Rationales for providing PROM and AROM for pts with PPV:
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-PPV is positive pressure ventilation
-We want to maintain muscle strength
-We want to prevent contractors, pressure ulcers, foot drop, and external
rotation of the hip/leg
-Can also help by using proper positioning and special mattresses
-Use portable vent while ambulating. Is this feasible?
What kind of pain might we monitor in flail chest?
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, -Intercostal, which may be there after the flail chest has resolved.
-We might need to consider long term pain medication
-They need to still be getting good chest expansion
When do we see resp alkalosis
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-pH 7.35-7.45
-CO2 goes opposite
-If they're hyperventilating
Normal O2 sats
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-92/3-100
What changes in treatment in hemo and pneumothorax?
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-Where the chest tube is placed (upper or lower)
What nursing assessments and interventions are needed for sedation management for
patients on positive pressure ventilation?
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-Need for optimal ventilation
-Before we sedate them, we need to know why they're anxious/distressed.
-We may paralyze the pt using nerve blocks
-Assessments: peripheral nerve stim, physiologic signs of pain, anxiety
(changes in HR/BP), vent synchrony
-Assess the pt as a whole
-Look at O2
-Main intervention is to provide sedation and normal daily care (since
they're sedated, we're now responsible for a total care pt)
What is weaning?
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-Titrate off the med (sedatives and pressers)
-We want them to start working
-This process depends on the pt
What do you expect for early drainage?
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-Serous/sanguanous
-Ask when they come back what it should look like and how much to
expect
-No more than 100mL:call Dr and assess site
Nursing management for subcutaneous emphysema:
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-Report?
-Air leaking into surrounding tissue
-A crackling sensation will be felt
Nursing assessment, interventions, and evaluation of cuff inflation:
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-This is to stabilize the ET tube and prevents the escape of gasses.
-We need to maintain the cuff pressure
-Assess Q8 for airway, positioning of the tube, cuff pressure
-Theres a device that is used to assess cuff pressure
-Pressure should be 20-25cm H2O
-Auscultate over the trachea and add air until there is no escape of air
around the tube
-There should be no air leaking at the end of inspiration
*you don't know HOW to do it, but it is an expectation to monitor the
pressure
Describe possible assessment findings (clinical manifestations) of patients
experiencing hypoxemic respiratory failure:
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-PPV is positive pressure ventilation
-We want to maintain muscle strength
-We want to prevent contractors, pressure ulcers, foot drop, and external
rotation of the hip/leg
-Can also help by using proper positioning and special mattresses
-Use portable vent while ambulating. Is this feasible?
What kind of pain might we monitor in flail chest?
Give this one a try later!
, -Intercostal, which may be there after the flail chest has resolved.
-We might need to consider long term pain medication
-They need to still be getting good chest expansion
When do we see resp alkalosis
Give this one a try later!
-pH 7.35-7.45
-CO2 goes opposite
-If they're hyperventilating
Normal O2 sats
Give this one a try later!
-92/3-100
What changes in treatment in hemo and pneumothorax?
Give this one a try later!
-Where the chest tube is placed (upper or lower)
What nursing assessments and interventions are needed for sedation management for
patients on positive pressure ventilation?
,Give this one a try later!
-Need for optimal ventilation
-Before we sedate them, we need to know why they're anxious/distressed.
-We may paralyze the pt using nerve blocks
-Assessments: peripheral nerve stim, physiologic signs of pain, anxiety
(changes in HR/BP), vent synchrony
-Assess the pt as a whole
-Look at O2
-Main intervention is to provide sedation and normal daily care (since
they're sedated, we're now responsible for a total care pt)
What is weaning?
Give this one a try later!
-Titrate off the med (sedatives and pressers)
-We want them to start working
-This process depends on the pt
What do you expect for early drainage?
Give this one a try later!
-Serous/sanguanous
-Ask when they come back what it should look like and how much to
expect
-No more than 100mL:call Dr and assess site
Nursing management for subcutaneous emphysema:
, Give this one a try later!
-Report?
-Air leaking into surrounding tissue
-A crackling sensation will be felt
Nursing assessment, interventions, and evaluation of cuff inflation:
Give this one a try later!
-This is to stabilize the ET tube and prevents the escape of gasses.
-We need to maintain the cuff pressure
-Assess Q8 for airway, positioning of the tube, cuff pressure
-Theres a device that is used to assess cuff pressure
-Pressure should be 20-25cm H2O
-Auscultate over the trachea and add air until there is no escape of air
around the tube
-There should be no air leaking at the end of inspiration
*you don't know HOW to do it, but it is an expectation to monitor the
pressure
Describe possible assessment findings (clinical manifestations) of patients
experiencing hypoxemic respiratory failure:
Give this one a try later!
