli</p> Signup and view all the answers

    What type of failure can occur with diseases affecting lung tissue, such as emphysema?

    <p>Combined ventilatory and oxygenation failure</p> Signup and view all the answers

    Which of the following factors can lead to fluid accumulation in the alveoli during ARDS?

    <p>Trauma to the lungs</p> Signup and view all the answers

    What is a significant risk associated with older adult clients regarding respiratory failure?

    <p>Decreased lung elasticity and thickened alveoli</p> Signup and view all the answers

    Which mechanism explains the transmission of SARS?

    <p>Airborne droplets from respiratory activities</p> Signup and view all the answers

    What can result from a lack of perfusion to the pulmonary capillary bed?

    <p>Pulmonary embolism may occur</p> Signup and view all the answers

    What leads to a decrease in surfactant production in ARDS?

    <p>Inflammatory response damaging alveoli</p> Signup and view all the answers

    What is the primary purpose of administering vecuronium to a client with acute respiratory distress syndrome (ARDS)?

    <p>To facilitate ventilation</p> Signup and view all the answers

    Which of the following factors contributes to combined ventilatory and oxygenation failure?

    <p>Poor respiratory movement</p> Signup and view all the answers

    Which action is essential when monitoring a patient administered remdesivir?

    <p>Obtain liver enzymes and GFR</p> Signup and view all the answers

    Which of the following antibiotics is commonly sensitive to cultured organisms in respiratory infections?

    <p>Vancomycin</p> Signup and view all the answers

    Which patient condition is most likely to develop dyspnea as a prominent symptom?

    <p>Severe asthma attack</p> Signup and view all the answers

    What is a common diagnostic finding on a chest x-ray for patients with ARDS?

    <p>Ground-glass opacities</p> Signup and view all the answers

    What is an important nursing action to take before administering the first dose of antibiotics for pneumonia?

    <p>Culture the sputum</p> Signup and view all the answers

    In which scenario is a patient's risk for acute respiratory distress syndrome (ARDS) increased?

    <p>Near-drowning incident</p> Signup and view all the answers

    When administering anticoagulants to a patient with COVID-19, which assessment is essential?

    <p>Assess for bruising at the injection site</p> Signup and view all the answers

    What is the primary action of antivirals like remdesivir when treating SARS-CoV-2 infections?

    <p>Slow replication of the virus</p> Signup and view all the answers

    Which laboratory value indicates severe hypoxemia in a patient with respiratory failure?

    <p>PaO2 less than 60 mm Hg</p> Signup and view all the answers

    Which medication action is associated with antirheumatics used in SARS-CoV-2 infections?

    <p>Inhibit inflammatory processes</p> Signup and view all the answers

    Which condition could cause elevated intracranial pressure that may lead to respiratory failure?

    <p>Hemorrhagic stroke</p> Signup and view all the answers

    During which phase should the nurse assure that emergency resuscitation equipment is available?

    <p>Preintubation phase</p> Signup and view all the answers

    What is identified as a common complication that can arise from ARDS?

    <p>Sepsis</p> Signup and view all the answers

    Which specific laboratory tests should be obtained before initiating therapy for a patient on anticoagulants?

    <p>Prothrombin time and INR</p> Signup and view all the answers

    Which of the following is a risk factor for developing oxygenation failure?

    <p>Low hemoglobin levels</p> Signup and view all the answers

    What is a key nursing action when administering bronchodilators in a patient with ARDS?

    <p>Monitor for wheezing and breath sounds</p> Signup and view all the answers

    What nursing intervention is most critical during the management of a patient with ARDS?

    <p>Maintaining optimal patient positioning</p> Signup and view all the answers

    What should be included in client education for those receiving anticoagulant therapy?

    <p>Risk of bleeding and bruising</p> Signup and view all the answers

    Which component is typically monitored during hemodynamic assessment in ARDS patients?

    <p>Pulmonary capillary wedge pressure</p> Signup and view all the answers

    Which of the following describes a vital nursing intervention during mechanical ventilation?

    <p>Frequent assessment of lung sounds and SaO2</p> Signup and view all the answers

    Which statement best describes the primary function of the nucleic acid amplification test (NAAT) for SARS-CoV-2?

    <p>It identifies viral ribonucleic acid (RNA).</p> Signup and view all the answers

    Which of the following describes the role of pulmonary capillary wedge pressure in ARDS?

