Question

Your​ 76-year-old female patient is having trouble breathing. When you auscultate her​ lungs, you hear crackles​ (rales), and you are concerned that she may have pulmonary edema. Her oxygen saturation is​ 92%, so you place her on​ 100% oxygen via a nonrebreather mask. Her breathing gets a little easier with the oxygen. You decide to expedite transport since she is anxious about her condition.​ Later, as you are completing your​ reassessment, you see that her respirations have slowed to 8 times per minute and she is barely staying awake. What should you do​ next?

A. Assist her with using her​ metered-dose inhaler.
B. Begin ventilating her with a​ bag-valve mask.
C. Shake her to keep her awake.
D. Ask your partner to pull over and wait for ALS backup.

Answer 1

When the 76-year-old patient's respirations drop to 8 per minute, and she struggles to stay awake, immediate action should be taken to ventilate her with a bag-valve mask to assist with breathing and prevent respiratory failure.

Step-by-step explanation:

You have described a scenario in which a 76-year-old female patient with trouble breathing and suspected pulmonary edema is initially treated with 100% oxygen via a nonrebreather mask. When her respirations slow to 8 times per minute and she is barely staying awake, the correct course of action would be B. Begin ventilating her with a­ bag-valve mask. This intervention is necessary because her respiratory rate has dropped significantly below the normal range of 12-15 breaths per minute, indicating that she may not be moving enough air on her own to maintain sufficient oxygenation and carbon dioxide removal. Since the patient's condition suggests impending respiratory failure, it's crucial to provide assisted ventilation to support her breathing until she can receive further medical treatment.