Respiratory

Build practical clinical judgment in respiratory through clear visual lessons created for international nursing learners and teaching discussions.

55 presentation slides and a matching infographic.

Lesson text and sources

Read alongside the visual presentation. Expand a lesson to review its text, teaching explanation and references.

1. Respiratory

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 01 / 55 RN Clarity C19 • SYSTEM Respiratory Assess the person behind the oxygen number. Independent NCLEX-RN® preparation • USA + Canada

Teaching explanation

A focused bedside course on asthma, COPD, pulmonary embolism, ARDS and chest-drain concerns. It builds assessment and escalation reasoning, not independent ventilator-setting or drug-prescribing competence. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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2. Breathing assessment has several parts

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 02 / 55 RN Clarity Breathing assessment has several parts Observe effort, speech and alertness. Review oxygenation and the support being used. Compare findings and response over time.

Teaching explanation

Do not equate a recorded saturation with a complete respiratory assessment. A patient’s function and trajectory can reveal a concern that one number does not explain. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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3. Connect air movement with gas exchange

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 03 / 55 RN Clarity Connect air movement with gas exchange 01 Air must reach functioning lung regions. 02 Gas exchange also depends on blood flow. 03 Failure of either process can compromise the patient. Sources: COPD • PE · Details and public links in notes

Teaching explanation

This simplified pathway explains ventilation and perfusion. Different disorders disturb different parts of the process. It is not a diagnostic algorithm. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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4. Translate respiratory language

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 04 / 55 RN Clarity Translate respiratory language 01 Dyspnea = the patient’s experience of difficult breathing. 02 Ventilation = movement of air supporting carbon-dioxide removal. 03 Oxygenation = transfer of oxygen into blood.

Teaching explanation

Pulse oximetry estimates oxygen saturation; it does not measure carbon dioxide. Use the full clinical assessment and ordered blood-gas testing when indicated. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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5. Record the support with the observation

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 05 / 55 RN Clarity Record the support with the observation 01 State the device and prescribed oxygen setting. 02 Describe work of breathing and mental status. 03 Report the trend and any assessment limitation. Sources: COPD • TEAM · Details and public links in notes

Teaching explanation

A saturation without its oxygen context is incomplete. Avoid implying two identical saturation values mean equal illness when one patient needs substantially more support. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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6. Follow the response to respiratory care

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 06 / 55 RN Clarity Follow the response to respiratory care 01 Identify the change and assess urgently when needed. 02 Implement the authorized support and obtain help. 03 Reassess the patient and communicate the response. Sources: TEAM · Details and public links in notes

Teaching explanation

The loop is not complete when oxygen or an inhaler is given. The team needs to know whether symptoms, effort and overall condition improved. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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7. A device reading has limitations

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 07 / 55 RN Clarity A device reading has limitations 01 Check the signal and measurement context. 02 Consider symptoms when a reading seems reassuring. 03 Escalate a mismatch between the patient and monitor. Sources: OX · Details and public links in notes

Teaching explanation

FDA notes accuracy concerns related to factors including skin pigmentation. Do not apply a guessed numerical correction based on race or skin tone. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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8. Let the patient describe the change

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 08 / 55 RN Clarity Let the patient describe the change 01 Ask what breathing usually feels like. 02 Clarify what is harder now, such as speaking or walking. 03 Use short questions when breathing is difficult. Sources: TEAM • COPD · Details and public links in notes

Teaching explanation

Do not demand a long history from a severely distressed patient. Obtain urgent help while gathering essential information. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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9. Acute asthma can severely limit airflow

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 09 / 55 RN Clarity Acute asthma can severely limit airflow 01 Airway narrowing can make breathing difficult. 02 Speech, effort and alertness help assess severity. 03 A severe attack requires urgent treatment and reassessment. Sources: ASTH · Details and public links in notes

Teaching explanation

Do not judge severity from wheeze volume alone. The clinical team follows the current acute-asthma pathway. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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10. Respond to the severe asthma pattern

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 10 / 55 RN Clarity Respond to the severe asthma pattern 01 Recognize distress or reduced alertness. 02 Obtain emergency help and prescribed acute treatment. 03 Reassess airflow, effort and overall response. Sources: ASTH • TEAM · Details and public links in notes

Teaching explanation

A silent chest with distress is concerning. Do not wait for a peak-flow measurement if the patient cannot perform it safely or the delay would impede emergency care. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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11. Less wheeze does not always mean improvement

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 11 / 55 RN Clarity Less wheeze does not always mean improvement 01 Compare air entry, effort and speech. 02 Review alertness and response to treatment. 03 A quieter but exhausted patient needs urgent reassessment.

