Mechanical ventilation

Question 1

What may require mechanical ventilation?

Answer 1

1. during surgery
2. acute respiratory illness
3. respiratory failure

Question 2

What are the interventions for mechanical ventilation?

Answer 2

1. establish a means of communication, such as asking yes/no questions, providing writing materials, using a dry erase board and/or a picture communication board, or lip reading
2. maintain a patent airway
3. Maintain adequate but not excessive cuff pressure (less than 20 mmHg is recommended to reduce the risk of tracheal necrosis)
4. Administer meds as prescribed
5. Reposition endotracheal tube every 24 hours or by protocol. Monitor skin for breakdown
6. prevent complications

Question 3

What are the ways that a nurse can maintain a patent airway?

Answer 3

1. ensure advanced airway device is secured
2. assess position and placement of tube, document in cm at the client’s lips or teeth
3. Prevent accidental extubation; wrist restraints may be required
4. suction oral and tracheal secretions as indicated by assessment
5. assess respiratory status every 1-2 hours and as needed
6. Monitor ventilator settings and alarms. Never turn off ventilator alarms. If the cause of an alarm cannot be ID’d and corrected, and status begins to decline, then ventilate the client using a manual resuscitation bag until resolved

Question 4

What does a low-pressure alarm indicate?

Answer 4

indicates low volume and is usually associated with tube disconnection, a cuff leak, or a tube dislodgement

Question 5

What does a high-pressure alarm indicate?

Answer 5

indicates increased pressure, which may be caused by secretions, kinking of the tube, pulmonary edema, or the client coughing or biting the tube

Question 6

What does an apnea alarm indicate?

Answer 6

Indicates there has been no spontaneous breath within a preset time period

Question 7

What should the head of the bed be put at for someone on a ventilator?

Answer 7

at least 30 degrees