module 7 realizeit

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School

Herzing University *

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233

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Mechanical Engineering

Date

Jan 9, 2024

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docx

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Uploaded by CorporalDragonfly967

NSG233.07.01.01 Mechanical Ventilation Noninvasive positive-pressure ventilation High-frequency oscillatory support ventilators Volume-cycled ventilators Positive pressure ventilators a method of positive-pressure ventilation that can be given via facemasks that cover the nose and mouth, nasal masks, or other oral or nasal devices such as the nasal pillow (a small nasal cannula that seals around the nares to maintain the prescribed pressure). deliver very high respiratory rates (i.e., 180 to 900 breaths/min) that are accompanied by very low tidal volumes and high airway pressures (hence the name high-frequency oscillatory support ) deliver a preset volume of air with each inspiration. inflate the lungs by exerting positive pressure on the airway, pushing air in, similar to a bellows mechanism, and forcing the alveoli to expand during inspiration. Pressure-cycled ventilators delivers a flow of air (inspiration) until it reaches a preset pressure, and then cycles off, and expiration occurs. SIMV APRV PSV PAV delivers a preset tidal volume and number of breaths per minute. a time-triggered, pressure-limited, time-cycled mode of mechanical ventilation that allows unrestricted, spontaneous breathing throughout the ventilatory cycle. applies a pressure plateau to the airway throughout the patient-triggered inspiration to decrease resistance within the tracheal tube and ventilator tubing. provides partial ventilatory support in which the ventilator generates pressure in proportion to the patient’s inspiratory efforts. BiPAP Pressure support ventilation Continuous mandatory (volume or pressure) ventilation CPAP offers independent control of inspiratory and expiratory pressures while providing pressure support ventilation (PSV). applies a pressure plateau to the airway throughout the patient-triggered inspiration to decrease resistance within the tracheal tube and ventilator tubing. the ventilator delivers a preset tidal volume or pressure at a preset rate of respirations. provides positive pressure to the airways throughout the respiratory cycle. NSG233.07.01.02 Nursing support during Mechanical Ventilation The nurse maintains the patient's head of the bed so that it is elevated 30° or higher unless contraindicated to prevent the risk of aspiration. Increased adventitious breath sounds may indicate a need for suctioning. Which of the following would be a nursing diagnosis for a patient receiving mechanical ventilation? Select all that apply. Ineffective airway clearance

Impaired gas exchange Impaired verbal communication Which of the following would be potential complications of patients receiving mechanical ventilation? Select all that apply. Ventilator problems Alterations in cardiac function Barotrauma *** Based on the assessment data, potential complications may include the following:  Ventilator problems (increase in peak airway pressure or decrease in pressure or loss of volume)  Alterations in cardiac function  Barotrauma and pneumothorax  Pulmonary infection and sepsis  Delirium and postintensive care syndrome Nursing support during weaning Which of the following is true regarding nutritional support when weaning mechanical ventilation? Select all that apply. Adequate protein intake is important increasing respiratory muscle strength. Consultation with dietitian or nutrition support team should be arranged soon after the patien admitted. Daily nutrition should be closely monitored. Put the following in order: The patient is gradually removed from the ventilator Patient is removed from the endotracheal or tracheostomy tube Patient is weaned from oxygen therap Which of the following are methods of weaning mechanical ventilation? Select all that apply.

T-piece trials SIMV CPAP key pharmacological concepts related to care of clients with mechanical ventilation support Neuromuscular blocking agents facilitate easy tracheal intubation and mechanical ventilation by relaxing the vocal cords, jaw, and associated respiratory muscles. The PPIs are the strongest gastric acid suppressants used in patients who are critically ill. Recurring seizures or status epilepticus requires treatment with anticonvulsant drugs. A fingerstick blood glucose test should be done, and if hypoglycemia is indicated, a 50% dextrose solution (50 mL IV) should be given. Serum drug levels are needed when acetaminophen, alcohol, aspirin, digoxin, lithium, or theophylline is known to be an ingested drug, to assist with treatment. NSG233.07.02.01 Thoracic Surgery & Chest Drainage Management Chest tubes may be inserted to drain fluid or air from any of the three compartments of the thorax (the right and left pleural spaces and the mediastinum). Water seal system Dry suction system with a one- way valve Dry suction water seal system After the suction is turned on, bubbling appears in the suction chamber. A positive- pressure valve is located at the top of the suction chamber that automatically opens with increases in positive pressure within the system. dry suction with a one-way mechanical valve. The dry suction control regulator provides a dial that conveniently regulates vacuum to the chest drain.

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NSG233.07.02.02 Nursing Process for Thoracic Surgery and Chest tube management Which of the following, in the immediate postoperative period, would an arterial line be used for? Select all that apply. Hemoglobin and hematocrit ABGs The patient should cough at least every hour during the first 24 hours and when necessary thereafter As soon as physiologically possible, usually within 8 to 12 hours, the patient is helped to get out of bed. Although this may be painful initially, the earlier the patient moves, the sooner the pain will subside. NSG233.07.02.03 Identify key pharmacological concepts related to the care of a patient experiencing thoracic sur Which of the following are guidelines regarding morphine? Select all that apply. When pain is thought to be present, identify and treat the underlying cause when possible. Prevent pain when possible. Consider patient-controlled analgesia (PCA) The agonist narcotic, oxycodone in an extended-release form carries a high-risk BLACK BOX WARNING of serious, life-threatening, or fatal respiratory depression when crushed, chewed, or dissolved. Adverse effects include CNS depression, respiratory depression, nausea and vomiting, and constipation. Pupils will be constricted by narcotics not dilated, respirations should be decreased not increase, and diarrhea is not an adverse effect of the opioids. Contraindications and cautions are respiratory depression, acute or chronic lung disease, liver or kidney disease, prostatic hypertrophy, pregnancy, increased intracranial pressure and head injury, seizure disorders, or hypersensitivity reactions to morphine. Lactation is a consideration (it may be safer to wait 4–6 hours after administration to nurse an infant). Additional contraindications may include Addison's disease, severe alcoholism, and toxic psychosis.