Vents
What does DOPE mnemonic stand for?
Displaced, Obstructed, Pneumothorax, Equipment
Used in conjunction with other modes to maintain pressure at the end of expiration to prevent alveolar collapse.
Positive End-Expiratory Pressure (PEEP)
What should you include in your assessment?
Monitor vital signs, oxygen saturation, and lung sounds frequently.
Site Management: Ensure the occlusive dressing (often Vaseline gauze) is intact and clean; check for subcutaneous emphysema (crepitus) around the site
Water Seal Chamber: Observe for tidaling (rise and fall with breathing). Continuous bubbling indicates an air leak
A blockage in the pulmonary artery, often resulting from a DVT, causing sudden respiratory distress and tachycardia.
Pulmonary embolism
Name becks triad
narrowing pulse pressure, muffled heart sounds, JVD
Secretions, coughing, kinked tube, biting (not enough sedation) will set of ________pressure alarm
High Pressure Alarm
provides two distinct pressures—higher for inhaling, lower for exhaling—offering greater comfort and support for complex sleep apnea, COPD, or high-pressure needs
BiPAP (Bilevel Positive Airway Pressure)
pus accumulated in the pleural space
Empyema
a patient with a pulmonary embolism must also have what diagnostic done?
vascular ultrasound of legs to r/o dvt
What intervention should you prepare for with a pericardial tamponade?
Pericardiocentesis (needle drainage) or surgery (pericardial window). Temporizing measures include IV fluids, oxygen, and medications to raise blood pressure, followed by treating the underlying cause, such as infection or trauma
Low pressure/volume alarm may indicate:
disconnection, leak, or tube extubation
delivers a single, constant pressure to keep airways open, ideal for standard obstructive sleep apnea.
CPAP (Continuous Positive Airway Pressure)
a life-threatening medical emergency characterized by rapid respiratory failure, severe chest pain, and profound hypotension due to air trapping in the chest. Key symptoms include severe dyspnea (shortness of breath), tachycardia (fast heart rate), diminished breath sounds on one side, and jugular vein distension
Tension pneumothorax
right sided heart failure due not due to left sided heart failure
cor pulmonale
What emergency treatment should you prepare for a tension pneumothorax?
Tension pneumothorax is a life-threatening medical emergency requiring immediate decompression to release trapped air, usually via needle decompression (14-16 gauge needle) in the 2nd-3rd intercostal space (midclavicular) or 4th-5th (anterior axillary). This is immediately followed by definitive treatment with a chest tube (tube thoracostomy) to drain air and re-expand the lung
Name a complication of intubation
Monitor for infection, pneumothorax, and stress ulcers
A hybrid mode where the ventilator delivers a minimum rate, but allows the patient to trigger additional breaths, which are delivered at the set
Assist/Control (A/C):
What should you do if a chest tube becomes dislodged?
If the tube falls out, cover the site immediately with an occlusive dressing (e.g., Vaseline gauze) secured on three sides and notify the provider
A life-threatening, non-cardiogenic pulmonary edema triggered by sepsis, trauma, or pneumonia. It causes severe, progressive hypoxemia despite supplemental oxygen.
Acute Respiratory Distress Syndrome (ARDS)
5 P's of ARDS Therapy: Perfusion (hemodynamic support), Positioning (prone positioning), Protective Lung Ventilation (low tidal volumes), Protocol Weaning, and Preventing Complications.
What are the nursing priorities in caring for a patient with flail chest?
Management includes oxygenation, adequate analgesia, and ventilatory support, with surgical fixation considered in selected patients to reduce morbidity. Lay them on their injured side (unconscious) or sit up and lean towards injured side
Name essential nursing care for the intubated patient
Airway Patency: Verify ET tube marking at lips/teeth (usually 21-23 cm) and secure it.
Assessments: Check vital signs, breath sounds, SpO2, and ABGs frequently.
Oral Care: Perform frequent oral care to prevent Ventilator-Associated Pneumonia (VAP).
HOB greater than 30-45 degrees
Safety: Always have a manual resuscitation (Ambu) bag at the bedside (obturator for trach)
Provides a minimum number of mandatory breaths but allows the patient to breathe spontaneously between them. Often used for weaning.
Synchronized Intermittent Mandatory Ventilation (SIMV)
What should you report to the provider?
Sudden, excessive, or bright red drainage (> 100 mL/hr) or sudden stop in drainage
Sudden increase in chest pain, dyspnea, or oxygen saturation drop.
New or worsening crepitus (subcutaneous emphysema).
Persistent bubbling in the water seal chamber (indicates a new or worsening air leak).
a clinical protocol where continuous sedatives are paused daily in mechanically ventilated ICU patients to allow them to wake up, assess neurological status, and determine if they are ready to be removed from the ventilator
sedation vacation
Treatment for a sucking chest wound (like a gun shot)
applying an airtight occlusive dressing, such as a chest seal, plastic wrap, or foil, taped on three sides to create a one-way valve.