Mechanical Ventilation- is the medical term for artificial ventilation where

mechanical means are used to assist or replace spontaneous breathing. It is utilized

in intensive care unit and long-term care settings to assist patients who require
additional respiratory support. Mechanical ventilation may be required for a
variety of reasons: to control the patient’s respirations during surgery or treatment,
to oxygenate the blood when the patient’s ventilatory efforts are inadequate, and to
rest the respiratory muscles, among others.

ASESSMENT

The nurse plays a vital role in assessing the patient’s status and the functioning of
the ventilator.
In assessing the patient, the nurse evaluates the patient’s physiologic status and how
he or she is coping with mechanical ventilation.
Physical assessment includes systematic assessment of all body systems, with an in-
depth focus on the respiratory system.
Respiratory assessment includes vital signs, respiratory rate and pattern, breath
sounds. Increased adventitious breath sounds may indicate a need for suctioning.
The nurse also evaluates the spontaneous ventilatory effort and potential evidence of
hypoxia.
The nurse maintains the patient’s head of the bed so that it is elevated 30° or higher
unless contraindicated to prevent the risk of aspiration and ventilator associated
pneumonia.
The nurse evaluates the settings and functioning of the mechanical ventilator and
verifies endotracheal tube position as applicable.
The nurse will assess the patient’s neurologic status and effectiveness of coping with
the need for assisted ventilation and the changes that accompany and also assess the
patient’s comfort level and ability to communicate as well.
Compromised nutrition has been associated with a poor prognosis, it is important to
assess the patient’s gastrointestinal system and nutritional status.

INDICATIONS
If a patient has evidence of respiratory failure or a compromised airway, endotracheal
intubation and mechanical ventilation are indicated. This clinical evidence may be
corroborated by a continuous decrease in oxygenation (PaO2), an increase in arterial
carbon dioxide levels (PaCO2), and a persistent acidosis (decreased pH); however, if the
patient’s status appears emergent, then waiting for these laboratory results prior to
ensuring these ventilator support measures is imprudent.
Conditions such as thoracic or abdominal surgery, drug overdose, neuromuscular
disorders, inhalation injury, COPD, multiple traumas, shock, multisystem failure, and
coma may lead to respiratory failure and the need for mechanical ventilation.
Indicated with patients with

PAO2- Partial pressure of oxygen mm Hg (millimeters of mercury)

PACO2- Partial pressure of carbon dioxide FEV- Forced expiratory volume.
Nursing actions, nursing care, nursing intervention
Two general nursing interventions that are important in the care of the patient who is
mechanically ventilated are pulmonary auscultation and interpretation of arterial blood
gas measurements. The nurse is often the first to note changes in physical assessment
findings or significant trends in blood gases that signal the development of a serious
problem.

Potential Complications