Exam 1 - Mechanical ventilation Flashcards
(14 cards)
Complications that can occur with mechanical ventilation
- Decreased cardiac output
- Sodium and water balance
- GI bleeding
- VAP
- Alveolar hyperventilation/hypoventilation
- Inability to wean from vent
- Tracheal necrosis
- Pneumothorax
- Positive end-expiratory pressure – extra pressure is added at exhalation that keeps the alveoli open a little bit longer for gas exchange
- Started at 5 cm
PEEP
- Continuous positive airway pressure
* Use on vent or just a mask– tight mask forcing O2 continuously
CPAP
- Bi-level positive airway pressure
- Continuous O2 fluctuates between high and low pressure
- Good for weaning
BiPAP
Best measure of ventilation
PaCO2
If PaCO2 is elevated, what does it indicate?
Poor ventilation and respiratory effort
If PaCO2 is low, what does it indicate?
Hyperventilation
What does a low exhaled volume alarm mean?
No pressure - free flowing
Loss of tidal volume - could be due to an air leak, dislodged tubing
What does a high pressure alarm mean?
Hard time getting air in d/t resistance
Increased airway resistance - could be d/t mucus plug, tension pneumothorax, pt fighting vent by coughing
Can occur when weaning
Interventions for vent management
o Monitor pt and vent settings and lungs q2h
o Offer forms of communication and stress reduction techniques
o Monitor for signs of bleeding
o Maintain adequate nutrition
o Mouth care q2h
o Correct cuff pressure (minimal leak technique)
o Suction PRN
o Tube placement – check at lip
o Monitor fluid balance
o ABGs – usually done q4h
o Position – turning q2h, HOB 30 degrees, ROM
Nutrition concerns for pt on vent
Carbohydrate load is a concern because metabolism of carbs results in increased CO2 production
Enteral feeding Pulmocare
High in fat and protein, low in carbs
Keep HOB up when receiving tube feedings
Check gastric residuals
Criteria for weaning off vent
- Must be capable of maintaining spontaneous respirations
- Must have a vital capacity of 10/15 mL/kg
- Minute ventilation of 6 mL/min
- No hypotension
- No tachycardia
- Hemodynamically stable
Education for vent
Stress reduction techniques
Teach about vent to family