Teaching explanation

Wheeze can diminish when little air is moving. Improvement requires supporting findings, not simply less sound. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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12. Case 1: the wheeze disappears

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 12 / 55 RN Clarity Case 1: the wheeze disappears FICTIONAL BEDSIDE SCENARIO 01 A patient with an asthma attack was wheezing loudly. 02 The patient is now exhausted and can barely speak. 03 A learner assumes the quieter chest means recovery. Sources: ASTH · Details and public links in notes

Teaching explanation

Fictional case. Obtain urgent assessment and emergency support. Do not interpret the sound change in isolation. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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13. Case 1: report the whole respiratory change

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 13 / 55 RN Clarity Case 1: report the whole respiratory change “The patient is more exhausted and speech is limited.” “The chest is quieter despite continued distress.” “Emergency reassessment is needed now.” Sources: TEAM · Details and public links in notes

Teaching explanation

Include current support and the response to treatments already given. A specific report communicates urgency without requiring the nurse to assign a formal severity category independently. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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14. Case 1: verify recovery beyond the sound

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 14 / 55 RN Clarity Case 1: verify recovery beyond the sound 01 Reassess speech, effort and alertness. 02 Follow the prescribed ongoing treatment and monitoring. 03 Confirm the next assessment and disposition plan. Sources: ASTH • TEAM · Details and public links in notes

Teaching explanation

Do not stop observation after a brief improvement. The treating team determines whether response is sustained and what further care is required. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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15. COPD deterioration has several possible causes

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 15 / 55 RN Clarity COPD deterioration has several possible causes 01 An exacerbation can worsen respiratory symptoms. 02 Pneumonia, embolism or cardiac illness may also contribute. 03 Assessment must consider the full presentation. Sources: COPD · Details and public links in notes

Teaching explanation

Do not attribute all breathlessness to the existing COPD label. A different or concurrent condition may require a different treatment plan. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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16. Assess ventilation as well as oxygenation

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 16 / 55 RN Clarity Assess ventilation as well as oxygenation 01 Review mental status, effort and current support. 02 Obtain clinical review and ordered gas assessment. 03 Reassess after the prescribed respiratory intervention. Sources: COPD • TEAM · Details and public links in notes

Teaching explanation

New drowsiness may signal ventilatory failure or another cause. Noninvasive ventilation requires appropriate selection, monitoring and a plan if it fails. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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17. Oxygen treatment needs an assessed target

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 17 / 55 RN Clarity Oxygen treatment needs an assessed target 01 Use the patient-specific or protocol-directed target. 02 Monitor the response and relevant blood-gas findings. 03 Do not withhold needed oxygen because COPD is present.

Teaching explanation

The lesson avoids the misleading instruction that oxygen must never be given to COPD patients. Titration and reassessment are essential; a saturation does not rule out carbon-dioxide retention. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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18. Case 2: the saturation hides the concern

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 18 / 55 RN Clarity Case 2: the saturation hides the concern FICTIONAL BEDSIDE SCENARIO 01 A patient with COPD is receiving oxygen. 02 The saturation appears acceptable, but the patient becomes drowsy. 03 A learner says the monitor proves breathing is adequate. Sources: COPD • OX · Details and public links in notes

Teaching explanation

Fictional case. Urgent reassessment is needed. Consider ventilation, medication effects and other causes; do not diagnose carbon-dioxide retention solely from drowsiness. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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19. Case 2: make the ventilation concern visible

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 19 / 55 RN Clarity Case 2: make the ventilation concern visible “Alertness has worsened despite this saturation.” “The current oxygen device and setting are documented.” “The patient needs urgent respiratory and medical review.” Sources: TEAM · Details and public links in notes

Teaching explanation

The report includes the oxygen context and changed function. The team determines further gas testing and ventilatory support. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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20. Case 2: assess the support’s effect

