mandatory breaths have a set tidal volume, pt initiated breaths have varying tidal volume
initial mode for ventilation or weaning mode
disadvantage: increased work of breathing and can lead to pt/vent asynchrony
AC/CMV - ✔✔Assist control or continuous mandatory ventilation
pt initiated or ventilator control breaths have set tidal volume
disadvantages: hyperventilation which may cause respiratory alkalosis or hyperinflation, less
comfortable for pt
,spontaneous (CPAP) - ✔✔used to strengthen respiratory muscles and evaluate readiness to extubate
ASV - ✔✔Adaptive support ventilation, adjusts ventilation breath by breath depending on pts lung
mechanics. If pt does not initiate breath, vent will deliver pressure control breath. if pt does take a
breath, ASV will give however much pressure support is needed to meet VT
vent alarms - ✔✔Happens when there is too much or too little pressure.
Low pressure=vent came out, apnea, disconnection, cuff leak
High pressure=pt coughs, mucous plug in the resp tract you as the nurse want to suction the pt
Make sure you perform good oral hygiene to prevent VAP
ETT suctioning - ✔✔preoxygenate prior to each pass, use sterile catheter, wear PPE, watch
for hemodynamic changes, assess lung sounds
nursing care of intubated patient - ✔✔-sedation vacation
-oral cares q2h
-GI prophylaxis
-increase HOB
-check placement of tube frequently
-move oral tubes from one side of the mouth to the other
ICU liberation bundle - ✔✔Assess and manage pain - IV opioids
, Family engagement - family presence, involvement in making decisions
Goals of care - honor pt wishes
weaning criteria - ✔✔FiO2 50% or less
PEEP 10 or less
LOC acceptable
stable hemodynamics
ABGs WDL
primary pulmonary function review - ✔✔exchange of gases between ambient air and the blood
relatively dry alveoli and adequately perfused capillaries = healthy lungs
overall goal is to exhale CO2 and ensure proper oxygenation
ventilation - ✔✔movement of air in and out of the lungs
oxygenation - ✔✔the process of delivering oxygen to the blood
diffusion - ✔✔movement of gases between air spaces in lungs and bloodstream
how do we know that ventilation and/or oxygenation is less than optimal in our pts? - ✔✔-
respiratory assessment
-pulse oximetry
-ABGs
-imaging
-P/F ratio
perfusion - ✔✔movement of blood in and out of capillary beds
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