NR 341 Complex Adult Health Nursing Case study.pdf

8. Mr. R has been on mechanical ventilation for 2 days in the CCU now. He is receiving PPN via an antecubital IV and antibiotics. His vent settings have been weaned according to his ABGs and current vent settings are: SIMV with rate of 10, Peep 5, tidal volume 7mL/kg, FiO2 60%. Since it appears that Mr. R continues to require mechanical ventilation, what is he at high risk for? What interventions will help prevent this? According to his vent settings, what else is he at high risk for? And what interventions will help prevent these risks? He is at risk for skin break down from the tube and infection. Nursing interventions will be performed oral care on the patient and suction the secretions. He is also at risk for tracheal injury according to the vent setting, the nursing interventions will be Keeping the patient calm and comfortable during intubation will help reduce risk of injury. 9. During the initial assessment on Mr. R’s 3rd day of ventilation, the CCU nurse heard breath sounds on the right and diminished breath sounds on left side, with unequal chest rise. She notified the physician and a CXR was ordered to evaluate ETT placement. What do you suspect is happening? What will need to occur to resolve this problem? Will this patient require re-intubation? I suspect the endotracheal tube may have fallen into the right lung therefore not pushing oxygen into the left lungs. The cuff must be deflated so that the endotracheal tube may be retracted enough to allow the ventilator to work with both lungs. The patient will not need to be re-intubated.