    <p>Reflects fluid status in the lungs</p> Signup and view all the answers

    What is the recommended action when providing care for a patient with a kinetic therapy bed?

    <p>Monitor for client distress and adjust rotation gradually</p> Signup and view all the answers

    What is essential to monitor after administering enteral nutrition in a client with ARDS?

    <p>Metabolic and caloric needs</p> Signup and view all the answers

    What is a recognized sign of severe acute respiratory syndrome (SARS-CoV-2) infection?

    <p>Loss of taste and smell</p> Signup and view all the answers

    Which of the following interventions is crucial in safely managing patients with respiratory distress?

    <p>Close monitoring of hemodynamic status</p> Signup and view all the answers

    What is the most critical action for a nurse to take when a patient exhibits absent breath sounds and dyspnea after a motor vehicle crash?

    <p>Administer oxygen via a high-flow mask.</p> Signup and view all the answers

    In which position should a nurse place a client with ARDS to promote effective ventilation?

    <p>Prone.</p> Signup and view all the answers

    What nursing action is essential when monitoring a client on mechanical ventilation?

    <p>Ensure continuous ECG monitoring for changes.</p> Signup and view all the answers

    How should a nurse assess the need for suctioning a client on mechanical ventilation?

    <p>Auscultate for coarse crackles over the trachea.</p> Signup and view all the answers

    What should a nurse do to prevent aspiration when administering enteral feedings?

    <p>Elevate the head of the bed 30° to 45°.</p> Signup and view all the answers

    Which medication class is recommended for clients with SARS-CoV-2 infection who require supplemental oxygenation?

    <p>Corticosteroids.</p> Signup and view all the answers

    What is a critical nursing action when administering benzodiazepines?

    <p>Monitor respirations in clients not on mechanical ventilation.</p> Signup and view all the answers

    Which of the following actions should a nurse prioritize when suctioning a patient?

    <p>Oxygenate the client before the procedure.</p> Signup and view all the answers

    When using propofol, what is a key monitoring action that nurses must perform?

    <p>Titrate to desired sedation based on the patient's neurologic status.</p> Signup and view all the answers

    How should a nurse manage a client receiving corticosteroids to prevent side effects?

    <p>Administer with an antiulcer medication.</p> Signup and view all the answers

    Which nursing action is essential when using neuromuscular blocking agents?

    <p>Monitor muscle strength and provide sedation.</p> Signup and view all the answers

    What is a major consideration when using mechanical ventilation in patients with high PEEP?

    <p>It can lead to pneumothorax due to lung collapse.</p> Signup and view all the answers

    What is a significant risk associated with the use of opioids in patients receiving mechanical ventilation?

    <p>Severe respiratory depression.</p> Signup and view all the answers

    Which intervention can a nurse take to support a client's emotional needs during critical care?

    <p>Encourage verbalization of feelings and provide alternative communication methods.</p> Signup and view all the answers

    Study Notes

    Respiratory Failure Overview

    • Respiratory failure encompasses acute respiratory failure (ARF), acute respiratory distress syndrome (ARDS), and severe acute respiratory syndrome (SARS).
    • Older adults are more susceptible to respiratory decompensation due to age-related lung changes (decreased elasticity, thicker alveoli) that diminish pulmonary reserve.

    Acute Respiratory Failure (ARF)

    • ARF arises from inadequate ventilation and/or oxygenation, causing a ventilation-perfusion mismatch.
    • Ventilatory failure results from:
      • Mechanical lung or chest wall abnormalities.
      • Impaired respiratory muscle function (especially the diaphragm).
      • Respiratory control center malfunction in the brain.
    • Oxygenation failure results from:
      • Inadequate perfusion to pulmonary capillaries (e.g., pulmonary embolism).
      • Conditions altering gas exchange medium (e.g., pulmonary edema, pneumonia).
    • Lung diseases (e.g., asthma, emphysema, cystic fibrosis) can lead to both oxygenation failure and increased breathing effort, eventually causing respiratory muscle fatigue and ventilatory failure.
    • Combined ventilation and oxygenation failure leads to more severe hypoxemia than either failure alone.
    • ARF diagnosis is based on arterial blood gas (ABG) values.

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    Description

    Test your understanding of respiratory failure, including acute respiratory failure, ARDS, and SARS. This quiz will cover causes, effects, and implications for older adults. Brush up on your knowledge and learn about the mechanisms behind ventilatory and oxygenation failures.

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