Reference no: EM133568955

Questions

1. Mrs. Smith has a long history of smoking. On Monday, she developed pleuritic chest pain in the right side of her chest. She also has a high fever, dyspnea, and a cough. On examination, she has absent breath sounds on the right and a pleural friction rub.

Mrs. Smith's radiograph shows a dense white collection of fluid at the base of the right lung. A thoracentesis reveals numerous white blood cells and bacteria in her pleural fluid. Mrs. Smith's diagnosis is empyema.

1. What is empyema?

2. What are the clinical manifestations?

3. Why does Mrs. Smith experience dyspnea?

2. Ms. Lo, age 24, was admitted yesterday for a femur fracture from a skiing accident. She develops sudden dyspnea and pain in the left side of her chest that is worse with breathing. Assessment reveals tachypnea, tachycardia, and some slight crackles in the lower left lung. Ms. Lo's serum d-dimer is elevated. A spiral CT confirms her diagnosis of pulmonary embolism (PE).

1. How did Ms. Lo develop a pulmonary embolism?

2. How does a large pulmonary embolism cause a V/Q mismatch? What type of mismatch?

3. What are the clinical manifestations of a PE?

3. Fred Brown arrives in the emergency department by ambulance with acute dyspnea, tachypnea, and cyanosis. His arterial blood gases are pH 7.32 HCO3 23, PaCO2 58 mmHg.

1. How would you interpret these blood gases?

2. What are the etiologies of this interpretation?

3. What complication is this client at risk for developing?

4. Mr. Lee had been feeling tired for several weeks. When he developed extreme shortness of breath, his wife took him to the emergency department. The ER listened to his lungs, took an x-ray, and gave him IV Lasix. He was admitted to the hospital with pulmonary edema from acute Left sided heart failure. After a few days, he was discharged from the hospital with various medications and instructions to eat a low sodium diet.

1. What did the ER nurse hear when the lungs were auscultated?

2. What are the etiologies of pulmonary edema?

3. What are other clinical manifestations of pulmonary edema?

5. Mr. Clug had a perforated appendix which required surgery and being placed on nasogastric suctioning. The nurse assesses a B/P of 80/40. The nurse calls the provider, and she orders arterial blood gases to be performed. The results from the lab are as follows: pH 7.59, HCO3 32, PCO2 42. Based on the blood pressure and blood gases what acid-base disorder would the nurse expect?

1. What other clinical manifestations should the nurse assess in the client?

2. What electrolyte disorder is the client at risk for developing?

3. What complications is the client at risk for developing?