What nursing consideration is most important in the care of a child on a mechanical ventilator?
a. Humidification is not necessary.
b. Respiratory assessment is done by the ventilator.
c. Positioning the child for comfort and optimum ventilation is necessary.
d. Support and reassurance are not as important because the child is unconscious.
ANS: C
The ventilator will do the work of breathing, but the nurse must position the child with attention to achieving optimum gas exchange. The reason for mechanical ventilation and the child's comfort are part of the assessment. Mechanical ventilation is usually achieved by intubation or tracheostomy. These routes bypass the humidification that occurs in the upper airway. The ventilator provides some information about the work of breathing, but patient assessment must be done by the nurse. Support and reassurance are always important for both the child and family. Opioids and anxiolytics are often used to decrease the child's anxiety. Careful assessment is indicated.
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