Robert is on mechanical ventilation in the rehabilitation unit. You are caring for him and are training a new nurse to the unit. She is very interested in learning and is full of questions
a. What are some of the nursing considerations to watch for with a ventilated client?
b. What complications are clients who are mechanically ventilated at risk for?
c. There are several modes of mechanical ventilation to discuss. What are the two classifications that they fall into, how do they function, and what disease processes are they usually effective for?
Students' answers should include the following:
a. Discussion should include, but not be limited to, accidental removal of tube, laryngeal spasms, coughing fits which may dislodge tube, atelectasis from wrong tidal volume or vent settings, ulcerations, secondary pneumonia, aspiration from secretions or tube feedings, abnormal electrolytes, and abnormal ABGs.
b. The main complications to discuss are VAP, lung tissue damage, decreased lung expansion, and how these occur.
Discussion should also include lesser complications of confusion, secondary infections, alkalosis or acidosis, immobility of limbs, and bed sores. Also, accidental removal of tube may result in respiratory arrest.
c. The two included in discussion should be positive and negative pressure, how they function with the lungs, and the diseases included in this discussion should be cystic fibrosis, poliomyelitis, myasthenia gravis, comatose clients, and those under general anesthesia.
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