a. A relative increase in antibody titers indicates viral infection. Has been NPO since midnight in preparation for surgery The postoperative use of nonverbal communication techniques b. Outcomes Interventions Rationale with reference Eval of goal/outcomes Gas r/t alveolar- membrane AEB Positive for strep Bi-pap to maintain rhonchi diminished breath bilaterally. c. Determine the need for suctioning. Hospital acquired pneumonia may be due to an infected. Impaired Gas Exchange Nursing Diagnosis & Care Plans - NurseStudy.Net f. PEFR c. Have the patient hyperextend the neck. Please read our disclaimer. Pleural friction rub occurs with pneumonia and is a grating or creaking sound. Which values indicate a need for the use of continuous oxygen therapy? d. SpO2 of 88%; PaO2 of 55 mm Hg When is the nurse considered infected? Impaired Gas Exchange - Nursing Diagnosis & Care Plan c. Mucociliary clearance Auscultate breath sounds at least every 2 to 4 hours or as the patients condition dictates. 3.3 Risk for Infection. b. What accurately describes the alveolar sacs? What process would they have needed to complete in order to have been successful? - Manifestations of a lung abscess usually occur slowly over a period of weeks to months, especially if anaerobic organisms are the cause. Which medication therapy does the nurse anticipate will be prescribed? Avoid instillation of saline during suctioning. This also increases the risk for aspiration pneumonia. Give health teachings about the importance of taking prescribed medication on time and with the right dose. However, with increasing respiratory distress, respiratory acidosis may occur. Nutrition reviews, 68(8), 439458. The patient has been diagnosed with an early vocal cord cancer. a. Rest lowers the oxygen demand of a patient whose reserves are likely to be limited. Attempt to replace the tube. d. SpO2 of 88%; PaO2 of 55 mm Hg. h. Absent breath sounds What is the most appropriate action by the nurse? The patient may demonstrate abnormal breathing, difficulty breathing (dyspnea), restlessness, and inability to tolerate activity. b. treatment with antifungal agents. 3. d. Comparison of patient's current vital signs with normal vital signs. A patient develops epistaxis after removal of a nasogastric tube. Help the patient get into a comfortable position, usually the half-Fowler position. FON-Chapter7-Case Study Practices and Critical thinking Questions a. Touching an infected object and then touching your nose or mouth can also transfer the germs. 3. For this reason, the nurse should sit the patient up as tolerated and apply oxygen before eliciting additional help. Oxygen is administered when O2 saturation or ABG results show hypoxemia. Being aware of the patient's condition, what approach should the nurse use to assess the patient's lungs (select all that apply)? 6. a. b. ineffective airway clearance related to pneumonia and copd impaired gas exchange related to acute and chronic lung.