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 20 / 55 RN Clarity Case 2: assess the support’s effect 01 Monitor alertness, breathing and prescribed gas checks. 02 Report intolerance or inadequate response promptly. 03 Confirm the escalation plan if support fails. Sources: COPD • TEAM · Details and public links in notes

Teaching explanation

A mask in place does not prove noninvasive ventilation is effective. The trained team assesses response and need for other support. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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21. Pulmonary embolism obstructs blood flow

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 21 / 55 RN Clarity Pulmonary embolism obstructs blood flow 01 A clot can block part of the pulmonary circulation. 02 Severity varies and can include circulatory collapse. 03 Evaluation determines risk and the treatment approach. Sources: PE · Details and public links in notes

Teaching explanation

The 2026 adult guideline introduces updated clinical categories. This deck does not ask students to assign definitive risk or treatment from symptoms alone. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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22. Respond to a new embolism concern

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 22 / 55 RN Clarity Respond to a new embolism concern 01 Assess sudden respiratory or chest symptoms. 02 Obtain urgent clinical help for instability. 03 Support the ordered investigation and treatment. Sources: PE • TEAM · Details and public links in notes

Teaching explanation

Do not independently begin or stop anticoagulation from a general case. Bleeding risk, diagnosis and severity affect the clinical plan. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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23. A risk factor is not a diagnosis

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 23 / 55 RN Clarity A risk factor is not a diagnosis 01 Recent immobility or surgery adds context. 02 Symptoms overlap with other conditions. 03 Testing and clinical assessment resolve the question.

Teaching explanation

A normal-looking patient or one reassuring observation does not independently exclude PE. Conversely, risk factors alone do not establish it. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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24. Case 3: sudden symptoms after immobility

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 24 / 55 RN Clarity Case 3: sudden symptoms after immobility FICTIONAL BEDSIDE SCENARIO 01 A patient develops sudden breathlessness and chest discomfort. 02 There has been recent reduced mobility. 03 A learner attributes the symptoms to anxiety without assessment. Sources: PE · Details and public links in notes

Teaching explanation

Fictional case. Obtain prompt assessment and urgent help if unstable. Anxiety may coexist with physical illness; the label must not end the evaluation. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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25. Case 3: describe onset and context

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 25 / 55 RN Clarity Case 3: describe onset and context “Breathlessness and chest discomfort began suddenly.” “There has been recent reduced mobility.” “The patient needs assessment for an acute cause.” Sources: TEAM · Details and public links in notes

Teaching explanation

Include current observations and relevant medicines. State the concern without announcing a confirmed embolus. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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26. Case 3: track the treatment and bleeding risks

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 26 / 55 RN Clarity Case 3: track the treatment and bleeding risks 01 Follow the ordered diagnostic and treatment plan. 02 Reassess symptoms and hemodynamic status. 03 Report bleeding or further deterioration. Sources: PE • TEAM · Details and public links in notes

Teaching explanation

When anticoagulation is prescribed, monitoring and teaching depend on the product and patient. Do not generalize one drug’s laboratory testing to all anticoagulants. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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27. ARDS can severely impair gas exchange

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 27 / 55 RN Clarity ARDS can severely impair gas exchange 01 Acute lung injury can produce major oxygenation problems. 02 Care addresses the cause and supports the patient. 03 Ventilation strategies aim to limit additional lung injury. Sources: ARDS · Details and public links in notes

Teaching explanation

ARDS diagnosis uses a defined clinical framework. Do not label every low saturation or bilateral opacity as ARDS. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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28. Support the prescribed lung-protective plan

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 28 / 55 RN Clarity Support the prescribed lung-protective plan 01 Confirm the ventilatory and monitoring plan with the team. 02 Observe tolerance and report deterioration. 03 Reassess after interventions and position changes. Sources: ARDS • TEAM · Details and public links in notes

Teaching explanation

The ICU team determines settings using the patient’s physiology and relevant measurements. Learners should not calculate or change ventilator settings from a generic slide alone. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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29. Proning requires a coordinated team

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 29 / 55 RN Clarity Proning requires a coordinated team 01 Selected patients with severe ARDS may benefit. 02 Airway, lines, pressure areas and monitoring need planning. 03 Follow the trained team’s procedure and reassessment.

