The nurse is caring for a client who was orally intubated yesterday for respiratory distress due to pneumonia. She is on AC mode. Her ventilator settings are: RR 14, FiO₂ 40%, PEEP 5 cm H₂O, VT 400 mL.While suctioning, you hear air escaping from around her mouth, and the ventilator alarm shows “low exhaled tidal volume.” The client appears anxious. Vital signs: HR 112, RR 26, SpO₂ 89%.Which action should the nurse perform first?

A client with hypermagnesemia reports lethargy, nausea, and vomiting since this morning. The medical record indicates adequate renal function and normal sinus rhythm on the ECG. Which initial prescription should the nurse anticipate from the provider?

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). The nurse observes a new onset of agitation and confusion. Which action should the nurse take first?

The nurse is caring for a client at risk of ARDS. Which sequence of findings indicates the client is progressing from acute respiratory failure to ARDS?

A nurse is caring for a client who has experienced nausea and vomiting for one week and has been self-medicating with baking soda for abdominal pain. The client’s arterial blood gas (ABG) results are pH of 7.48, a bicarbonate level (HCO₃⁻) of 34 mEq/L, and a PCO₂ of 42 mm Hg. The client reports symptoms of dizziness and muscle twitching.  Which action should the nurse prioritize to address this client’s condition?

A nurse manager is addressing a conflict between staff members that has not yet become apparent to the team but is creating tension among a few individuals. Which stage of conflict does this situation represent?

A nurse receives a newly admitted client with uncontrolled Diabetes Mellitus. The nurse notes deep and rapid respirations (Kussmaul respirations), confusion, and a blood glucose level of 400 mg/dL. Arterial blood gas results reveal:pH: 7.25PaCO₂: 30 mm HgHCO₃⁻: 15 mEq/LWhich priority action should the nurse take?

A nurse is caring for a client who arrives at the emergency department complaining of lethargy, abdominal pain, and deep rapid breathing. Which arterial blood gas (ABG) result should the nurse anticipate from the respiratory therapist?

A nurse is caring for a client following a thoracentesis who is experiencing difficulty breathing and shortness of breath. What finding requires immediate follow-up?   Select all that applyRead the chart below.    Medical History Nurses’ Notes  The client reports increased dyspnea x 4 days. Denies cough or fever.Past medical history: Two-pack-a-day smoker for 50 years. Diagnosed with lung cancer 4 years ago and treated. Over the last year has developed frequent pleural effusions treated with thoracentesis. Hypertension.Surgical history: Right lower lobectomy 4 years ago. The left hernia was repaired 25 years ago. 1000:Alert and oriented x 3. Reports difficulty breathing.Respirations 28/min and labored.Oxygen saturation 91%.Crackles auscultated left lung base. Fremitus decreased left chest wall. 1200:Thoracentesis is performed by the provider.1,000 mL cloudy yellow fluid was removed, labeled, and sent to a lab for testing.Dressing applied to puncture site.Respiratory rate 24/min and regular.Oxygen saturation 95%.   

While at clinicals, you respond to a patient’s ventilator alarm. You observe the following ventilator settings and measured parameters: Volume-targeted, time-cycled mode set VT 450mL, VTE 375mL, Ti 1 sec, PEEP 6cmH2O, FiO2 0.35, PIP 10cmH2O. You note that the exhaled tidal volume is significantly lower than the set tidal volume, and the peak inspiratory pressure is unusually low. Which of the following has most likely caused this discrepancy?