Respiratory Nursing Diagnoses & Interventions – Flashcards

Oxygenate/Ventilate 1. Mechanical ventilation - std tx with ARDS patients 2. Lowest FiO2 to maintain PaO2 > 60 mmHg - anything more than 50 for 24 hrs --> oxygen toxicity 3. TV < 10 mL/kg (~6 mL/kg) - N+ 4-6 mL PEEP - recruits albeoli & prevents further atelectasis; increases functional residual capacity to allow for continuous gas exchange (complications - pneumothorax, decreased venous return)

Suction PRN using proper technique No matter how much you suction this patient, you can't get it all out. Standard is based on patient assessment - PRN. Don't suction too often otherwise you may suction out too much oxygen.

Sedatives - Versed (most comfortable) Analgesics - Morphine Sulfate (MSO4) - peripheral vasodilator - good for HF/edema patients - can cause hallucinations and vomiting Paralytics - Norcuran/Pavulon (may increase pulse and BP, may cause RESPIRATORY DEPRESSION) Always sedate before paralyzing!

Bedrest Frequent position changes - back to side repositioning can desat a patient Prone position - improves oxygenation; adverse effects - decrease SpO2, facial edema, extubation, delay in CPR, peripheral nerve damage, skin breakdown (used as last resort)

Calorie requirement 1.5 - 2 X normal - due to severe stress state which increases metabolic state Enteral nutrition - aspiration precautions (HOB 30 - 45 degrees; residual volumes q 4-6 hours)

Warm nurturing environment Need to feel safe and cared for Explain procedures, equipment, changes in condition, plan of care & outcomes Communication with intubated patients Frequent family visits when possible Personal items in room