Teaching explanation

Proning is not simply turning a ventilated patient alone. The course does not prescribe a universal schedule or suggest awake proning is interchangeable with the severe ventilated-ARDS recommendation. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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30. Case 4: a turn is treated as routine

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 30 / 55 RN Clarity Case 4: a turn is treated as routine FICTIONAL BEDSIDE SCENARIO 01 A ventilated patient with severe ARDS is scheduled for proning. 02 A learner proposes starting before the required team is ready. 03 Airway and line responsibilities have not been assigned. Sources: ARDS • TEAM · Details and public links in notes

Teaching explanation

Fictional case. Confirm the trained team and safety preparation before the planned maneuver. This is a coordination exercise, not a full proning procedure. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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31. Case 4: clarify the team plan

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 31 / 55 RN Clarity Case 4: clarify the team plan “We need the required team and airway plan.” “Line and monitoring responsibilities must be clear.” “Let us confirm readiness before the maneuver.” Sources: TEAM · Details and public links in notes

Teaching explanation

Use a check-back to confirm responsibilities. Do not let schedule pressure replace preparation for a high-risk movement. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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32. Case 4: reassess after the position change

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 32 / 55 RN Clarity Case 4: reassess after the position change 01 Check the patient and monitoring through the protocol. 02 Confirm airway and device security with the team. 03 Report intolerance or a new concern immediately. Sources: ARDS • TEAM · Details and public links in notes

Teaching explanation

The relevant outcomes include the patient’s response and device integrity. Completion of the turn is not the endpoint of care. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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33. A chest drain is part of a specific treatment plan

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 33 / 55 RN Clarity A chest drain is part of a specific treatment plan 01 The drain may remove air or fluid from the pleural space. 02 The indication and device determine expected findings. 03 New symptoms or system problems need assessment. Sources: DRAIN • BOTTLE · Details and public links in notes

Teaching explanation

Do not use one memorized bubbling rule for every chamber and every drainage system. Know the device and the treating team’s instructions. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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34. Respond to a drain concern systematically

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 34 / 55 RN Clarity Respond to a drain concern systematically 01 Assess the patient’s breathing and current symptoms. 02 Check the system through the trained local procedure. 03 Obtain urgent help for deterioration or an unresolved problem. Sources: BOTTLE • TEAM · Details and public links in notes

Teaching explanation

Do not clamp a bubbling air-leak drain as a routine response. Specific clamping circumstances require specialist direction. Device manipulation must match the protocol and competence. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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35. A quiet drainage system needs context

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 35 / 55 RN Clarity A quiet drainage system needs context 01 Interpret drainage and movement with the indication. 02 Check the patient and the system rather than guessing. 03 Report unexpected change or suspected obstruction.

Teaching explanation

Do not assume that no bubbling proves complete lung recovery or that any bubbling means the same problem. The team interprets the finding with the device, imaging and examination. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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36. Case 5: bubbling prompts an unsafe shortcut

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 36 / 55 RN Clarity Case 5: bubbling prompts an unsafe shortcut FICTIONAL BEDSIDE SCENARIO 01 A patient has a drain for a pleural air leak. 02 Bubbling is observed. 03 A learner proposes clamping the tube to stop the sound. Sources: BOTTLE · Details and public links in notes

Teaching explanation

Fictional case. Do not routinely clamp the bubbling drain. Assess the patient and obtain the appropriate device and pleural-team guidance. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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37. Case 5: explain the need for the right procedure

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 37 / 55 RN Clarity Case 5: explain the need for the right procedure “The drain is treating an air-leak problem.” “We should not clamp it just to stop bubbling.” “Let us assess the patient and follow the drain pathway.” Sources: TEAM · Details and public links in notes

Teaching explanation

This original dialogue is tied to the stated air-leak context. It is not a claim that clamping can never be ordered for any pleural procedure. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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38. Case 5: confirm function and follow-up

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 38 / 55 RN Clarity Case 5: confirm function and follow-up 01 Complete the directed system assessment. 02 Reassess the patient’s respiratory condition. 03 Hand over the finding and the confirmed plan. Sources: TEAM • BOTTLE · Details and public links in notes

