A 45-year-old male postsurgical patient is on a ventilator in the critical care unit. He has been tolerating the ventilator well and has not required any sedation. He becomes tachycardic and hypertensive
His respiratory rate has increased to 28 breaths/min. The ventilator is set on synchronized intermittent mandatory ventilation (SIMV) at a rate of 10 breaths/min. The patient has been suctioned recently via his endotracheal tube, and his airway is clear. He responds appropriately to the nurse's commands. The nurse should: a. assess the patient's level of pain.
b. decrease the SIMV rate on the ventilator.
c. provide sedation as ordered.
d. suction the patient again.
A
Pulse, respirations, and blood pressure frequently result from activation of the sympathetic nervous system by the pain stimulus. Because the patient is postoperative, the patient should be assessed for the presence of pain and need for pain medication. Decreasing the SIMV does nothing because the patient is already overriding the ventilator. Providing sedation may calm the patient but will not solve the problem if the physiological changes are from pain. The patient has just been suctioned and his lungs are clear. There is no need to suction again.
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