Patient-centered Care, Teamwork and Collaboration, Safety
Learning Objectives:
- Discuss the nursing care for a client receiving mechanical ventilation including collaborating with respiratory and physical therapy to meet clients’ needs.
- Discuss the role of the RN in identifying clients who need to be isolation precautions and the specific requirements for the precautions.
- Differentiate between respiratory acidosis and respiratory alkalosis conditions experienced by clients with regard to occurrence, clinical manifestations, diagnostic tests, and medical and nursing management.
Here are some videos to review.
ABGs. I took this class when preparing for the CCRN. This is my favorite way to interpret ABGs. Hope it helps.
Chest tubes. His memory tricks are a bit strange, but it seemed helpful for visual learners.
Respiratory medications:
Pick a respiratory disease and complete:
- Evidence-Based Practice: Students should include ONE current peer-reviewed professional nursing journal article (within 5 years of pub.) and write a short paragraph how the article to supports interventions, teaching, or assessment of the future clients with that respiratory illness.
- Review ventilator association pneumonia (VAP) prevention interventions or VAP bundles, including the early mobility policy.
- What is included?
- When can a client on a ventilator be ambulated? What is the role of physical therapy when ambulating these clients?
- What is the role of respiratory therapist?
- Review isolation/transmission precautions.
- What testing is performed to identify clients with TB and C-diff?
- Which diseases are in which type of precautions and what PPE is required?
- Review and interpret Arterial Blood Gas (ABG)’s. Be prepared to discuss in clinical conference.
- Mr. Frank is a 60 year-old with pneumonia. He is admitted with dyspnea, fever, and chills. His blood gas is below:
pH 7.48
CO2 32
PO2 60
HCO3 21
SaO2 84% on RA What is your interpretation?
What interventions would be appropriate for Mr. Frank?
- Ms. Strauss is a 24 year-old university student. She has a history of ulcerative colitis and is complaining a of a four day history of bloody-watery diarrhea. A blood gas is obtained to assess her acid/base balance:
pH 7.28
CO2 43
pO2 88
HCO3 18
SaO2 96% on RA What is your interpretation?
What interventions would be appropriate for Ms. Strauss?
- Mr. Karl is a 80 year-old nursing home resident admitted with urosepsis. Over the last two hours he has developed shortness of breath and is becoming confused. His ABG shows the following results:
pH 7.02
CO2 32
pO2 77
HCO3 14
SaO2 89% on RA What is your interpretation?
What interventions would be appropriate for Mr. Karl?
- Mrs. Lauder is a thin, 61 year-old patient with a history of COPD. She has an ABG done as part of her routine care in the pulmonary clinic. The results are as follows:
pH 7.37
CO2 50
pO2 74
HCO3 35
SaO2 89% on 2LNC What is your interpretation?
What interventions would be appropriate for Mrs. Lauder?
- Ms. Steele is a 17 year-old with intractable vomiting. She has some electrolyte abnormalities, so a blood gas is obtained to assess her acid/base balance.
pH 7.50
CO2 36
pO2 92
HCO3 27
SaO2 97% on RA What is your interpretation?
What interventions would be appropriate for Ms. Steele?
- Mr. Simmons to Kussmal breathing. He has a history of Type-I diabetes mellitus and is now febrile. His ABG shows:
pH 7.12
CO2 28
pO2 86
HCO3 14
SaO2 93% on RA What is your interpretation?
What interventions would be appropriate for Mr. Simmons?
- Ms. Berth is being mechanically ventilated and a blood gas is obtained to assess her for weaning. The results are as follows:
pH 7.49
CO2 30
pO2 100
HCO3 18
SaO2 98% on 30% FIO2
What is your interpretation? What interventions would be appropriate for Ms. Berth?
