NURSING
HESI Critical Care Cardiac Pulmonary.pdf

Opposite of normal respiration gas is delivered at

Info icon This preview shows pages 4–6. Sign up to view the full content.

Opposite of normal respiration Gas is delivered at pressures above atmospheric pressure. Normally we use the negative pressure to pull air into the lungs (this is why mechanical ventilation can be so uncomfortable) Think back to A&P3. Normally you have negative pressure in the pleural space. Because of this, when you exhale the alveoli get smaller and move away from the pleural space. The negative pressure in the pleural space pulls the alveoli towards it again to help initiate breathing. This is just pushing air into the body Tracheostomy For any pt requiring airway management or mechanical ventilation for a prolonged period of time. Ex. Long term care facilities/nursing homes. There is no set time that someone should have a tracheostomy, etc. but the average time that someone will have one is about 10 days to 2 weeks (they usually get off of the ventilator and get put on this) At this time you want to determine whether the patient should get a tracheostomy of if care should be removed (basically whether they are getting better or if there is no hope) That was the average time, but they can get a tracheostomy on day 2 of being on a ventilator! Types: Single Cannula. Fenestrated. Different valves. Done in operating room. Newer technique where trach can be done @ bedside. Make sure you have an extra trach at the bedside. Obturator (should be taped near pts bed); used in case the trach comes out. If pt pulls it out or coughs it out, stick obturator in hole to keep airway open. Used until new trach can be put back in. When the patient is brain dead (which does NOT mean everyone in a vegetative state) then you can NOT transfer them to a long term care facility (because they are brain dead). This means that the hospital has to deal with them, but they cannot take care of them for very long so you have to pull the plug eventually If you have to wait for the family to cope, if family members still need to come and visit, if organs need to be donated, etc. then they stay on the machine a little longer but eventually you have to withdraw care When this occurs then it is the doctors responsibility to tell the patients family that the patient is gone and that the plug has to be pulled (so the nurse does NOT have to inform the patients about this, but they can help by comforting)
Image of page 4

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

Critical Care NR 340 Exam 1 (5) Ventilator Settings Ventilator settings come from the physician and the respiratory therapist is in charge of the ventilator itself. As a nurse you need to know what the settings are and where the alarm is located. FiO2 (Fraction of inspired oxygen) How much O2 given: 100%, 30%, etc This is how much O2 the machine is giving you Room Air is 21% O2 Tidal Volume (Vt) Amt of air ventilator is giving for every breath. Based on height/weight/lung status Avg: 500 mL. For every breath the ventilator gives to you, you will get 500 mL of air for every breath . Don’t want higher than 600 ml.
Image of page 5
Image of page 6
This is the end of the preview. Sign up to access the rest of the document.
  • Fall '18

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern