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ECCO 3.7 Caring for Patients with Pulmonary Disorders Part 2 fully solved & updated .
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ECCO 3.7 Caring for Patients with Pulmonary Disorders Part 2 fully solved & updated .
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ECCO 3.7: Caring for Patientswith Pulmonary Disorders:
Part 2 fully solved & updated
2024-2025
ECCO 3.7: Caring for Patients with Pulmonary Disorders: Part 2 fully
solved & updated 2024-2025
ECCO 3.7: Caring for Patients with Pulmonary Disorders: Part 2 fully
solved & updated 2024-2025
Invasive Ventilation - answer Endotracheal intubation
Tracheostomy tubes
Mechanical Ventilation
Trouble shooting ventilators
Endotracheal Intubation Indications - answer *Intubation with an
ETT is indicated for*
- Anesthesia purposes during surgery
- Inability to protect the airway
- Altered mental status (head injury, drug overdose)
- Anticipated airway obstruction (facial burns, epiglottitis, major
facial or oral trauma)
- Apnea
- Ineffective clearance of secretions
- High risk of aspiration
,- Respiratory distress
- Planned postprocedural short-term ventilation
The ETT will be placed orally unless contraindicated by an injury or
proposed surgical procedure
Endotracheal Intubation Key Considerations - answer *Is there
failure of airway maintenance or protection?*
- Depressed LOC
- Impaired swallowing
- Airway obstruction
*Is there failure of oxygenation or ventilation?*
- *Oxygenation*: PaO2 < 60 mmHg + normal/low PaCO2
- *Ventilation*: Acidosis with PaCO2 > 50 mmHg
*Is the patient a candidate for noninvasive positive pressure
ventilation (NIPPV)?*
- Exacerbation of chronic obstructive pulmonary disease (COPD)
- Acute cariogenic pulmonary edema
Endotracheal Intubation: Identify Patient Care Priorities during Pt
Extubation - answer *Call the medical emergency response team*
Endotracheal intubation can be a non-emergent or emergent
procedure and is performed by credentialed practitioners in your
facility
*Prepare for immediate reintubation*
First, ensure all members of team are present and that the
intubation equipment is ready. Next, anticipate the needs of the
person performing the procedure. Then perform the patient
,assessment, positioning, and teaching. Finally, administer the
medications, and be prepared to assist with the reintubation
*Apply a bag-valve mask (BVM) resuscitator for ventilation until
reintubation*
It's important to have a BVM resuscitator available at the bedside to
bridge the pt to reintubation in the event of accidental extubation
Endotracheal Intubation: Readying Equipment and Pt - answer The
immediate safety of the patient is paramount.
*Emergency Reintubation*
In emergency reintubation, help is needed immediately.
- Call for help.
- Maintain an open airway.
- Provide ventilation and oxygenation.
*Nursing Priorities*
A provider or respiratory therapist (RT) will perform the intubation.
Each attempt at intubation should last 10 seconds or less.
- Protect the patient by calling for ventilations with the BVM when
intubation attempts are unsuccessful.
- Conduct intraprocedural assessments including checking vital
signs, SpO2, respiratory effort if any, and response to medications
and to the procedure.
- Observe the patient for changes in assessments that indicate
deteriorating physiologic condition during an intubation attempt.
ETT Placement - answer Intubation is performed after
administration of analgesics and sedation to minimize discomfort
and anxiety. The type of medications administered will depend on
the condition of the pt and urgency of the situation.
, *Step 1 Position Pt*
Position pt supine, elevating head with a bowl or rolled blanket, in
the sniffing position. Exception are pt with suspected neck trauma
*Step 2 Preoxygenate and Anticipation*
Preoxygenation using 100% oxygen with BVM. Anticipate medication
administration.
*Step 3 Auscultate and Confirm*
Immediately after ETT is inserted, assess for breath sounds
bilaterally while ventilating through the ETT while ventilating
through the ETT with the BVM using 100% oxygen. Conduct a
secondary confirmation with end tidal CO2 (EtCO2) measurement
device
*Step 4 Observe and Monitor*
Throughout the procedure, continually monitor SpO2 and cardiac
rhythm. Conduct a secondary confirmation with EtCO2 observing for
symmetrical chest expansion
*Step 5 Connect and Adjust*
Secure the ETT with a holder or taper and document the depth of ET
placement in cm, marked at teeth or nare, per hospital protocol
*Step 6 Obtain Radiographic Confirmation*
CXR is ordered to document actual ETT location and distance from
carina. The ETT may need to be pulled back several centimeters or
reinserted, per chest x-ray reading
Post-Intubation Nursing Priorities - answer Reassuring the pt
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