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Discussion

here is a question for you

a patient dx with emphysema is currently going into respiratory distress. as a nurse you would?

A.call the dr.

b.give 2L of O2 via nasal cannula for 5 hrs

c.provide Positive Pressure Ventilation

d. put the patient in a supine position

this was an example question that was given during class.

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Well you would definately call the doc with any changes, laying the pt supine would not help the pt to breathe easier. Other than call the doc I would give O2, not sure that the part about doing it for 5 hours makes sense. I believe any positive pressure ventilation would have to be by doc order. So I believe the answer would be call the doc first.

I guess call the dr also.

I think it would depend on how distressed the patient was. If they're starting to turn blue, I'd call a code. If they're just having a little difficulty, and they had an order for o2, I'd put that on then call the doctor.

Eh, I don't like any of those options, but mostly b/c our teachers never had "call the doc" as the correct response, lol! They always want us to consider what the nurse is able to do first.

a patient dx with emphysema is currently going into respiratory distress. as a nurse you would?

A.call the dr.

b.give 2L of O2 via nasal cannula for 5 hrs

c.provide Positive Pressure Ventilation

d. put the patient in a supine position

this was an example question that was given during class.

I'm going to vote C for the following reasons.

immediately eliminate D since patients should be put fully upright when having breathing difficulty.

B is questionable...why would you put the patient on O2 for a specific amount of time? With emphysema you need to know the ABGs of the patient since their CO2 and O2 levels are not normal.

A is something you do after doing a nursing intervention.

I'm going to vote C for the following reasons.

immediately eliminate D since patients should be put fully upright when having breathing difficulty.

B is questionable...why would you put the patient on O2 for a specific amount of time? With emphysema you need to know the ABGs of the patient since their CO2 and O2 levels are not normal.

A is something you do after doing a nursing intervention.

That is where I am at as well, I don't like the 5 hour part being thrown in. ABC's teach us we need to do something NOW and then call the doctor and he should be sitting and leaning forwards even.

The oxygen would be good if not for those added detail things as a starting point.

I vote C as well. O2 is considered a medication and requires a dr's order. Since it doesn't tell you in the question whether that order exists or not, I think C is your best bet.

I vote C as well. O2 is considered a medication and requires a dr's order. Since it doesn't tell you in the question whether that order exists or not, I think C is your best bet.

We were taught in school that here at least if O2 is needed in an emergency the nurse may give it and then get the order from the Dr. it's one of the few things we can. I don't know if that is facility policy or state or how that works though.

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Everywhere I've ever worked, nurses are able to implement O2 (but no more than 2 lpm, in most places) as an emergency nursing intervention for resp distress before contacting the physician. I'm suspicious of the "for 5 hours" specification, though.

Id go for positive pressure ventilation and calling the Dr. with emphysema patients the positive pressure will relieve the not only the symptoms of distress but also have an effect on its cause..

and remember when in doubt, call the Dr.

I call it the CARE principal

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I vote C as well. O2 is considered a medication and requires a dr's order. Since it doesn't tell you in the question whether that order exists or not, I think C is your best bet.

We were taught that 2L O2 can be given without an order.

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If the patient is going into respiratory distress, they need treatment. Call the doctor--immediately.

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