When explaining respiratory failure to the patient's family, what should the nurse use as an accurate description?

Correct Answer: C

Rationale: The correct answer is C: Inadequate gas exchange to meet the metabolic needs of the body. This is the accurate description of respiratory failure as it reflects the core issue of the condition - the lungs' inability to effectively exchange oxygen and carbon dioxide to support the body's metabolic needs. Explanation for why the other choices are incorrect: A: The absence of ventilation - This is too simplistic and does not encompass the full spectrum of respiratory failure, which involves both ventilation and gas exchange. B: Any episode in which part of the airway is obstructed - This describes airway obstruction, not respiratory failure, which involves broader issues with gas exchange. D: An episode of acute hypoxemia caused by a pulmonary dysfunction - This choice focuses only on hypoxemia and pulmonary dysfunction, which are components of respiratory failure but do not fully capture the complexity of the condition.

Correct Answer: A

Rationale: The correct answer is A: Increased PaO2 with decreased oxygen requirements. Prone therapy improves oxygenation in ARDS by optimizing ventilation-perfusion matching. When the patient's PaO2 increases and oxygen requirements decrease, it indicates improved oxygenation efficiency. Reduced chest expansion and decreased lung compliance (B) would suggest worsening lung function. Improved respiratory rate with increased tidal volumes (C) could indicate compensatory mechanisms, not necessarily improved oxygenation. Decreased blood pressure and heart rate (D) are more indicative of hemodynamic changes rather than the effectiveness of prone therapy in ARDS.

Correct Answer: B

Rationale: The correct answer is B: Obtain oxygen saturation using pulse oximetry. In a patient with sepsis, it is crucial to assess oxygen saturation to evaluate respiratory status and tissue perfusion. The patient's vital signs indicate signs of respiratory distress (elevated temperature, increased respirations) and potential hypoperfusion (low blood pressure). Oxygen saturation will provide critical information on the patient's oxygenation status. A: Notifying the healthcare provider may be necessary but addressing the immediate respiratory concern is the priority. C: Documenting and monitoring are important, but immediate intervention is needed due to the patient's critical condition. D: Administering acetaminophen is not appropriate at this time as the priority is to assess and address respiratory distress and potential hypoperfusion.

Correct Answer: C

Rationale: The correct answer is C: white-out infiltrates bilaterally. In acute respiratory distress syndrome (ARDS), chest x-ray typically shows diffuse bilateral infiltrates leading to a "white-out" appearance due to severe inflammation and fluid accumulation in the lungs. This finding is indicative of ARDS as it reflects the hallmark feature of widespread alveolar damage and edema. Explanation for incorrect choices: A: Infiltrates only on the upper lobes do not align with the diffuse bilateral involvement seen in ARDS. B: Enlargement of the heart with bilateral lower lobe infiltrates suggests congestive heart failure rather than ARDS. D: A normal chest x-ray would not be expected in a patient suspected of having ARDS, as there would be significant pathological changes present in the lungs.

Correct Answer: B

Rationale: The correct answer is B: No one. Sharing personal passwords violates confidentiality and security protocols. The charge nurse is responsible for safeguarding client information and should not share her password with anyone, including the nurse manager, nursing student, or unit clerk. Sharing passwords can lead to unauthorized access to sensitive data, compromising client privacy and violating HIPAA regulations. It is essential to maintain individual accountability for accessing electronic records to ensure data integrity and protect client confidentiality.