Teaching explanation

If deterioration occurs, prioritize urgent patient assessment and help. Do not spend prolonged time troubleshooting equipment while an unstable patient waits. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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39. Worked trend: an unchanged number can mislead

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 39 / 55 RN Clarity Worked trend: an unchanged number can mislead Fictional COPD observations Finding Earlier Now Alertness Conversational Drowsy Oxygen support Documented setting Still required SpO₂ Within ordered target Within ordered target Interpret alertness and support with the saturation. Sources: COPD • OX · Details and public links in notes

Teaching explanation

The table does not assign normal ranges or diagnose ventilatory failure. It demonstrates why the patient’s changing condition matters. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

Sources

40. Explain what the monitor cannot establish

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 40 / 55 RN Clarity Explain what the monitor cannot establish The saturation is only one observation. New drowsiness requires assessment. Ventilation and other causes must be considered. Sources: COPD • OX · Details and public links in notes

Teaching explanation

Ask learners to describe the concern without asserting a blood-gas result that has not been obtained. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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41. Practice question: a quieter asthma chest

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 41 / 55 RN Clarity Practice question: a quieter asthma chest CHOOSE • EXPLAIN YOUR REASONING 01 A: Assume recovery because wheeze is less audible. 02 B: Reassess urgently when speech and alertness worsen. 03 C: Delay help until the patient can complete testing. Sources: ASTH · Details and public links in notes

Teaching explanation

Original single-best-answer exercise, not an official NCLEX-RN® item. B is best for the severe deterioration described. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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42. Answer: B responds to the clinical trajectory

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 42 / 55 RN Clarity Answer: B responds to the clinical trajectory 01 Function has worsened despite less sound. 02 Emergency assessment takes priority. 03 Treatment response needs repeated review. Sources: ASTH • TEAM · Details and public links in notes

Teaching explanation

Ask why a quieter chest may have different meanings in different contexts. The goal is integrated assessment, not one-sign reasoning. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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43. Inhaler teaching needs demonstration

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 43 / 55 RN Clarity Inhaler teaching needs demonstration 01 Identify the exact device and prescribed purpose. 02 Observe technique and correct the relevant steps. 03 Ask for a repeat demonstration and confirm the action plan. Sources: ASTH • TEAM · Details and public links in notes

Teaching explanation

Different inhaler types require different techniques. Do not teach a single breath pattern for every device. Verify the product instructions and the patient’s ability to use it. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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44. Translate the respiratory handoff terms

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 44 / 55 RN Clarity Translate the respiratory handoff terms 01 “Air entry” describes what is heard on assessment. 02 “FiO₂” means the inspired oxygen fraction. 03 “NIV” means noninvasive ventilatory support.

Teaching explanation

Some devices deliver a variable oxygen concentration. Do not convert every flow rate into an exact FiO₂ without the appropriate device context. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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45. Hand over support and the response

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 45 / 55 RN Clarity Hand over support and the response 01 State the current device and prescribed settings. 02 Describe work of breathing, alertness and trend. 03 Confirm the next reassessment and escalation plan. Sources: TEAM · Details and public links in notes

Teaching explanation

Include an adverse response or a failed support trial. A diagnosis and saturation alone do not describe the current respiratory risk. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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46. Make the home plan practical

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 46 / 55 RN Clarity Make the home plan practical 01 Explain the prescribed medicines and device use. 02 Confirm warning signs and the action plan. 03 Check access to treatment and follow-up. Sources: ASTH • COPD • TEAM · Details and public links in notes

Teaching explanation

Do not give a universal oxygen prescription or self-escalation instruction. The person needs their own written plan and a usable contact route. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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47. Ask about barriers without blame

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 47 / 55 RN Clarity Ask about barriers without blame “Show me how you use this inhaler.” “What makes the treatment difficult to follow?” “Let us make the next step clear and practical.” Sources: TEAM · Details and public links in notes

Teaching explanation

Cost, device difficulty and unclear instructions can affect use. Identify the barrier rather than simply recording nonadherence. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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48. Use a three-step breathing check

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 48 / 55 RN Clarity Use a three-step breathing check 01 Assess the person, support and trend. 02 Match the response to the current concern. 03 Reassess and confirm the next action. Sources: TEAM · Details and public links in notes

