ventilation Flashcards
endotrach intubtation
A tube is inserted through the client’s nose or mouth into the trachea.
mouth intubation
the easiest and quickest form of intubation and is often performed in the emergency department.
nasal intubation
performed when the client has facial or oral trauma.
- This route is not used if the client has a clotting problem.
what does mechanical ventilation provide
- Provides breathing support until lung function is restored
- Positive-pressure ventilators deliver air to the lungs under pressure throughout inspiration and/or expiration to keep the alveoli open during inspiration and to prevent alveolar collapse during expiration
benefits include of mechanical ventilation
- Forced/enhanced lung expansion
- Improved gas exchange (oxygenation)
- Decreased work of breathing
- Mechanical ventilation can be delivered via:
ET tube. - Tracheostomy tube.
nursing actions mechanical ventilation
- Maintain a patent airway.
- Assess the position and placement of tube.
- Apply protective barriers (soft wrist restraints) according to hospital protocol to prevent
self-extubation. - Suction oral and tracheal secretions to maintain tube patency.
- Support ventilator tubing to prevent mucosal erosion and displacement.
- Have a resuscitation bag with a face mask available at the bedside at all times in case of ventilator malfunction or accidental extubation.
Assess respiratory status every
1 to 2 hr: breath sounds equal bilaterally, presence of reduced or absent breath sounds, respiratory effort, or spontaneous breaths.
- Suction the tracheal tube to clear secretions from the airway.
- Monitor and document ventilator settings hourly.
Pressure (high pressure) alarms
indicate excess secretions, client biting the tubing, kinks in the tubing, client coughing, pulmonary edema, bronchospasm, or pneumothorax.
Apnea alarms
indicate that the ventilator does not detect spontaneous respiration in a preset time period.
- airway may not be in right place
Analgesics
morphine and fentanyl
Sedatives
propofol, diazepam, lorazepam, midazolam, and haloperidol, vichyronia
neuromuscular blocking agents
pancuronium, atracurium, and vecuronium are infrequently used in the clinical setting due to the their long half-life.
- The use of a sedative or analgesic agent in conjunction with a neuromuscular blocking agent is typically prescribed.
Ulcer-preventing agents
- famotidine or lansoprazole
- zantach and proton inhibitor
nursing actions for readiness for extubation
- Assess for readiness for extubation
- Labored respirations, increased use of accessory muscles, and diaphoresis
- Restlessness, anxiety, and decreased level of consciousness
- Have a manual resuscitation bag with a face mask and oxygen readily available at the client’s bedside.
- Have reintubation equipment at bedside.
- Suction the oropharynx and trachea.
- Deflate the cuff on the endotracheal tube, and - remove the tube during peak inspiration.
post exutination
- Following extubation, monitor for signs of respiratory distress or airway obstruction, such as ineffective cough, dyspnea, and stridor.
- Assess SpO2 and vital signs every 5 min.
- Encourage coughing, deep breathing, and use of the incentive spirometer.
- Reposition the client to promote mobility of secretions.
- Older adult clients have decreased respiratory muscle strength and chest wall compliance, which makes them more susceptible to aspiration, atelectasis, and pulmonary infections.
- Older adult clients require more frequent position changes to promote mobility of secretions.
