Chapter 9, Problem 4TBP

An 85-year old female patient was admitted in the ICU for Encephalopathy (hypoxic, ischemic) and Chronic respiratory failure. The following are the pertinent physical examination findings: Awake, does not follow instructionsIntubated, (+) NGT, (+) IJ catheter, (+) central line, (+) indwelling catheterAfebrile, (+) bibasal crackles(+) tightness bilateral heelcords, (+) pressure ulcer on sacral area, grade 3, (+) grade 2 pressure sore on bilateral calcaneus What are the complications of immobility and prolonged positioning seen on this patient?

A Rapid Response Team (RRT) was called to the medical-surgical unit to evaluate a patient who was admitted 4 days ago with pneumonia. The primary nurse called the RRT team due to recognizing the following early clinical manifestations of acute respiratory distress syndrome (ARDS): a. Bradycardia and increased work of breathing b. Respiratory distress and frothy sputum c. Dyspnea and tachypnea d. Cyanosis and apprehension