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88Meme 88Meme
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A month ago
Before being placed on noninvasive positive pressure ventilation (NIPPV), a client has these ABGs: pH 7.25, PaCO2 66 mm Hg, PaO2 90 mm Hg, HCO3 23 mm Hg. One hour after being placed on NIPPV the client's ABGs are: pH 7.32, PaCO2 46 mm Hg, PaO2 92 mm Hg, HCO3 24 mm Hg. What should the nurse do? (Select all that apply.)
1. Increase the oxygen
2. Plan for immediate intubation
3. Increase the expiratory pressure
4. Check the mask for an air leak
5. Continue monitoring
Textbook 

High-Acuity Nursing


Edition: 6th
Authors:
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linhhhlinhhh
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Posts: 438
A month ago
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More questions for this book are available here
The answer is 4, 5
Rationale:
1. A PaO2 of 90 mm Hg is within the normal range and does not require an increase in supplemental oxygen.
2. Immediate intubation is not indicated unless the client is in respiratory distress or hypoxic as the PaCO2 is decreasing.
3. The expiratory pressure is increased to improve oxygenation by recruiting alveoli and preventing atelectasis. This client is not hypoxic and does not require adjustments to the expiratory pressure.
4. After one hour using NIPPV, more improvement in ABGs would be anticipated. The client's values suggest continued hypoventilation. Hypoventilation is the most common mechanical problem associated with NIPPV and repositioning the mask to improve the seal may relieve it.
5. The nurse should continue to monitor this client.
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88Meme Author
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A month ago
Thanks
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Smart ... Thanks!
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This helped my grade so much Perfect
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