A patient is being manually weaned from mechanical ventilation. Which of the following should the nurse do to support the patient at this time?
1. Turn off the ventilator for the prescribed period of time.
2. Calmly reassure the patient and coach the patient to breathe independently.
3. Change the ventilator settings so the patient can breathe spontaneously between set breaths.
4. Have intubation equipment at the bedside.
2
Rationale: Manual weaning requires close patient contact throughout the weaning period because the nurse plays a crucial part in patient monitoring and coaching correct breathing rate and depth for the trial period. The nurse's calm reassurance is instrumental in assisting the patient past the period of anxiety often associated with removal from the mechanical ventilator. Turning off the ventilator for the prescribed period of time will not help the patient with the initial anxiety created by being off of the ventilator. Changing the ventilator settings so the patient can breathe spontaneously between set breaths is done when a patient is being mechanically weaned. The patient has not been extubated so having reintubation equipment at the bedside is not indicated at this time.
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