2000: 85-year-old male receiving mechanical ventilation for a severe chronic obstructive pulmonary disease (COPD) exacerbation. Client was found at home with an oxygen saturation of 79%, cyanotic, and with respiratory distress. The client was intubated via endotracheal tube (ETT) in the emergency department. He is admitted to the ICU for treatment. Will adjust ventilator settings and add sedation for comfort.
1900: Mechanical ventilator settings -
- Mode: Assist-control
- Tidal volume (VT): 450 mL
- Rate: 12/minute
- Fraction of inspired oxygen (FiO2): 100%
Propofol 50 mcg/kg/minute
2000: Add positive end-expiratory pressure (PEEP) to ventilator at 10 cm H2O
The nurse reviews the physician's orders from 1900 and 2000
➢ Complete the following sentence from the list of options
Based on the ventilator settings, the nurse should obtain a physician's order for [promethazine / ondansetron / pantoprazole] to prevent a stress ulcer. Positive end-expiratory pressure (PEEP) could cause the client to develop [hypotension / respiratory acidosis / fever] so the nurse should monitor the client's [arterial blood gas. / blood pressure. / temperature.]
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