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?

Answer 1

In response to a patient with slowed respirations and decreased consciousness, immediate assisted ventilation with a bag-valve mask is necessary to prevent respiratory failure and ensure adequate oxygenation.

Step-by-step explanation:

When dealing with a patient whose respirations have slowed to 8 times per minute and is barely staying awake, it is essential to provide immediate intervention to ensure adequate ventilation and oxygenation. The slowed respiratory rate, accompanied by altered mental status, could indicate impending respiratory failure, which is a medical emergency.

As a health care provider, you should initiate assisted ventilation using a bag-valve mask (BVM) attached to an oxygen source, ensuring that each breath is delivered over one second and causes visible chest rise. It is also crucial to monitor the patient's vital signs continuously and be prepared for rapid deterioration, which might necessitate advanced airway management or cardiopulmonary resuscitation (CPR) if the patient goes into cardiac arrest.

The initial improvement with the administration of oxygen via a nonrebreather mask indicates that the patient was experiencing some benefit from increased oxygen delivery. However, the subsequent decrease in respiratory rate and level of consciousness necessitates a higher level of care, such as that provided by assisted ventilation.