Title: Module Case Study: Respiratory
Course: NUR 2710C Adult Health Nursing II > Section: Module 2:3 Respiratory

Review the following Case Study then answer the questions below.  Each question is worth 12 points.

Write your answers in a Word Document.  Save the file with your name and the title of the module then attach it here for grading.

Each case study should be read thoroughly for understanding of the situation and then analyzed by answering the questions with specific information to introduction of patient, problem, pathophysiology, nursing physical assessment, nursing process, recommendations and community resources. For maximum effectiveness it is essential to complete learning objectives and assigned readings prior to the analysis of the case study and to utilize the nursing process and critical thinking to assist with decision-making. The case study rubric is provided to assist with performance expectations.

E.B. is a 60-year-old male admitted to the Intensive Care Unit following a radical neck dissection and tracheostomy for treatment of laryngeal cancer. E.B. is currently on a mechanical ventilator and sedated. He is able to open his eyes and squeeze your hand on command. Upon auscultation of his lungs the assessment findings reveal bilateral rhonchi. His cardiac monitor displays sinus tachycardia, Heart Rate 120 and he has a blood pressure reading of 128/76, a respiratory rate of 18, and a temperature of 36.4° C (97.5° F).

Questions:

1. You recognize that maintaining a patent airway is a priority, besides auscultating rhonchi in his lungs, what other assessment findings would suggest a need for suctioning?

2. You have identified the need to suction E.B.'s tracheostomy in order to clear his secretions. Discuss the sequence the steps for suctioning.

3. The nurse should always be alert for signs of impending respiratory insufficiency, explain what the nurse should be alert for:

4. How can the patient maintain optimal gas exchange?

5. Discuss in detail the guidelines for nursing interventions for weaning a patient from mechanical ventilation.