Teaching explanation

Apply this sequence to the five cases. The action differs between airway narrowing, ventilatory failure, embolism and a device problem. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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49. Know the local respiratory pathways

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 49 / 55 RN Clarity Know the local respiratory pathways 01 Locate urgent respiratory and critical-care support. 02 Verify oxygen, inhaler, NIV and drain procedures. 03 Use current orders and trained device practice. Sources: TEAM · Details and public links in notes

Teaching explanation

Sources from international societies support clinical teaching but do not create one USA/Canada scope. Follow local authorization and device-specific training. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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50. Teacher debrief: interpret the whole patient

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 50 / 55 RN Clarity Teacher debrief: interpret the whole patient Which finding challenged the reassuring number? What did the support device add to your interpretation? How did reassessment change the next step?

Teaching explanation

Use a handoff exercise where the oxygen device is initially omitted. Ask the learner what information is missing and why it matters. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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51. Evidence guide: airways and embolism

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 51 / 55 RN Clarity Evidence guide: airways and embolism GINA • Asthma summary guide GOLD • COPD report GOLD • 2026 changes summary AHA/ACC and partners • Acute pulmonary embolism Current 2026 editions inform the clinical concepts. Sources: ASTH • COPD • CHANGE • PE · Details and public links in notes

Teaching explanation

Original teaching and fictional cases are used. No proprietary guideline diagrams, tables or slide sets are reproduced. Public links and locators are in notes. Additional supporting sources: NHLBI, COPD Treatment (2024), Medicines, pulmonary rehabilitation and oxygen therapy: https://www.nhlbi.nih.gov/health/copd/treatment ; NHLBI, Respiratory Failure Symptoms, oxygen/carbon-dioxide symptoms: https://www.nhlbi.nih.gov/health/respiratory-failure/symptoms ; BTS adult oxygen guideline (2017), executive summary and COPD/hypercapnia assessment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5531304/ . Apply local targets and clinical orders; no universal dose or oxygen flow is taught. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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52. Evidence guide: respiratory support

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 52 / 55 RN Clarity Evidence guide: respiratory support ATS • Updated ARDS guideline BTS • Pleural procedures statement BTS • Chest-drain system appendix FDA • Pulse oximeters Device procedures and settings require the clinical plan. Sources: ARDS • DRAIN • BOTTLE • OX · Details and public links in notes

Teaching explanation

ATS ARDS guidance is the 2024 update; BTS pleural guidance is the 2023 statement. These dates are stated rather than relabeled as new 2026 guidelines. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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53. Evidence guide: learning and application

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 53 / 55 RN Clarity Evidence guide: learning and application AHRQ • TeamSTEPPS tools Five original fictional cases. One original practice question. Public guideline and regulator sources. Apply patient-specific orders and local procedures. Sources: TEAM · Details and public links in notes

Teaching explanation

This is a focused respiratory clinical-judgment course, not a complete ventilator, pleural-procedure or medication manual. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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54. Read the patient and the trajectory

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RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 54 / 55 RN Clarity Read the patient and the trajectory Combine symptoms, function and measured findings. Explain the concern clearly. Verify the response to every important intervention.

Teaching explanation

End with a concise respiratory handoff. Ask learners to identify what a pulse oximeter can and cannot tell them. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

Sources

55. Assess breathing. Check the response.

Slide text

RN Clarity C19 / CLINICAL SYSTEMS RN Clarity • Learning for practice 55 / 55 RN Clarity Assess breathing. Check the response. See the person behind the number. RN Clarity • rnclarity.com Independent preparation for the NCLEX-RN® examination. NCLEX-RN® is an NCSBN trademark. RN Clarity is independent and not endorsed by NCSBN.

Teaching explanation

NCLEX® and NCLEX-RN® are registered trademarks of NCSBN. RN Clarity is independent and is not affiliated with, sponsored by or endorsed by NCSBN. Educational preparation, not a clinical order set. Source and scope Sources accessed for this revision: 2026-09-08. Cases and practice dialogue are fictional. Apply patient-specific orders, local protocols and scope requirements.

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Supports learning and orientation. Follow current local policies and scope of practice.

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