Guided Lecture Notes, Chapter 10, Airway Management and Ventilatory Support

Learning Objective 1. Describe nursing care for a patient with an oropharyngeal airway, nasopharyngeal airway, endotracheal tube, or tracheostomy tube.

·  Discuss the uses of artificial airways. (Refer to PowerPoint Slide 2.)

·  Describe the different types of airways and their uses. (Refer to PowerPoint Slide 3 to 12.)

Learning Objective 2 Describe proper suctioning technique and indications for suctioning.

·  Describe indications and techniques for suctioning as listed on the slides. (Refer to PowerPoint Slides 16 and 17.)

Leaning Objective 3. Compare and contrast commonly used ventilator modes.

·  Discuss that the goal of mechanical ventilation is to maintain alveolar ventilation appropriate for the patient’s metabolic needs and to correct hypoxemia and maximize oxygen transport. Desired clinical outcomes of mechanical ventilation may include the following:

·  Reversal of hypoxemia

·  Reversal of acute respiratory acidosis

·  Relief of respiratory distress

·  Prevention or reversal of atelectasis

·  Resting of ventilatory muscles

·  Reduction in systemic oxygen consumption, myocardial oxygen consumption, or both

·  Stabilization of the chest wall

·  Explain that ventilators are classified as either negative-pressure or positive-pressure ventilators.

o  Negative-pressure ventilators encase the patient’s body and exert negative pressure that pulls the thoracic cage outward to initiate inspiration. In the current clinical practice, use of negative-pressure ventilators is limited.

o  Positive-pressure ventilators, which are much more commonly used, deliver air by pumping it into the patient’s lungs. With positive-pressure ventilation, the normal relationship between intrapulmonary pressures during inspiration and expiration is reversed (i.e., pressures during inspiration are positive and pressures during expiration are negative).

·  Discuss ventilator settings and definitions. (Refer to PowerPoint Slides 25 to 27.)

·  Explain the various modes of ventilation. (Refer to PowerPoint Slides 28 to 31.)

Learning Objective 4. Describe nursing care for a patient receiving mechanical ventilation.

·  Describe nursing care of the ventilated patient. Explain the role of respiratory therapy in the care of the patient. (Refer to PowerPoint Slide 32.)

Learning Objective 5. Describe general principles of weaning.

·  Describe tips for successful weaning and methods of weaning. (Refer to PowerPoint Slides 35 and 36.)