Nutrition & GI in Vent Patients
Starting tube feeds within this time frame helps keep the gut active and lowers complications.
What is within 24 hours of mechanical ventilation?
In a nonverbal, intubated patient, these symptoms are a high-yield indicator of discomfort.
What are restlessness and an increased respiratory rate?
Insert this device in an unconscious patient without a gag to keep the tongue from occluding the airway.
What is an oropharyngeal airway (OPA)?
If drainage suddenly stops and dyspnea worsens, this simple systems check comes first.
What is check for kinks/obstruction in the tubing?
Persistent hypoxia of 83% on 4-6 L nasal cannula calls for this device at 10-15L/min.
What is a non-rebreather mask?
When patients are sedated and gastric feeds aren't tolerated or place the patient at risk for aspiration, this approach is preferred.
What is small-bowel (post-pyloric) feeding via tube?
With cognitive impairment or sedation in the ICU, this type of tool should be used to assess pain.
What is a pain scale appropriate to cognitive level (e.g., CPOT/validated tool)?
Use this airway adjunct when support is needed but the gag reflex is present.
What is a nasopharyngeal airway (NPA)?
Vigorous bubbling in the water-seal chamber suggests this problem.
What is an air leak (trace from insertion site to unit)?
This oral care agent plus head-of-bed elevation is central to VAP prevention.
What is chlorhexidine oral care (and HOB ≥30°)?
This team member helps match calories, protein, and route to the patient’s condition.
Who is the dietitian?
Before coaching coughing and deep breathing in a patient with pain, the nurse should do this to improve participation and prevent complications.
What is administer ordered analgesia and allow time for effect?
Before deciding to suction, the nurse should perform this respiratory assessment.
What is auscultate lung sounds/assess for retained secretions?
Criteria suggesting a chest tube can come out: no air leak and this imaging finding.
What is improved/re-expanded lung on chest X-ray?
High FiO₂ and large tidal volumes raise risk for these two lung complications.
What are oxygen toxicity and volutrauma?
These “big dose” feedings are generally avoided in ventilated or ICU patients because they can overwhelm sluggish GI motility.
What are large bolus feedings?
A frustrated vented patient can still express needs using these alternatives (name two).
What are communication boards/writing pads/speaking valves/text-to-speech/lip reading (any two)?
To prevent hypoxemia around suctioning, do this both before and after each pass.
What is hyperoxygenate with 100% oxygen?
First action for a tube that pops out of the pleural space during a turn.
What is have the patient exhale and apply a sterile 3-sided occlusive dressing?
The core physiologic benefit of PEEP that allows lower FiO₂.
What is prevention of alveolar collapse (↑ surface area for gas exchange)?
Early, gentle, continuous enteral feeding + post-pyloric access when needed primarily prevents this GI complication of immobility and sedation.
What is ileus (impaired GI motility)?
When a vented patient becomes agitated with high-pressure alarms, this assessment comes before escalating sedation.
What is a pain assessment (and treat pain first with IV opioids as ordered)?
Each suction pass should be limited to about this duration.
What is 10–15 seconds?
Prolonged ventilation with airway obstruction is a classic indication for this airway surgery, which can also facilitate weaning when done earlier.
What is tracheostomy?
A PEEP of 10 cm H₂O with falling blood pressure signals this hemodynamic consequence.
What is impaired venous return/decreased cardiac output (hypotension)?