Reference no: EM133297466

Assignment:

Maria Hernandez is an 80-year-old female (weight 40 kg) who is admitted to the intensive care unit following a motor vehicle collision. She was driving and wearing her seat belt when she ran her car off the road and hit a tree. She remembers the collision and did not lose consciousness. Her injuries include a left anterior flail segment of the lung, a fractured left shoulder, and facial bruising. She is hemodynamically stable but has respiratory distress with paradoxical movement of her left anterior chest wall. She has no head or neck injury. Recently she has had several unexplained blackouts. She takes a beta blocker daily for hypertension. She was intubated and ventilated in the ED because of respiratory distress. Initial ventilation was tidal volume 700 mLs at a rate of 12 breaths with 100% oxygen.

She is breathing above the ventilatory rate of 12 taking 24 breaths per minute. Peripheral perfusion is WNL. . An intravenous infusion of lactated Ringer solution was started at 100 ml per hour. Arterial blood gases were obtained half an hour later. At this time, Ms. Hernandez's vital signs are TO 98.8°F, HR 110 bpm, BP 120/60 mmHg, R 16/min, and pulse oximeter 89% on 100% oxygen. Her ABG values are pH 7.25, pCO2 55 mmHg, pO2 58 mmHg, HCO3 24 mEq/L.

Question 1. What is Ms. Hernandez's primary problem related to the mechanism of injury?

Question 2. What is the cause of her respiratory distress, define and explain thoroughly?

Question 3. What do her ABG results indicate?

3 a. What nursing diagnosis is added to the care plan based on the most acute/abnormal information in this scenario?

Question 4. Refer to the concept of Oxygenation: What assessments will need to be implemented Ms. Hernandez for while she is intubated?

Question 5. Refer to the concept of Oxygenation: How will you help Ms. Hernandez communicate while she is intubated?

Question 6. Refer to the concept of Legal Issues: Ms. Hernandez's nephew calls to inquire about her condition. What regulations or policies apply when another individual calls seeking information about a client? How do you respond to the nephew?